Surveys carried out among palliative care physicians have shown that most participants do not support euthanasia and assisted suicide. Belgium, however, is one of the few countries in the world in which voluntary euthanasia is allowed by law. The potential influence of this legal dimension thus warranted a study of the attitudes of Belgian palliative care physicians toward euthanasia and assisted suicide. To this end, an anonymous self-administered questionnaire in Dutch was sent to all physicians working in Flemish palliative care. (...) 99 physicians responded .A majority of the physicians who responded are of the opinion that voluntary euthanasia can be ethically justified . Most physicians believe, nonetheless, that non-voluntary euthanasia is always unethical . More than three quarters of the respondents favour the inclusion of a ‘palliative filter’ in the law on euthanasia. Using a traditional cluster algorithm, the following three clusters were obtained: staunch advocates of euthanasia , opponents of euthanasia , and an intermediate group . There were no significant differences between the clusters on the level of gender, age, and years of experience in palliative care. A statistically significant association exists, however, between the euthanasia clusters and the religious or ideological clusters we had obtained in an earlier study. Church attending respondents are least likely to be staunch advocates of euthanasia. The majority of the physicians favour legalisation on assisted suicide. There is no significant association between the euthanasia clusters and attitudes toward assisted suicide.We conclude that although most Flemish palliative care physicians agree that there may be circumstances in which a euthanasia request is justified, they also strongly believe in the effects of good palliative care and want the ‘palliative filter’ to be included in the law on euthanasia. Religion and worldview are an important factor determining attitudes towards euthanasia. (shrink)

Palliative sedation is an option of last resort to control refractory suffering. In order to better understand palliative-care nurses’ attitudes to palliative sedation, an anonymous questionnaire was sent to all nurses (589) employed in palliative care in Flanders (Belgium). In all, 70.5% of the nurses (n = 415) responded. A large majority did not agree that euthanasia is preferable to palliative sedation, were against non-voluntary euthanasia in the case of a deeply and continuously sedated patient and considered it generally better (...) not to administer artificial floods or fluids to such a patient. Two clusters were found: 58.5% belonged to the cluster of advocates of deep and continuous sedation and 41.5% belonged to the cluster of nurses restricting the application of deep and continuous sedation. These differences notwithstanding, overall the attitudes of the nurses are in accordance with the practice and policy of palliative sedation in Flemish palliative-care units. (shrink)

The article puts into question the idea that the nucleus of religion - the God-talk - is peaceful , whereas all aggression should be located on the side of humankind, through differentiating a conceptual model of relating war to the concept of God in the Jewish-Christian tradition. He urges a more complex model of connecting God to issues of war and peace.

Life-science phenomena are often explained by specifying the mechanisms that bring them about. The new mechanistic philosophers have done much to substantiate this claim and to provide us with a better understanding of what mechanisms are and how they explain. Although there is disagreement among current mechanists on various issues, they share a common core position and a seeming commitment to some form of scientific realism. But is such a commitment necessary? Is it the best way to go about mechanistic (...) explanation? In this article, we propose an alternative antirealist account that also fits explanatory practice in the life sciences. We pay special attention to mechanistic models, i.e. scientific models that involve a mechanism, and to the role of coherence considerations in building such models. To illustrate our points, we consider the mechanism for the action potential. 1 Introduction2 Some Core Features of Mechanistic Explanation3 Scientific Realism and Mechanistic Explanation4 Antirealist Mechanistic Explanation: The Case of the Action Potential5 Some Outstanding Issues for the Antirealist Mechanist6 Two Problems for the Realist Mechanist7 Conclusions. (shrink)

Background Clients are invited to play a role in decisions about their care. Collaborative deliberation comprises constructive engagement, recognition of alternative actions, comparative learning, construction and elicitation of preferences and preference integration. Collaborative deliberation between clients and professionals is a process that requires an interest in each other, sharing of views on alternatives and preferences and integrating into decisions. The aim is to gain insight into collaborative deliberation in consultations and the clients’ perception of arranging long-term care. Design A descriptive (...) qualitative study to explore collaborative deliberation in consultations between clients and professionals. Six organisations providing long-term care were included. Data collection of nine clients involved observations of consultation with field notes and audio-records, interviews with clients and professionals shortly and 3–6 months after the consultation and questionnaires to collect background information. The data were analysed by deductive content analysis. Findings Constructive engagement was visible in all consultations. Clients and professionals showed respect, empathy and curiosity towards each other. In most consultations, two or more alternative actions are recognised and discussed. Comparative learning appears to be two sided, the client and the professional learn from each other's knowledge and experiences. Construction and elicitation of preference, and preference integration, seems to be present, but difficult to recognise in all consultations. Discussion/conclusion Although all propositions could be identified, there seems room for improvement in preference elicitation and integration of these preferences in the discussions on courses of action. Assistance seems needed with preference elicitation, both for the clients and for the professional. (shrink)

