BackgroundThe COVID-19 pandemic has created ethical challenges for intensive care unit (ICU) professionals, potentially causing moral distress. This study explored the levels and causes of moral distress and the ethical climate in Dutch ICUs during COVID-19.MethodsAn extended version of the Measurement of Moral Distress for Healthcare Professionals (MMD-HP) and Ethical Decision Making Climate Questionnaire (EDMCQ) were online distributed among all 84 ICUs. Moral distress scores in nurses and intensivists were compared with the historical control group one year before COVID-19. ResultsThree (...) hundred forty-five nurses (70.7%), 40 intensivists (8.2%), and 103 supporting staff (21.1%) completed the survey. Moral distress levels were higher for nurses than supporting staff. Moral distress levels in intensivists did not differ significantly from those of nurses and supporting staff. “Inadequate emotional support for patients and their families” was the highest-ranked cause of moral distress for all groups of professionals. Of all factors, all professions rated the ethical climate most positively regarding the culture of mutual respect, ethical awareness and support. “Culture of not avoiding end-of-life-decisions” and “Self-reflective and empowering leadership” received the lowest mean scores. Moral distress scores during COVID-19 were significantly lower for ICU nurses (p < 0.001) and intensivists (p < 0.05) compared to one year prior.ConclusionLevels and causes of moral distress vary between ICU professionals and differ from the historical control group. Targeted interventions that address moral distress during a crisis are desirable to improve the mental health and retention of ICU professionals and the quality of patient care. (shrink)

Background: Debates over legalisation of physician-assisted suicide or euthanasia often warn of a “slippery slope”, predicting abuse of people in vulnerable groups. To assess this concern, the authors examined data from Oregon and the Netherlands, the two principal jurisdictions in which physician-assisted dying is legal and data have been collected over a substantial period.Methods: The data from Oregon comprised all annual and cumulative Department of Human Services reports 1998–2006 and three independent studies; the data from the Netherlands comprised all four (...) government-commissioned nationwide studies of end-of-life decision making and specialised studies. Evidence of any disproportionate impact on 10 groups of potentially vulnerable patients was sought.Results: Rates of assisted dying in Oregon and in the Netherlands showed no evidence of heightened risk for the elderly, women, the uninsured , people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations. The only group with a heightened risk was people with AIDS. While extralegal cases were not the focus of this study, none have been uncovered in Oregon; among extralegal cases in the Netherlands, there was no evidence of higher rates in vulnerable groups.Conclusions: Where assisted dying is already legal, there is no current evidence for the claim that legalised PAS or euthanasia will have disproportionate impact on patients in vulnerable groups. Those who received physician-assisted dying in the jurisdictions studied appeared to enjoy comparative social, economic, educational, professional and other privileges. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:134 When the woman saw that the fruit of the tree was good for food and pleasing to the eye, and also desirable for gaining wisdom, she took some and ate it —­Genesis 3:6 Abstract Aesthetics has emerged as an important battleground in the moral quest for a lower carbon society. Especially in the case of proposed wind farms (an environmentally benign technology in terms of low carbon emissions), (...) opponents frequently refer to the unsightly machines creating negative landscape impacts and ruining the view. This essay seeks to reflect on the particular ways in which visual aesthetics are framed and mobilized in this moral debate. Exploring the dividing lines between pictoral and more-­ than-­ representational approaches I ask if the moral dilemmas in our landscape decisions (e.g. individual rights to beauty or collective duties toward future generations) are obscured by physical or visual realms. The largely invisible nature of wind, electricity and climate change, set within the physical and tangible nature of landscapes and turbines, challenges us to experience the aesthetics of landscapes-­ with-­ machines through more creative and engaging means that are not limited to visibility, nor deaf to morality. SIN, DUTY, AND THE AESTHETICS OF NATURE As the first act of sin in the bible, Eve’s consumption of a visually aesthetic fruit led to humans being banned from the Garden of Eden. Looking at the above sentence more closely, we could even argue that “good for food” is not a positive condition (e.g. tasty, nourishing), but Justice in the Eye of the Beholder? ‘Looking’ Beyond the Visual Aesthetics of Wind Machines in a Post-­Productivist Landscape DAN VAN DER HORST Dan van der Horst / Justice in the Eye of the Beholder? 135 rather the absence of a negative (e.g. inedible), whilst “also desirable” may sound like the hunger for wisdom was only a secondary, additional attraction. The sentence thus draws attention to the key role of aesthetics in the making of a moral decision; would Eve have eaten the forbidden fruit if it was not “pleasing for the eye”? Aesthetic judgments may be informed by a range of factors, but as this bible quote illustrates, morality is key among them. Associations between right and wrong on the one side and beauty or ugliness on the other, are not exactly rare in written history, be they religious, literary or scholastic works. As a marked contribution to the latter, Immanuel Kant has paid particularly close attention to the links between aesthetics and morality, arguing amongst others that any universal agreement in judgments of the sublime must rest on an appeal to moral feelings.1 But universality is not the only logical link between aesthetic judgementandmorality.Peoplecanfeelasenseof‘duty’tofindcertainthings beautiful e.g. because that is the aesthetic judgment of the group they aspire to belong to.2 Whilst this sense of duty can refer to social conditioning and group belonging, it also has resonance for landscape aesthetics at a time of anthropogenic climate change (a universal threat) when we must “learn to love the low carbon landscape.”3 This presents a point of departure from the debate on the moral obligation of preserving aesthetically pleasing landscapes (as we tend to do through legal designations, e.g. national parks), an ethical logic which leads, to use the words of Holmes Rolston, “from beauty to duty.”4 Moreover a posi­ tive aesthetical appreciation of a landscape because it accommodates low carbon technologies, would potentially require an inverse ethical logic, i.e. from duty to beauty.5 Notwithstanding the clear conceptual links between moral and aesthetic judgment, in everyday life it may be far less clear what kind of moral issues may underpin particular expressions of aesthetic sensibility. This can be particularly problematic for the deployment of environmental technologies (i.e. technologies pursued to reduce pollution ) that have significant landscape footprints. That is where we can find universal moral claims demanding environmental action for the common good rubbing up against aesthetic landscape judgments in places where such developments are proposed. This produces an unsatisfactory situation in which the deployment of clean technologies ENVIRONMENT, SPACE, PLACE / VOLUME 10 / ISSUE 1 / 2018 136 is delayed, tensions within local communities may increase... (shrink)

