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Incidental or secondary findings (ISFs) in whole exome or whole genome sequencing have been widely debated in recent literature. The American College of Medical Genetics and Genomics’ recommendations on diagnostic ISFs have strongly catalyzed the discussion, resulting in worldwide reactions and a variety of international guidelines. This article will outline how propositions on levels of terminology, policy, and underlying values are still internationally criticized and adjusted. Unsolved questions regarding ISFs include a suitable terminology, adequate counseling or informed consent procedures, opt-out possibilities, reporting ISFs to (parents of) minors and values regarding professional duty, patient autonomy, and actionability. These questions will be characterized as intrinsically related and reciprocally maintained and hence, symptomatic, single-level reflections will be marked as ineffective. Instead, a level-integrative approach of the debate that explicitly acknowledges this interaction and considers a balance between internationally significant and case-specific solutions, will be advocated. Second, the inclusion of a patient perspective will be strongly encouraged to complement the professional preponderance in the current debate. The examination of lived patient experiences, a qualitative focus on the subjective meaning of ISFs, and a contextualization of meaning processes will be suggested as specific concretizations. This integrative and inclusive approach aims for a more comprehensive understanding of ISFs, a consideration of all relevant stakeholders’ perspective and, ultimately, an effective health-care policy.

Background: Palliative day-care centers are a marginal service within the palliative care landscape. Relevant research on the potential and added value of this service model is lacking, and it may therefore be underappreciated.Aim: To examine how representatives of Belgian palliative day-care centers perceive their strengths and added value, as well as the biggest challenges to their survival.Design: Qualitative study of individual interviews and an overarching focus group. Data collection was performed from December 2014 to April 2015. Inductive coding was used to extract relevant themes from the verbatim transcripts.Setting/Participants: Participants were professional representatives of all 5 Flemish palliative day-care centers: 7 participants for the individual interviews and 6 participants for the focus group.Results: Five strengths were identified: (1) unique care model, (2) contact with peers in a nonclinical environment, (3) a reliable and competent multiprofessional team, (4) care tailored to the individual, and (5) respite for family caregivers. The most significant challenges were (1) optimizing government funding and (2) achieving sufficiently high occupancy and referral. According to interviewees, this latter challenge was due to the low visibility of the service to professionals and the public, unclear referral criteria, and the psychological threshold for referral among patients and professionals.Conclusions: Palliative day-care centers strive to provide unique services for patients with advanced illness. However, negotiating adequate funding and raising referral by changing current perceptions are paramount to unlocking their potential. Scientific analysis of cost utility and patient outcomes associated with their use is necessary.

AbstractIn this article, a close study of Jean-Luc Nancy’s The Experience of Freedomis offered. After presenting the book’s main argument, i.e. a non-metaphysical thinking of freedom, we turn to the question of subjectivity and freedom in relation to the eventfulness of freedom itself. The article closes by questioning certain surprising tendencies in Nancy’s work. So, for instance, one might note a return of the concept of destiny (and therefore of a certain form of metaphysics) in Nancy’s debate with Heidegger. Throughout, this essay seeks to relate the theme of freedom to other works of Nancy, including his recent deconstruction of Christianity, and to the debate with Heidegger and Derrida that takes place around the question of the freedom of the human being.

AbstractIn a footnote to The Inoperative CommunityFrench philosopher Jean-Luc Nancy wonders how to escape Hegelian dialectics. Because Nancy in his later work often returns to this attempt of a ‘disclosure of our metaphysical horizon’, we not only consider this note as a crucial one in his attempt to ‘disclose’ our metaphysical horizon; on top of that, we think this note is really worthwhile considering for our philosophical era in general: how to think after the so called ‘end of metaphysics’? Nancy’s work is an explicit confrontation with this horizon. Therefore, in this paper we prefer to reconstruct his line of thought in this, from the influence of Georges Bataille and Maurice Blanchot, over Friedrich Hegel up to Martin Heidegger and Jacques Derrida. We focus on the way attempts for the disclosure of our metaphysical horizon out from the problem of community, one of the central topics in his work. We conclude with a discussion why Nancy’s ontological framework has the potential to break up the metaphysical horizon of our philosophical era.

Abstract: Traditionally, the average code of conduct within Western health care starts from the autonomy of the patient. In addition, medicine today is ‘evidence based’ and the patient is an ‘informed consent’. Yet, the individual autonomy of the patient in health care is not simply enhancing today. Quite a few fundamental changes have and are currently at work within health care, which I will summarize here with the paradigm of predictive medicine. One of the characteristics of this paradigm is the increase of medical consults which are not autonomously chosen by an individual. For reasons of public health and diminishing of health risks or for reasons of prevention, on one hand we are dealing with ethical codes centered around the autonomy of patients and the face-to-face relations with health care workers, on the other, we are dealing with a society that takes an increasingly greater medical initiatives. Therefore, the question arises if predictive medicine confronts us with the limits of an ethical code as we know it today. Is there not an urgent need for a political code of conduct in health care?

In one of his latest books, La pensee derobee (2001), Jean-Luc Nancy continues writing about the major themes of his work up until now: community, sense, being as being with, or singular plural being. These themes come together in a witnessing of the world “as such”: that is to say,the world here and now in which we are living in common. The sense of the world is nothing but this being-in-common. This makes Nancy a thinker of “globalization”, albeit in a very specific way, one concerned with the way in which we are “world”. One way to argue this is to consider the way in which Nancy's workis larded with enumerations. Very often he “recites” our singular plural being by giving lists of the diversity of “things”. This is also the case for a few of the texts in La pensee derobee. In trying to catch an echo of these “recitals”, I want to review the theme world in Nancy's oeuvre and ask the question if and how Nancy thinks of our global coexistence nowadays. A part of this text was presented at the 4th annual conference of The Society for European Philosophy at the Manchester Metropolitan University (11-13 September 2001).

This essay explores Jean-Luc Nancy's rethinking of political space in terms of an ontological 'being-with'. It elucidates how Nancy's thinking of community emerges out of the French philosopher's reworking of Heidegger's crucial notion of Mitsein. For Nancy, although Heidegger argues that Dasein is always already also Mitsein, Mitsein is nonetheless also occluded by the priority accorded to Dasein. The consequences for the way in which community or the space of the political is configured are profound since traditional conceptions of the subject of community thus remain unreconstructed. Nancy however does reconstruct community by emphasising that the primal ontological conditions of community are not conceived as the One, the Other or the We, but as the 'with', 'relationality', and the 'between'. The question of being (Seinsfrage) thereby becomes the question of being-with (Mitseinsfrage).