Euthanasia and physician-assisted suicide (PAS) by request and/or based on an advance directive are legal in The Netherlands under strict conditions, thus providing options for patients with Huntington's disease (HD) and other neurodegenerative diseases to stay in control and choose their end of life. HD is an inherited progressive disease characterised by chorea and hypokinesia, psychiatric symptoms and dementia. From a qualitative study based on interviews with 15 physicians experienced in treating HD, several ethical issues emerged. Consideration of these aspects (...) leads to a discussion about the professional role of a physician in relation to the personal autonomy of a patient. Such a discussion can raise awareness that talking about end-of-life wishes with an HD patient is part of the legal, professional and moral responsibility of the physician, and that a letter of intent on behalf of the physician can improve active participation in the process. Discussion of these issues can help to advance the debate on euthanasia and PAS in HD and other neurodegenerative diseases. (shrink)

The book explores the origin story of the Open Government Partnership and place the open government reform movement in the context of the long history of public sector reform.

The standard medical case report often reduces patients and caregivers to complexes of medical facts and clinical decisions. Restructuring the genre itself to acknowledge the human dimensions of both patients and physicians allows questions of human values to regain their stature as integral components of the discourse.

This article discusses the nature of euthanasia, and the way in which redevelopment of the concept of euthanasia in some influential recent philosophical writing has led to morally less discriminating killing/letting die/not saving being misdescribed as euthanasia. Peter Singer's defence of non-voluntary ‘euthanasia’of defective infants in his influential book Practical Ethics is critically evaluated. We argue that Singer's pseudo-euthanasia arguments in Practical Ethics are unsatisfactory as approaches to determining the legitimacy of killing, and that these arguments present a total utilitarian (...) improvement policy—not a case for non-voluntary euthanasia. (shrink)

The medical record, as a managerial, historic, and legal document, serves many purposes. Although its form may be well established and many of the cases documented in it routine in medical experience, what is written in the medical record nevertheless records decisions and actions of individuals. Viewed as an interpretive text, it can itself become the object of interpretation. This essay applies literary theory and methodology to the structure, content, and writing style(s) of an actual medical record for the purpose (...) of exploring the relationship between the forms and language of medical discourse and the daily decisions surrounding medical treatment. The medical record is shown to document not only the absence of a consistent treatment plan for the patient studied but also a breakdown in communication between different health professionals caring for that patient. The paper raises questions about the kind of education being given to house staff in this instance. The essay concludes with a consideration of how such situations might be more generally avoided. (shrink)

The objective of this study is to evaluate if use of a patient decision aid, when choosing between a repeat cesarean or a trial of labor after a cesarean, reduces medical liability exposure. The authors conclude that use of a PDA conferred liability protection when potential jurors were presented with a hypothetical malpractice claim against an obstetrician following a TOLAC.

Although certain aspects of C.S. Lewis's work have been studied in great detail, others have been comparatively neglected. This collection of essays looks at Lewis's life and work, and those of his friends and associates, from many different angles, but all connected through a common theme of identity. Questions of identity are essential to the understanding of any writer. The ways authors perceive themselves and who they are, the communities they belong to by birth or choice, inevitably influence their work. (...) The way they present other people, real or fictional, are also rooted in their own conception of identity. In this volume, scholars from several countries examine gender and family roles; national, regional, racial and professional identities; membership of a particular church; ideological attachments and personal descriptions, either with regard to Lewis and those who knew him and influenced him, or in a study of their writings. Authors studied here include J.R.R. Tolkien, Dorothy L. Sayers, Charles Williams, George MacDonald and T.S. Eliot. (shrink)

ABSTRACTThe recognition of emotional facial expressions is often subject to contextual influence, particularly when the face and the context convey similar emotions. We investigated whether spontaneous, incidental affective theory of mind inferences made while reading vignettes describing social situations would produce context effects on the identification of same-valenced emotions as well as differently-valenced emotions conveyed by subsequently presented faces. Crucially, we found an effect of context on reaction times in both experiments while, in line with previous work, we found evidence (...) for a context effect on accuracy only in Experiment 1. This demonstrates that affective theory of mind inferences made at the pragmatic level of a text can automatically, contextually influence the perceptual processing of emotional facial expressions in a separate task even when those emotions are of a distinctive valence. Thus, our novel findings suggest that language acts as a contex... (shrink)

As sharing and secondary research use of biospecimens increases, IRBs and researchers face the challenge of protecting and respecting donors without comprehensive regulations addressing the human subject protection issues posed by biobanking. Variation in IRB biobanking policies about these issues has not been well documented.