Involving patients in decisions on primary prevention can be questioned from an ethical perspective, due to a tension between health promotion activities and patient autonomy. A nurse-led intervention for prevention of cardiovascular diseases, including counselling (risk communication, and elements of shared decision-making and motivational interviewing) and supportive tools such as a decision aid, was implemented in primary care. The aim of this study was to evaluate the nurse-led intervention from an ethical perspective by exploring in detail the experiences of patients (...) with the intervention, and their views on the role of both the nurse and patient. The study had a qualitative design. 18 patients who had received the intervention participated. Data were gathered by in-depth interviews. The interviews were analysed using directed content analysis. The findings revealed that patients perceived the consultations not as an infringement on their autonomy, but as supportive to risk reduction efforts they tried but found hard to realise. They specifically emphasised the role of the nurse, and appreciated the nurse's realistic advice, encouragement, and help in understanding. Patients' views on and experiences with risk management are in line with notions of relational autonomy, caring cooperation and communicative action found in the literature. We conclude that patients define the relationship with the nurse as shared work in the process of developing a healthier lifestyle. (shrink)

‘Waar blijven de intellectuelen?’ vroeg Balkenende in het najaar van 2006 . Waar blijven die maatschappelijke wetenschappers die eens in de zoveel jaar met een nieuw boek komen dat Nederland een Spiegel voorhoudt en aan het Denken zet? Een doorwrocht wetenschappelijk, maar toch uitstekend leesbaar boek dat de opiniepagina's wekenlang beheerst en ons zelfbegrip voor altijd verandert. Waar blijven de nieuwe Bram de Swaan, Trudy Dehue, Cees Schuyt, Hans Achterhuis, Christien Brinkgreve, Anton Zijderveld of Lolle Nauta? Wie gaat ons waarschuwen (...) voor de gevaren van utopieën of protoprofessionalisering of ons aansporen tot kleine deugden ? (shrink)

Meta-arguments are arguments about one or more arguments, or argumentation in general. They contrast to ground-level arguments, which are about natural phenomena, historical events, human actions, abstract entities, etc. Although meta-arguments are common in all areas of human cognitive practice, and although implicit studies of them are found in many works, and although a few explicit scholarly contributions exist, meta-argumentation has never been examined explicitly, directly, and systematically in book-length treatment. This lacuna is especially unfortunate because such treatment can offer (...) not only an understanding of a special class of arguments, but also a promising way of doing logic and argumentation theory. This is the first book that attempts a systematic treatment of meta-arguments, providing both an illustration of the meta-argumentational approach to logical theory, and an analysis of an especially rich collection of meta-arguments. First, it elaborates an empirical methodology derived partly from a critical appreciation of Stephen Toulmin's applied-logic approach, and partly from a novel application of the author's historical-textual approach. Then it examines theoretical meta-arguments, by such scholars as Tony Blair, Robert Fogelin, Alvin Goldman, Trudy Govier, David Hitchcock, Ralph Johnson, Henry Johnstone, Erik Krabbe, Frans van Eemeren, Carl Wellman, and John Woods, on such topics as defining argument, methods of criticism, deep disagreements, and conductive or pro-and-con arguments. Thirdly, it studies famous meta-arguments by such classics as John Stuart Mill, David Hume, and Galileo Galilei, on such topics as freedom of discussion, women's liberation, the existence of God and intelligent design, and the motion of the earth. (shrink)

We are pleased to publish this WSIA edition of Trudy’s Govier’s seminal volume, Problems in Argument Analysis and Evaluation. Originally published in 1987 by Foris Publications, this was a pioneering work that played a major role in establishing argumentation theory as a discipline. Today, it is as relevant to the field as when it first appeared, with discussions of questions and issues that remain central to the study of argument. It has defined the main approaches to many of those issues (...) and guided the ways in which we might respond to them. From this foundation, it sets the stage for further investigations and emerging research. This is a second edition of the book that is corrected and updated by the author, with new prefaces to each chapter. (shrink)