(1996). Korte Notities Over Het Godsbegrip Bij Grieken En Romeinen En De Vergoddelijking Van Jezus in Het Nieuwe Testament. Bijdragen: Vol. 57, No. 2, pp. 149-157.

In the recently published Papyrus Bodmer 30 one of the six poems deals with the story of Genesis 22. At many places the poem drastically deviates from the biblical text, and the editors of the papyrus are insufficiently aware of the background of these deviations. In this article the authors demonstrate that almost all of them have their background in a centuries long process of both Jewish and Christian reflection on this biblical chapter. It is the very specific ‘Wirkungsgeschichte’ of (...) Gen. 22 that explains most of the poem’s specifics. (shrink)

In this essay an attempt will be made to trace the origins and history of the accusation that Jews are cannibals. Its origins go back much further into history than most people know, and for that reason it is this aspect of our topic that will receive the most attention. At the same time, it will be demonstrated that this anti-Jewish myth has an unprecedented tenacity, since it is still readily believed in by millions up until the present day. Part (...) I: Antiquity1Frist Encounters The encounters between Jews, on the one hand, and Greeks and Romans, on the.. (shrink)

Les décisions politiques sur les risques environnementaux complexes font fréquemment intervenir des éléments scientifiques contestés. Il n’y a généralement pas de « faits » qui conduisent à une politique correcte unique. Les éléments de preuve qui sont intégrés dans les avis scientifiques destinés à une décision politique nécessitent une évaluation de leur qualité. En 2003, l’Agence néerlandaise d’évaluation environnementale a adopté une méthode standardisée, désignée sous le nom de « guide », dans le cadre de laquelle les principaux aspects de (...) la production et de l’utilisation des connaissances sont présentés grâce à une liste de contrôle visant à l’évaluation et à la communication des incertitudes. Dans cet article, nous présentons des résultats de l’application de ce guide à la controverse sur les risques des particules en suspension. La délibération active sur l’incertitude dans un contexte d’expertise entraîne un processus d’apprentissage commun entre les experts et les décideurs politiques, ce qui conduit à une meilleure prise de conscience du phénomène d’incertitude et de ses implications politiques.Policy decisions on complex environmental risks often involve disputed science. Typically, there are no “ facts” to support a single unequivocally correct policy. The evidence provided in scientific studies for policy-making decisions requires high-quality assessment. In 2003, the Netherlands Environmental Assessment Agency adopted a standardized method, referred to as “guidelines”, whereby key quality aspects of knowledge production and use are presented in the form of a checklist for uncertainty assessments and communication. In this article, we present the outcomes of applying the guidelines in controversies on the risks of ambient particulate matter. In the policy–advisory context, active deliberation on uncertainty produces a common learning process for advisors and policy makers, which leads to a deeper understanding and increased awareness of the phenomenon of uncertainty and its policy implications. (shrink)

Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the (...) contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people’s perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization. (shrink)

There is increasing recognition that sustainable diets need to be ‘culturally appropriate’. In relation to food consumption, however, it is often unclear what cultural appropriateness–or related terms, such as cultural or social acceptability–actually means. Often these terms go undefined, and where definitions are present, they vary widely. Based on a systematic literature review this paper explores how cultural appropriateness of food consumption is conceptualised across different research literatures, identifying six main themes in how cultural appropriateness is understood and applied. The (...) paper then critically analyses these themes in relation to sustainable food system transformation. We explore how the themes conceptualise change, finding that cultural appropriateness is viewed in two main ways: either as a relatively static obstacle to be overcome, or as a dynamic and negotiated process. Both perspectives, we argue, entail different scientific, practical and political effects. Each perspective offers particular affordances for understanding and governing sustainable food system transition, although between perspectives there is likely to be a trade-off between theoretical sophistication and practical operationalizability. Based on this analysis we argue that researchers, policymakers and practitioners should be explicit about their commitment to a particular understanding of cultural appropriateness, as this will have implications for scientific and societal applications of their work. This is particularly the case, we suggest, in relation to the transdisciplinary collaborations necessary to effectively address the ‘wicked problem’ of food system sustainability. We conclude by offering a tentative general definition of cultural appropriateness as it relates to food consumption. (shrink)

Aggleton & Brown propose that familiarity-based recognition depends on a perirhinal-medial dorsal thalamic system. However, connections between these structures are sparse or absent. In contrast, the perirhinal cortex is connected to midline/intralaminar nuclei. In a human, a lesion in this thalamic domain, sparing the medial dorsal nucleus, impaired familiarity-based recognition while sparing recollective-based recognition. It is thus more likely that the intralaminar/midline nuclei are involved in recognition.

Over the past decades, both wild and domesticated insect pollinators are in dramatic decline, which puts at stake the existence of species, ecosystem resilience and global food security. Globally, 87 of major food crops depend on animal pollination. Together these account for 35 % of the world food production volume. Pollinator mediated crops are indispensable for essential micronutrients in the human diet. Many ornamental plants as well as crops for fibre, fodder, biofuels, timber and phytopharmaceuticals also depend on insect pollinators. (...) This article aims to map the current situation of pollinators worldwide, with a focus on the critical role of pollinators in the human food chain and ecosystem sustainability, their intrinsic and extrinsic value, as well as the causes of their declines and the interventions needed to conserve them, in order to develop an argument for the importance of conserving and restoring pollinator populations and diversity. The present pollinator crisis threatens global and local food security, can worsen the problems of hidden hunger, erodes ecosystem resilience, and can destabilise ecosystems that form our life support system. An integrated approach that simultaneously addresses the key drivers is needed. This includes creation and restoration of floral and nesting resources, a global phase out of prophylactic use of neonicotinoids and fipronil, improvement of test protocols in authorisation of agrochemicals, and restoration and maintenance of independence in regulatory science. The authors argue that an international treaty for global pollinator stewardship and pollinator ecosystem restoration should be initiated in order to systemically counteract the current crisis. (shrink)

Introduction 1. Alexander in Modern Scholarship; The Present Translation The anti-Manichaean treatise of Alexander of Lycopolis has for a long time been...

In pleas for the recognition of cultural minority rights, claims to educational authority often figure as concrete examples. The right to educational authority is said to be an exemplary minority right. This is striking, for of all minority rights this is one which is impossible to justify. Difficulties invovled in recent attempts to reconcile cultural minority rights with liberal democracy demonstrate that educational minority rights in particular cannot be justified without underestimating civic and liberal risks and ignoring the complicated nature (...) of the relationships between communities and ‘their’ children and between parents and ‘their’ children. (shrink)

In academic research, many attempts have been undertaken to legitimize corporate community involvement by showing a business case for it. However, much less attention has been devoted to building understanding about the actual dynamics and challenges of managing CCI in the business context. As an alternative to existing predominantly static and top-down approaches, this paper introduces a social movement framework for analyzing CCI management. Based on the analysis of qualitative case study data, we argue that the active role of employees (...) pressuring for CCI policies and practices, as well as the organization audience responses to their efforts, are at the core of the challenges involved in managing CCI. These challenges also pose limits to how far CCI can be extended to a “business as usual” activity. (shrink)