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 27.2 (2003) 363-381 [Access article in PDF] Imre Lakatos and Literary Tradition Suzanne Black ALTHOUGH THE CANON DEBATES have largely subsided, the categories of tradition and canon remain problematic and unhelpfully contentious. Some authors view tradition as weighty and oppressive, while cultural studies scholars criticize the concept itself as elitist and exclusionary. Yet literature, like other creative pursuits, cannot avoid its past; nor should it (...) seek to do so. Progressive ideas have a history and a logical development; to argue otherwise leaves them vulnerable to accusations of faddish trendiness. Artists learn from the work of other artists, and critics rely on older examples to describe and understand what they study. Thus activist critics, writers, and moderate scholars all need some way to react to and to conceive of literary history.E. Dean Kolbas has argued that shared assumptions such as a preoccupation with educational institutions limit the arguments of conservative humanists and canon openers alike. 1 If the perspective of literary critics is indeed narrow, they may benefit from broader and more interdisciplinary studies of tradition. For example, historicist philosophy of science devoted considerable energy to understanding how major accomplishments influence the work of scientists. This scholarship offers several complex accounts of the ways science is shaped by its past, and so can offer literary critics another, more structured, more rational, and even more flexible, view of tradition. In addition, some of its preoccupations, like the emergence of consensus or criteria for the selection of representative examples, are relevant to the canon debates. Finally, because writers and scientists understand the past differently and because their ideas develop in distinct social contexts, literary theory and philosophy of science have potentially complementary strengths and weaknesses. [End Page 363]In this article I first summarize Imre Lakatos's conception of the research program and explain some of its potential benefits for an understanding of literary tradition. Then, to show that the concept of a "literary research program" makes sense, I use the category to examine the ideas of Ricardo Reis, a neo-classical persona created by the Portuguese modernist Fernando Pessoa. Finally, I turn to a discussion of W. H. Auden's "Letter to Lord Byron" to identify some difficulties in applying Lakatos's model to literature. To view Auden as working within a Byronic program directs attention to his interpretation of the older poet, but the poem's formal innovation and its irony suggest some important differences between artistic and scientific approaches to the past, as well as some limitations of Lakatos's analytical framework.During the 1960s and 1970s, partly in response to Thomas Kuhn, but also in reaction against other approaches to their field, several important philosophers of science sought to incorporate the history of science into their work. David J. Hess terms this tendency a historicist "period and style" 2 within philosophy of science. As the Hungarian philosopher Imre Lakatos (echoing Kant) contended, "Philosophy of science without history of science is empty; history of science without philosophy of science is blind." 3 Generalizing about how scientists think (or ought to think) while still bearing in mind actual science led some philosophers of science to devise subtle and provocative ways of viewing the past. Kuhn's notion of paradigms as "models from which spring particular coherent traditions of scientific research" 4 is the best known and influenced Stanley Fish and Frank Kermode. Generally, however, literary critics are unaware of philosophers' responses to Kuhn and of their attempts to refine his category of paradigm. Larry Laudan, for example, sought to delineate the role of "research traditions" in the natural sciences. As his terminology suggests, these formulations overlap to some extent with literary understandings of past practice.But how much overlap is there, and is it significant? While Kuhn and Laudan both mention the arts, they disagree about the relevance of their work to the humanities. In 1969, noting that "topics" such as "competing schools," "changing standards of value" and "altered modes of perception" "have long been basic for the art historian," Kuhn argued that The Structure of Scientific Revolutions "makes them central to... (shrink)