Forgiveness and Revenge is a powerful exploration of our attitudes to serious wrongdoings and a careful examination of the values that underlie our thinking about revenge and forgiveness. From adulterous spouses to terrorist factions, we are surrounded by wrongdoing, yet we rarely agree which response is appropriate. The problem of how to respond realistically and sensitively to the wrongs of the past remains a perplexing one. Trudy Govier clarifies our thinking on this subject by examining the moral and practical impact (...) of revenge and forgiveness, both personal and political. Forgiveness and Revenge offers much-needed clarity and reason where emotions often prevail. It is essential reading for anyone interested in the ethics of attitudes to wrongdoing. (shrink)

Dantis, Trudy As a 'definite community of Christian faithful', every parish is called to embody the presence of the church in the wider community. It does this by being a place of living communion and participation that is wholly mission-oriented, an environment conducive to hearing God's word and growing in the Christian life, and one that is engaged in dialogue, proclamation, outreach, worship and celebration. In doing so, a parish becomes 'salt' and 'light' for the community it is located in. (...) Parish vitality can therefore be likened to the 'saltiness' or 'luminosity' of a parish community. It is imperative for every parish community to grow in health and strength if it is to be an effective source of evangelisation and an authentic witness of the Gospel. As Wittberg notes, 'To the extent that their communal "salt" loses its flavor, parishes - are worse than irrelevant, because they no longer image God'. (shrink)

Self-trust is a necessary condition of personal autonomy and self-respect. Self-trust involves a positive sense of the motivations and competence of the trusted person; a willingness to depend on him or her; and an acceptance of vulnerability. It does not preclude trust in others. A person may be rightly said to have too much self-trust; however core self-trust is essential for functioning as an autonomous human being.

We explore the relationship between argument and narrative with reference to parables. Parables are typically thought to convey a message. In examining a parable, we can ask what that message is, whether the story told provides reasons for the message, and whether those reasons are good reasons. In exploring these questions, we employ as an inves-tigative technique the strategy of reconstructing parables as argu-ments. We then proceed to con-sider the cogency of those argu-ments. One can offer arguments through narratives and, (...) in particu-lar, through parables, but that do-ing so likely brings more risks than benefits, from an epistemic point of view. (shrink)

The book also comes with an exhaustive array of study aids that enable the reader to monitor and enhance the learning process.

In this paper we engage in a conversation speaking from three different perspectives and discuss the ways literature and our personal life experiences can inform policy and practice in relation to the concepts of well-being, education, and culture. We gathered around a metaphorical kitchen table, bringing to it our life experiences, as well as the literature that informed our individual research programs (positive psychology, Indigenous world view, and narrative inquiry) and we began to unpack the questions: “What role does culture (...) play in understanding and educating for well-being and why should an education system be concerned about it?”. (shrink)

In this paper I explore Ralph Johnson's proposal that in addition to premises and conclusion every argument should have a dialectical tier in which the arguer addresses objections to the argument, and considers alternative positions. After exploring several reasons for thinking that Johnson's proposal is a good one, I then raise a number of objections against it and move ahead to respond to those objections, which I do by distinguishing making out a case for a conclusion from offering an argument (...) for it, and distinguishing supplementary arguments from one's main argument. I contend that it is not realistic to see arguers as having an obligation to respond to all objections and to address all alternative positions; we must somehow discriminate those which need and merit a reply from those which do not. (shrink)

An aim of all of the management of healthcare systems is the smooth provision of services. A great deal of effort is put into ensuring processes will obtain this ideal – the well‐run system. The central argument in this paper is that these processes result in a system that perpetrates violence and coercion on its clients and workers. This violence is structural and personalizing in its effects. Moreover, time and effort is taken away from the actual work of the system (...) for its management. Under such managerialist control, the idea of chaos and the need to ensure order are used to fuel an apparatus that takes the focus from other aspects of the system such as the power relations that keep the system as it is. In such an ordering, the clinical audit is promoted as a method to ensure order by keeping ahead of, or removing the potential for chaos. In using Žižek's ideas about violence it is possible to identify how efforts and attempts to correct the system are doomed to fail just as they hide how nurses' enrolment in the service of the system leads to alienation and subjectification. A central aim of this paper is to rethink how power and implicit violence are practised in such processes. To overcome the inherent violence of the audit culture, this paper suggests an interruption of audit cultures with a promotion of more radical positions for nursing practice and clinically based research. The hope is to recalculate and interrupt how nurses are to operate in the management structures that organize healthcare. (shrink)