J. Hoogland

Maintaining integrity in times of scarce resources.

In many industrialised countries health care expenditures have increased to such an extent, that governments have felt the need to control the cost increase. At the same time the medical possibilities have increased constantly and so has the demand, both quantitatively and qualitatively, in the population for health care provisions. Thus,many industrialised countries governments see themselves confronted with a tension between the cost and the quality of health care. In a number of countries changes in the health care system have already been introduced or are being introduced to reduce this tension (e.g. the Netherlands, Great Britain, Germany and some central European countries). Costs in health care to a large extent result from actions and decisions of physicians. Changes in the organisation and financing of health care in order to control expenses, tend to affect the position of physicians, in particular their freedom of action. However, a physicians freedom of action entails an important ethical value, and policies that affect it may have significant ethical implications. This leads to the question as to how far it is ethically justifiable to limit the freedom of action of physicians by policy measures, or better, governance instruments. for cost control. In order to answer this question we have approached the issue from two angles. First, we have made a philosophical analysis of the character of medical practice in order to ascertain the ethical value of the physicians freedom of action. Secondly, we have studied the effects of a few governance instruments as elements of a broader health care system on the freedom of the physicians. In the final part of the study these effects are evaluated in the light of the results of the first part of the study.

A distinctive of Christian Higher Education: Educating for vocation

Bram de Muynck, Pieter Vos, Jan Hoogland, and Jan Van der Stoep Driestar Christian University, Gouda, The Netherlands; Theological University Apeldoorn, Apeldoorn, The Netherlands; Protestant Theological University, Amsterdam, The Netherlands; University of Twente, Enschede, The Netherlands; Viaa, University of Applied Sciences, Zwolle, The Netherlands; VU University Amsterdam, Amsterdam, The Netherlands; Ede Christian University of Applied Sciences, Ede, The Netherlands

Christian Higher Education in a changing context: Shifting from pillars to practices

ABSTRACT The process of global modernization has reached a new phase. In many parts of the world, societies have become so complex that the logic that characterized first modernity no longer works. Simultaneously, societies are confronted by huge and complex side effects of modern rationality, such as climate change, migration influx, global inequality, and waning confidence in the nation-state. Consequently, we are entering an age of reflexive modernity. In our view, this new social configuration has important consequences for what Christian higher education can contribute to the education of new professionals. In this article, we will reflect on the way in which three collaborating Christian universities of applied sciences in the Netherlands are searching for answers on the challenges of our time. We propose, firstly, that they should give more attention to the relational formation of professionals than before. These professionals have to bridge the gap between professional and client, system and lifeworld, professionalism and personality, and professionalism and spirituality. Secondly, the professionals trained at Christian institutions of higher education should develop a strong professional ethos that allows them to act swiftly and efficiently in complex situations. In order to develop such an ethos, moral traditions are indispensable. Although the new social configuration does not seem to be very favorable for Christian higher education, on closer inspection it brings new opportunities.

The secular as an ordering of the sacred

On May 22th 2008 Bronislaw Szerszynski held his Van Riessen Memorial Lecture at the Delft University of Technology. In this lecture Szerszynski presented his own view on the relation between religion and the modern technological condition, which shows some striking parallels with the way in which Reformational Philosophy sees it. Szerszynski wanted to show that the sacred and the profane/secular are not just opposites excluding each other, but that the profane/secular itself must be understood in religious terms. In the first part of this article the background, presuppositions and trends of this debate will be sketched and in the second part the parallels and differences between Szerszynski and Reformational Philosophy will be delineated.