New agrifood technologies are often difficult to grasp for the public, which may lead to resistance or even rejection. Insight into which technology features determine public acceptability of the technology could offer guidelines for responsible technology development. This paper systematically assesses the relative importance of specific technology features for consumer response in the agrifood domain in two consecutive studies. Prominent technology features were selected from expert judgment and literature. The effects of these features on consumer evaluation were tested in a (...) consumer study. Fictitious technologies were used to avoid any uncontrollable contextual influences that existing new technologies may evoke. Results show that technologies that were seen as more natural and newer were perceived less risky, more beneficial, and were evaluated more positively. Technologies applied to food were judged to be more beneficial, but also more risky than those applied to non-food. Technologies used in the production process were perceived to be less risky and evaluated more positively than those used in the product. Technologies owned by the market leader were perceived to be more beneficial, and evaluated more positively than those that were freely available. In a next study, effects of the technology features on consumer response were tested for existing new agrifood technologies. This study replicated the results for perceived naturalness, perceived newness, and place in the production process where the technology is applied. However, in contrast to the first study, we did not find an effect of application area and technology ownership. (shrink)

Institutional review boards are almost universally considered to be overworked and understaffed. They also require substantial commitments of time and resources from their members. Although some surveys report average IRB memberships of 15 people or more, federal regulations require only five. We present data on IRB meetings at eight of the top 25 academic medical centers in the United States funded by the National Institutes of Health. These data indicate substantial contributions from primary reviewers and chairs during protocol discussions but (...) little from other members, which implies that it may be possible for smaller IRBs to accomplish the same tasks with no reduction in the quality of review. (shrink)

Peut-on s'entendre en matière d'esthétique? Y a-t-il une objectivité possible des jugements dans ce domaine marginal de la philosophie? La question du sens commun dans la Critique de la faculté de juger, semble, aux dires de certains, mener directement à cette problématique contemporaine. Nous ne reprendrons pas ici les multiples articles et ouvrages sur le sensus communis parus dans la dernière décennie à la suite de l'impact conceptuel du thème de la rationalité communicationnelle. Notre intention est plutôt, au-delà de la (...) “dérive” du célèbre paragraphe 40 vers une idée plus actuelle de “consensus”, de repérer les tensions entre le versant transcendantal et le versant empirique du sens commun qui surgissent significativement à l'occasion de cette dérive. Avant d'aborder le sens esthétique défini dans la troisième Critique et de le confronter aux interprétations qui nous semblent plus déterminantes comme celles de L. Ferry de J.-F. Lyotard ou de J. Habermas nous voudrions d'abord examiner l'usage général de cette notion dans l'histoire de la philosophie précritique pour vérifier ensuite la spécificitÉ qu'elle acquiert chez Kant. (shrink)

Research has shown that it requires less time to process information that is part of an objective causal relation describing states of affairs in the world (She was out of breath because she was running), than information that is part of a subjective relation (She must have been in a hurry because she was running) expressing a claim or conclusion and a supporting argument. Representing subjectivity seems to require extra cognitive operations. In Mental Spaces Theory (MST; Fauconnier, Gilles. 1994. Mental (...) spaces: Aspects of meaning construction in natural language. Cambridge: MIT Press) the difference between these two relation types can be described in terms of an extra mental space in the discourse representation of subjective relations: representing the Subject of Consciousness (SoC). In processing terms, this might imply that the processing difference is not present if this SoC has already been established in the discourse. We tested this prediction in two eye tracking experiments. The results of Experiment 1 showed that signaling the subjectivity of the relation by introducing a subject of consciousness beforehand did not diminish the processing asymmetry compared to a neutral context. However, the relative complexity of subjective relations was diminished in the context of Free Indirect Speech (No! He was absolutely sure. There was no doubt about it. She was running so she was in hurry; Experiment 2). In terms of MST and the representation of subjectivity in general, this implies that not only creating a representation of a thinking subject, but also assigning a claim to this thinking subject requires extra processing effort. (shrink)

