An increasing number of older patients have to decide on a treatment plan for advanced chronic kidney disease, involving dialysis or conservative care. Shared decision-making is recommended as the model for decision-making in such preference-sensitive decisions. The aim of SDM is to come to decisions that are consistent with the patient’s values and preferences and made by the patient and healthcare professional working together. In clinical practice, however, SDM appears to be not yet routine and needs further implementation. A shift (...) from a biomedical to a person-centered conception might help to make the process more shared. Shared should, therefore, be interpreted as two persons bringing two perspectives to the table, that both need to be explored during the decision-making process. Starting from the patient’s perspective will enable to determine the mutual goals of care first and, subsequently, determine the best way for achieving those goals. To perform such SDM, the healthcare professional needs to become a skilled companion, being part of the patient’s relational context, and start asking the right questions about what matters to the patient as person. In this article, we describe the need for a person-centered conception of SDM for the setting of older patients with advanced CKD. (shrink)

The introduction of novel diagnostic techniques in clinical domains such as genomics and radiology has led to a rich ethical debate on how to handle unsolicited findings that result from these innovations. Yet while unsolicited findings arise in both genomics and radiology, most of the relevant literature to date has tended to focus on only one of these domains. In this article, we synthesize and critically assess similarities and differences between “scanning the body” and “sequencing the genome” from an ethical (...) perspective. After briefly describing the novel diagnostic contexts leading to unsolicited findings, we synthesize and reflect on six core ethical issues that relate to both specialties: terminology; benefits and risks; autonomy; disclosure of unsolicited findings to children; uncertainty; and filters and routine screening. We identify ethical rationales that pertain to both fields and may contribute to more ethically sound policies. Considerations of preserving public trust and ensuring that people perceive healthcare policies as fair also support the need for a combined debate. (shrink)

As of October 23, 2020, almost 42 million cases of COVID-19 have been reported globally. Although many different treatments have been applied in infected...

\noindent\textbf{Introduction} Online interventions hold great potential for Therapeutic Change Process Research (TCPR), a field that aims to relate in-therapeutic change processes to the outcomes of interventions. Online a client is treated essentially through the language their counsellor uses, therefore the verbal interaction contains many important ingredients that bring about change. TCPR faces two challenges: how to derive meaningful change processes from texts, and secondly, how to assess these complex, varied and multi-layered processes? We advocate the use text mining and multi-level (...) models (MLMs): the former offers tools and methods to discovers patterns in texts; the latter can analyse these change processes as outcomes that vary at multiple levels. \noindent\textbf{Method} We (re-)used the data from \cite{Lamers2015} because it includes outcomes and the complete online intervention for clients with mild depressive symptoms. We used text mining to obtain basic text-variables from e-mails, that we analysed through MLMs. \noindent\textbf{Results} We found that we could relate outcomes of interventions to variables containing text-information. We conclude that we can indeed bridge text mining and MLMs for TCPR as it was possible to relate text-information (obtained through text mining) to multi-levelled TCPR outcomes (using a MLM). \noindent\textbf{Discussion} Text mining can be helpful to obtain change processes, which is also the main challenge for TCPR. We showed how MLMs and text mining can be combined, but our proposition leaves open how to obtain the most relevant textual operationalization of TCPR concepts. That requires interdisciplinary collaboration and discussion. The future does look bright: based on our proof-of-concept study we conclude that MLMs and text mining can indeed advance TCPR. (shrink)

It is impossible to deduce the properties of a strongly emergent whole from a complete knowledge of the properties of its constituents, according to C. D. Broad, when those constituents are isolated from the whole or when they are constituents of other wholes. Elanor Taylor proposes the Collapse Problem. Macro-level property p supposedly emerges when its micro-level components combine in relation r. However, each component has the property that it can combine with the others in r to produce p. Broad’s (...) nondeducibility criterion is not met. This article argues that the amount of information required for r is physically impossible. Strong Emergence does not collapse. But the Collapse Problem does. Belief in Strong Emergence is strongly warranted. Strong Emergence occurs whenever it is physically impossible to deduce how components, in a specific relation, would combine to produce a whole with p. Almost always, that is impossible. Strong Emergence is ubiquitous. (shrink)

The number of discriminable colours is often assumed to be of the order of several million but the extent of detectable chromatic diversity present in individual natural scenes is an open question. Here, the aim was to estimate the number of discriminable colours seen in natural scenes. Hyperspectral data were obtained from a set of natural scenes over the range 400 - 720 nm at 10 nm intervals (Nascimento et al, 2002 Journal of the Optical Society of America A 19 (...) 1484 - 1490) and the representation of each scene in CIELAB space computed for all pixels of the image. The number of discriminable colours was estimated by counting the number of unit volumes in the three-dimensional volume defined by the scene when represented in CIELAB space. We found that the number of discriminable colours estimated in a scene could vary by an order of magnitude from scene to scene, but rarely exceeded 105, indicating a limited chromatic diversity. (shrink)

Artikelen en lezingen uit de periode 1970-1982.

Uitgave ter gelegenheid van de vierhonderdste geboortedag van de Nederlandse jurist, diplomaat en schrijver Hugo de Groot (1583-1645).

