Introduction In 2007, a national review committee was instituted in The Netherlands to review cases of active ending of life for newborns. It was expected that 15–20 cases would be reported. To date, however, only one case has been reported to this committee. Reporting is essential to obtain societal control and transparency; the possible explanations for this lack of reporting were therefore explored. Methods Data on end-of-life decision-making were scrutinised from Dutch nation-wide studies (1995, 2001 and 2005), before institution of (...) the committee. Physicians received a questionnaire about their medical decision-making for stratified samples of deceased infants up to 1 year, drawn from the central death registry. Results In 2005, 58% of all deaths were preceded by an end-of-life decision, compared with 68% in 2001 and 62% in 1995. The use of drugs with a possible life-shortening effect tended to be lower. In 2005, all four cases in the study in which an infants' life was actively ended were preceded by a decision to forego life-prolonging treatment. In three cases, the infant's life expectancy was short; one case involved a longer life expectancy. Discussion The expected number of cases is probably an overestimation due to changes in medical practice such as the tendency to attribute less life-shortening effects to opioids. The lack of reports is probably also associated with requirements in the regulation; it may be difficult to fulfil them due either to time constraints or the nature of the suffering that is addressed. If societal control of active ending of life is considered useful, changes in the regulation may be needed. (shrink)

In this paper we examine ethical issues relevant to conducting mental health research with refugees and immigrant communities that have cultural orientations and social organisation that are substantially different to those of the broader Australian community, and we relate these issues to NH&MRC Guidelines. We describe the development and conduct of a mental health research project carried out recently in Melbourne with the Somali community, focusing on ethical principles involved, and relating these to the NH&MRC National Statement on Ethical Conduct (...) in Research Involving Humans, and the NH&MRC document Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research.The experience of conducting mental health research with the Somali community highlights the fact that the principles of inclusion and benefit enunciated in the NH&MRC document Values and Ethics are particularly pertinent when conducting research with refugees and immigrant communities that are culturally distant to those of the broader Australian community. These principles inform issues of research design and consent, as well as guiding respectful engagement with the participating community and communication of the research findings. (shrink)

This study described the relationships between academic class and student moral sensitivity and reasoning and between curriculum design components for ethics education and student moral sensitivity and reasoning. The data were collected from freshman (n = 506) and senior students (n = 440) in eight baccalaureate nursing programs in South Korea by survey; the survey consisted of the Korean Moral Sensitivity Questionnaire and the Korean Defining Issues Test. The results showed that moral sensitivity scores in patient-oriented care and conflict were (...) higher in senior students than in freshman students. Furthermore, more hours of ethics content were associated with higher principled thinking scores of senior students. Nursing education in South Korea may have an impact on developing student moral sensitivity. Planned ethics content in nursing curricula is necessary to improve moral sensitivity and moral reasoning of students. (shrink)

The author argues that there is a sharp contrast between Plato's earlier teleological explanation of nature and his later conception. In the Phaedo Anaxagoras' νοṽς as a teleological principle is rejected, the forms taking its place, in the Philebus the existence of a νοṽς explaining order and finality in nature, is strictly demonstrated. After that nature and consequences of this new doctrine are briefly discussed : the ineffable character of the transcendent cause of the world ; the reduction of the (...) number of the Forms to those of substances in nature ; the causality of νοṽς as an immanent and intermediate one ; the foundation of a mathematical science of nature. Thirdly the author makes an effort to reconstruct the philosophical grounds of this development, starting from the three theses, on which the argumentation of the Philebus is based. 1) νοṽς can only exist in a soul. It is argued that the dynamic conception of soul in the Phaedrus logically leads to the conclusion, that νοṽς also is movement . 2) To explain cosmic order and finality a νοṽς has to be accepted. This new idea occurs for the first time in the Sophistes and in the myth of the Politicus. 3) Cosmic order has a mathematical and astronomical character. This aspect is absent before the Philebus and seems to have been a consequence of Plato's discovery of the regularity in the planitary motions . Finally the author thinks he can indicate in the Sophistes the turning-point in the theory of Forms, as a result of the extension of the notion of being. (shrink)

Introduction: The Dutch Euthanasia Act states that euthanasia is not punishable if the attending physician acts in accordance with the statutory due care criteria. These criteria hold that: there should be a voluntary and well-considered request, the patient’s suffering should be unbearable and hopeless, the patient should be informed about their situation, there are no reasonable alternatives, an independent physician should be consulted, and the method should be medically and technically appropriate. This study investigates whether physicians experience problems with these (...) criteria in medical practice.Methods: In 2006, questionnaires were sent to a random, stratified sample of 2100 Dutch physicians . Physicians were asked about problems in their decision-making related to requests for euthanasia or assisted suicide after enforcement of the 2002 Euthanasia Act.Results: Of all physicians who had received a request for euthanasia or assisted suicide , 25% had experienced problems in the decision-making with regard to at least one of the criteria of due care. Physicians who had experienced problems mostly indicated to have had problems related to evaluating whether or not the patient’s suffering was unbearable and hopeless and whether or not the patient’s request was voluntary or well considered .Discussion: Physicians in The Netherlands most frequently reported problems related to aspects in which they have to evaluate the patient’s subjective perspective. However, it can be questioned whether placing emphasis on these subjective aspects is an adequate fulfilment of the duties imposed on physicians, as laid down in the Dutch Euthanasia Act. (shrink)

This lecture is divided, roughly, into three parts. First, there is a general and perhaps rather simple-minded discussion of what are the ‘facts’ that social anthropologists study; is there anything special about these ‘facts’ which makes them different from other kinds of facts? It will be useful to start with the common-sense distinction between two kinds or, better, aspects of social facts; first—though neither is analytically prior to the other—and putting it very crudely, ‘what people do’, the aspect of social (...) interaction, and second, ‘what—and how—people think’, the conceptual, classifying, cognitive component of human culture. Now in reality, of course (and perhaps not so ‘of course’; people do tend to think of them as separate ‘things’), these two aspects are inextricably intertwined. But it is essential to distinguish them analytically, because each aspect gives rise to quite different kinds of problems of understanding for the social anthropologist. We shall see that the problem of how to be ‘objective’, and so to avoid ethnographic error, arises in both contexts, but in rather different forms in each. (shrink)

This lecture is divided, roughly, into three parts. First, there is a general and perhaps rather simple-minded discussion of what are the ‘facts’ that social anthropologists study; is there anything special about these ‘facts’ which makes them different from other kinds of facts? It will be useful to start with the common-sense distinction between two kinds or, better, aspects of social facts; first—though neither is analytically prior to the other—and putting it very crudely, ‘what people do’, the aspect of social (...) interaction, and second, ‘what—and how—people think’, the conceptual, classifying, cognitive component of human culture. Now in reality, of course (and perhaps not so ‘of course’; people do tend to think of them as separate ‘things’), these two aspects are inextricably intertwined. But it is essential to distinguish them analytically, because each aspect gives rise to quite different kinds of problems of understanding for the social anthropologist. We shall see that the problem of how to be ‘objective’, and so to avoid ethnographic error, arises in both contexts, but in rather different forms in each. (shrink)

The experience of newborn screening for Krabbe disease in New York State demonstrates the ethical problems that arise when screening programs are expanded in the absence of true understanding of the diseases involved. In its 5 years of testing and millions of dollars in costs, there have been very few benefits, and the testing has uncovered potential cases of late-onset disease that raise difficult ethical questions in their own right. For these reasons, we argue that Krabbe screening should only be (...) continued as a research project that includes the informed consent of parents to the testing. (shrink)