F. J. W. Schelling a la réputation d'être l'idéaliste qui a le plus assigné de limites à l'idéalisme allemand. La «dernière philosophie» de Schelling, dont il est en grande partie question ici, contournerait l'interdit que Kant avait jeté sur l'intuition intellectuelle, d'une manière différente de ce qu'il est convenu d'appeler sa «première philosophie». Schelling poursuivrait un projet que Walter Schulz qualifie d'«achèvement de l'idéalisme allemand». Mais en quoi consiste cet achèvement? Si le programme ultime de ce philosophe conduit à de (...) tels confins, selon l'auteure M.-C. Challiol-Gillet, c'est dû à la reconnaissance de la structure extatique à la fois de la conscience humaine et de l'être divin. Les transformations philosophiques constantes chez Schelling n'excluraient pas une «profonde cohérence» qui a trait à l'«exigence d'un commencement scientifique de la philosophie positive». Aborder la philosophie de la dernière période, c'est admettre, en outre, l'existence de deux visages dans le projet philosophique schellingien, le négatif et le positif. L'ouvrage a pour tâche propre de les rendre observables, non seulement à partir des Leçons de Munich qui les avaient thématisés, mais depuis les premiers écrits où surgit la philosophie de l'identité. Si la philosophie «négative» est traditionnellement associée à cette dernière, on constate qu'elle a trait à ce qu'il reste de métaphysique classique dans la pensée de Schelling, tandis que la philosophie «positive» touche l'extériorisation de la raison, le passage à la considération de l'existence. Entre Munich et Berlin, endroits où le philosophe a enseigné durant la troisième période de son œuvre, l'«exigence positive» est établie comme celle d'un absolu qui se verse dans la différence, qui se met à «exister», qui se «potentialise», pour ainsi dire. S'agit-il d'une rupture entre le négatif et le positif? La raison qui s'«extasie» est davantage une première critique radicale du visage philosophique précédent. (shrink)

The least infringement principle has been widely endorsed by public health scholars. According to this principle, public health policies may infringe upon “general moral considerations” in order to achieve a public health goal, but if two policies provide the same public health benefit, then policymakers should choose the one that infringes least upon “general moral considerations.” General moral considerations can encompass a wide variety of goals, including fair distribution of burdens and benefits, protection of privacy and confidentiality, and respect for (...) autonomy.In this article, we argue that the Center for Disease Control and Prevention's 2006 HIV screening recommendations may violate the least infringement principle. This is a concern because, although not legally binding, the Recommendations appear to have already influenced state laws and will likely continue to do so as legislative proposals continue to be passed. At a minimum, therefore, the Recommendations have important implications for HIV screening within the United States. (shrink)

When experiencing personal distress, people usually expect their romantic partner to be supportive. However, when put in a situation to provide support, people may at times be struggling with issues of their own. This interdependent nature of dyadic coping interactions as well as potential spillover effects is mirrored in the state-of-the-art research method to behaviorally assess couple’s dyadic coping processes. This paradigm typically includes two videotaped 8-min dyadic coping conversations in which partners swap roles as sharer and support provider. Little (...) is known about how such dyadic coping interactions may feed back into one another, impacting the motivation and ability to be a responsive support provider. In three behavioral studies, we examined how sharers’ experiences may spill over to affect their own support provision in a subsequent dyadic coping interaction. We hypothesized that the extent to which sharers perceive their partner as responsive to their self-disclosure increases the quality of their own subsequent support provision, whereas sharers’ lingering negative affect reduces the quality of their own subsequent support provision. In line with our first hypothesis, perceived partner responsiveness predicted the provision of higher-quality support, though primarily as perceived by the partner. Sharers who perceived their partner to have been more responsive were somewhat more likely to subsequently engage in positive dyadic coping and were rated as more responsive by their partners. Negative dyadic coping behavior was unaffected. Evidence for our second hypothesis was mixed. While lingering negative affect did not affect positive dyadic coping behavior or perceived support, it did increase the chances of negative dyadic coping behavior. However, given the very low occurrences of negative affect and negative dyadic coping, these findings should be interpreted with caution. Taken together, these findings suggest that support interactions may feed back into one another, highlighting the complex and interdependent nature of dyadic coping. The strongest and most consistent findings concerned the spillover effect of perceived partner responsiveness on subsequent perceived support quality, speaking to the key role of believing that one’s partner is responsive to one’s needs in promoting healthy relationship functioning. (shrink)