In this 1974 book a practising scientist and gifted expositor sets forth an exciting point of view on the nature of science and how it works.

Overzicht van de rationalistische traditie in de filosofie van de kunst sinds Kant door een hoogleraar aan de Leuvense universiteit.

Contemporary society needs the recognition of a moral middle ground, where human behavior can be evaluated as permissible, understandable, or even valuable. As a counterforce to polarization and divisive politics, an identity model is proposed in which individual and group identities are transcended by a human and ecological identity.

Theodor W. Adorno is best known for his contributions to aesthetics and social theory. Critics have always complained about the lack of a practical, political or ethical dimension to Adorno's philosophy. In this highly original contribution to the literature on Adorno, J. M. Bernstein offers the first attempt in any language to provide an account of the ethical theory latent in Adorno's writings. Bernstein relates Adorno's ethics to major trends in contemporary moral philosophy. He analyses the full range of Adorno's (...) major works, with a special focus on Dialectic of Enlightenment, Minima Moralia and Negative Dialectics. In developing his account Bernstein lays particular stress on Adorno's contention that the event of Auschwitz demands a new categorical imperative. This book will be widely acknowledged as the standard work on Adorno's ethics and as such will interest professionals and students of philosophy, political theory, sociology, history of ideas, art history and music. (shrink)

Malthus did not leave us with a systematic treatment of colonization, but from remarks scattered throughout his publications and correspondence it is possible to assemble a fairly coherent account of his views on the advantages and disadvantages of colonies, and on the reasons why some have failed and others succeeded. Included in these scattered remarks are some comparisons between his own views on colonies and those of Adam Smith. The question of the relationship between Malthus and Adam Smith is a (...) rather complex and subtle one, and cannot be given the full consideration it deserves in one short paper. But, as a general summary, it can be said that Malthus had a high regard for Smith and considered himself a follower and disciple of Smith, by contrast with Ricardo, James Mill, and McCulloch etc., whom he considered as exponents of a ‘New System of Political Economy”. His own Principles of Political Economy was conceived as a collection of ‘tracts or essays”, not as a new systematic treatise replacing the Wealth of Nations, Joseph Gamier in his article ‘Malthus” in the Dictionnaire de l'Economie Politique, 1852, saw that the title of the Principles was in fact a misnomer: ‘Malgré son titre, le livre sur les Principes n'est point un traité complet, mais seulement une collection de dissertations.” In what was probably intended as a criticism of Ricardo's Principles of Political Economy and Taxation, 1817, Malthus stated that the ‘present period … seems to be unpropitious to the publication of a new systematic treatise on political economy”, and, referring to Smith's work, stated that ‘the treatise which we already possess is still of the very highest value”. Nevertheless, despite professing his affiliation, Malthus did not hesitate to criticize Smith when he disagreed with him. He recognized that the Wealth of Nations contained ‘controverted points” and that it would require some ‘additions … which the more advanced stage of the science has rendered necessary”. (shrink)

In this unflinching look at the experience of suffering and one of its greatest manifestations—torture—J.M. Bernstein critiques the repressions of traditional moral theory, showing that our morals are not immutable ideals but fragile constructions that depend on our experience of suffering itself. Morals, Bernstein argues, not only guide our conduct but also express the depth of mutual dependence that we share as vulnerable and injurable individuals. Beginning with the attempts to abolish torture in the eighteenth century, and then sensitively examining (...) what is suffered in torture and related transgressions, such as rape, Bernstein elaborates a powerful new conception of moral injury. Crucially, he shows, moral injury always involves an injury to the status of an individual as a person—it is a violent assault against his or her dignity. Elaborating on this critical element of moral injury, he demonstrates that the mutual recognitions of trust form the invisible substance of our moral lives, that dignity is a fragile social possession, and that the perspective of ourselves as potential victims is an ineliminable feature of everyday moral experience. (shrink)

John and Mary have fully consensual sex, but they do not want to have a child, so they use contraception with the intention of avoiding pregnancy. Unfortunately, although they used the contraception in the way in which it is supposed to be used, Mary has become pregnant. The couple decides to have the baby, whom they name ‘Ernie’. Now we fill in the story a bit. The universe is causally deterministic, and 30 years later Ernie performs some action A and (...) thereby brings about event E. We also stipulate that Ernie meets plausible compatibilist conditions for acting freely . That is, we suppose that there are no uncontroversially freedom- and responsibility-undermining conditions present in the context in which Ernie performs A, and, further, that Ernie meets plausible compatibilist conditions for acting freely. Let us say, for example, that one adopts the theory according to which the freedom-relevant condition on moral responsibility is that the agent exhibits ‘guidance control’ of his action and . On this approach, one acts freely in so far as one acts from one's own, suitably reasons-responsive mechanism. We can then simply stipulate that, in the relevant context, Ernie acts from his own, suitably reasons-responsive mechanism . If one prefers a different set of compatiblist-friendly conditions for acting freely, one can simply stipulate that Ernie meets them; indeed, the plausible compatibilist-friendly conditions seem to be compatible with each other, and thus Ernie could presumably meet all of them in the relevant context. In such a case, and given that the epistemic condition on acting freely and moral responsibility is met, I am inclined to say that Ernie …. (shrink)