Misinformation about the novel coronavirus is a pressing societal challenge. Across two studies, one preregistered, we assess the efficacy of two ‘prebunking’ interventions aimed at improving people’s ability to spot manipulation techniques commonly used in COVID-19 misinformation across three different languages. We find that Go Viral!, a novel five-minute browser game, increases the perceived manipulativeness of misinformation about COVID-19, improves people’s attitudinal certainty in their ability to spot misinformation and reduces self-reported willingness to share misinformation with others. The first two (...) effects remain significant for at least one week after gameplay. We also find that reading real-world infographics from UNESCO improves people’s ability and confidence in spotting COVID-19 misinformation. Limitations and implications for fake news interventions are discussed. (shrink)

In the reported, experiment participants hit a ball to aim at the vertex of a Müller–Lyer configuration. This configuration either remained stable, changed its shaft length or the orientation of the tails during movement execution. A significant illusion bias was observed in all perturbation conditions, but not in the stationary condition. The illusion bias emerged for perturbations shortly after movement onset and for perturbations during execution, the latter of which allowed only a minimum of time for making adjustments . These (...) findings indicate that allocentric information is exploited for online control when people make rapid adjustments in response to a sudden change in the environment and not when people guide their limb movements to interact with a stable environment. (shrink)

Four experiments examined the strategies that individuals develop in sentential reasoning. They led to the discovery of five different strategies. According to the theory proposed in the paper, each of the strategies depends on component tactics, which all normal adults possess, and which are based on mental models. Reasoners vary their use of tactics in ways that have no deterministic account. This variation leads different individuals to assemble different strategies, which include the construction of incremental diagrams corresponding to mental models, (...) and the pursuit of the consequences of a single model step by step. Moreover, the difficulty of a problem (i.e., the number of mental models required by the premises) predisposes reasoners towards certain strategies. Likewise, the sentential connectives in the premises also bias reasoners towards certain strategies, e.g., conditional premises tend to elicit reasoning step by step whereas disjunctive premises tend to elicit incremental diagrams. (shrink)

Interactive technology assessment (iTA) provides an answer to the ethical problem of normative bias in evaluation research. This normative bias develops when relevant perspectives on the evaluand (the thing being evaluated) are neglected. In iTA this bias is overcome by incorporating different perspectives into the assessment. As a consequence, justification of decisions based on the assessment is provided by stakeholders having achieved agreement. In this article, agreement is identified with wide reflective equilibrium to show that it indeed has the potential (...) of justifying decisions. We work out several conditions for this agreement to be achievable and just. (shrink)

About a decade ago, the Netherlands Environmental Assessment Agency unwittingly embarked on a transition from a technocratic model of science advising to the paradigm of ‘‘post-normal science’’. In response to a scandal around uncertainty management in 1999, a Guidance for ‘‘Uncertainty Assessment and Communication’’ was developed with advice from the initiators of the PNS concept and was introduced in 2003. This was followed in 2007 by a ‘‘Stakeholder Participation’’ Guidance. In this article, the authors provide a combined insider/outsider perspective on (...) the transition process. The authors assess the extent to which the PNS paradigm has delivered new approaches in the agency’s practice and analyze two projects—on long-term options for Dutch sustainable development policy and for urban development policy—the latter in somewhat more detail. The authors identify several paradoxes PBL encounters when putting the PNS concept into practice. It is concluded that an openness to other styles of work than the technocratic model has become visible, but that the introduction of the PNS paradigm is still in its early stage. (shrink)

The King Report on Corporate Governance (1994) evoked unprecedented interest in corporate governance in South Africa. This does not mean that corporate governance was not an issue of concern before the release of this historical report. To the contrary, corporate governance in its broader sense has been at stake since the inception of the first publicly owned companies in South Africa. This article intends to give an overview of corporate governance in South Africa. It starts by making a distinction between (...) broad and narrow conceptions of corporate governance. Before applying this distinction to the practice of corporate governance in South Africa, a brief overview of the corporate landscape in South Africa is provided. Then the South African situation with regard to broad and narrow corporate governance respectively is analysed. The article ends with a discussion of the review of corporate governance that currently is in the making in South Africa. Throughout the article both the financial and ethical dimensions of corporate governance is attended to. (shrink)