Children who experience well-being are engaging more confidently and positively with their caregiver and peers, which helps them to profit more from available learning opportunities and support current and later life outcomes. The goodness-of-fit theory suggests that children’s well-being might be a result of the interplay between their temperament and the environment. However, there is a lack of studies that examined the association between children’s temperament and well-being in early childhood education and care, and whether this association is affected by (...) ECEC process quality. Using a multilevel random coefficient approach, this study examines the association between toddlers’ temperament and well-being in Norwegian ECEC and investigates whether process quality moderates this association. Results reveal an association between temperament and well-being. Staff-child conflict moderates the association between shyness and well-being, and between activity and well-being. Moreover, high emotional behavioral support moderates the association between activity and well-being. Extra attention should be paid by the staff to these children’s needs. (shrink)

Critically significant parental effects in behavioral genetics may be partly understood as a consequence of maternal brain structure and function of caregiving systems recently studied in humans as well as rodents. Key parental brain areas regulate emotions, motivation/reward, and decision making, as well as more complex social-cognitive circuits. Additional key environmental factors must include socioeconomic status and paternal brain physiology. These have implications for developmental and evolutionary biology as well as public policy.

Jean-Paul Grandjean – devenu de Fouchy en 1743, lorsqu’il est nommé secrétaire perpétuel de l’Académie des sciences – s’est formé à l’astronomie auprès de J.-N. Delisle, avant le départ de ce dernier pour la Russie. Fouchy installe bientôt chez lui un observatoire qu’il équipe d’instruments du constructeur Claude Langlois, et où il mène différentes observations. Le domaine d’intérêt principal de Fouchy concerne les «machines»; il s’agit entre autres d’appareils venant équiper les quarts-de-cercle pour en faciliter l’emploi. Comme secrétaire perpétuel, il (...) demeure en fonction jusqu’en 1776 et, à ce titre, il prononce de nombreux éloges dont une dizaine sont relatifs à des astronomes. (shrink)

Les efforts pour déterminer par des voies non kantiennes les frontières de la raison dépendent de perspectives ouvertes par les idéalistes postkantiens, comme le soutient Rolf-Peter Horstmann, dans un ouvrage d'abord publié en 1991 chez l'éditeur Anton Hain. L'avant-propos présente d'intéressantes idées sur l'«utilité pratique» de l'histoire de la philosophie et sur la question métaphilosophique de la différence entre la matière des problèmes et la manière de les poser. Une nouvelle théorie philosophique pourrait élucider d'anciens problèmes sans en réviser les (...) présupposés, ou reprendre carrément les fondements des tentatives antérieures. Des structures de rationalité auraient une genèse, culmineraient à un moment donné, puis deviendraient désuètes. Rendre justice à la signification et à la dynamique de l'idéalisme allemand exige de comprendre son évolution comme un processus visant l'établissement de normes de rationalité différentes de celles de la tradition des Temps modernes. L'ouvrage analyse ainsi les motifs d'une formulation nouvelle des fondements de ce «courant» de pensée. (shrink)

O’Meara’s translation and commentary of Ennead 19 (Sur les Vertus) is a short and elegant book: the style is sparse, the meaning limpid, and the thesis skilfully developed. The translation meticulously follows the movement of Plotinus’ argumentation. Ample cross references are made to other tractates, and helpful mentions abound of secondary literature in languages other than French. The historical sections are short: Middle Platonist antecedents of Plotinus’ theory of virtue are occasionally...

Despite the burgeoning literature on professionalism in other health professions, psychology lags behind in the level of attention given to this core competency. In this article, we review definitions from other health professions and how they address professionalism. Next, we review how this competency evolved within health service psychology (HSP), and we propose a definition. We offer an approach for assessing professionalism within HSP. Consideration is given to strategies and methods for providing effective education and training in this multifaceted competency. (...) Finally, recommendations are made for creating a culture of professionalism within HSP and honoring psychology’s social contract with multiple publics. (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.