Global climate change threatens the health, economic prospects, and basic food and water sources of people. A wide range of changes in household energy behaviour is needed to realise a sustainable energy transition. We propose a general framework to understand and encourage sustainable energy behaviours, comprising four key issues. First, we need to identify which behaviours need to be changed. A sustainable energy transition involves changes in a wide range of energy behaviours, including the adoption of sustainable energy sources and (...) energy-efficient technology, investments in energy efficiency measures in buildings, and changes in direct and indirect energy use behaviour. Second, we need to understand which factors underlie these different types of sustainable energy behaviours. We discuss three main factors that influence sustainable energy behaviours: knowledge, motivations, and contextual factors. Third, we need to test the effects of interventions aimed to promote sustainable energy behaviours. Interventions can be aimed at changing the actual costs and benefits of behaviour, or at changing people’s perceptions and evaluations of different costs and benefits of behavioural options. Fourth, it is important to understand which factors affect the acceptability of energy policies and energy systems changes. We discuss important findings from psychological studies on these four topics, and propose a research agenda to further explore these topics. We emphasise the need of an integrated approach in studying the human dimensions of a sustainable energy transition that increases our understanding of which general factors affect a wide range of energy behaviours as well as the acceptability of different energy policies and energy system changes. (shrink)

Most research in environmental psychology is conducted in individualistic countries and focuses on factors pertaining to individuals. It is yet unclear whether these findings also apply to more collectivistic countries, in which group factors might play a prominent role. In the current paper, we test the individual-focused value–identity–behaviour pathway, in which personal biospheric values relate to pro-environmental actions via environmental self-identity, in an individualistic and a collectivistic country. Furthermore, we test in both countries whether a new group-focused pathway also exists, (...) in which group values relate to pro-environmental behaviour via environmental group identity, particularly in collectivistic countries. Questionnaire studies were conducted among Dutch and Chinese students. Our results indicated that personal biospheric values, mostly via environmental self-identity, predict pro-environmental behaviour in both countries. We also found initial support for our newly proposed value–identity–behaviour pathway at the group level, particularly in China. Yet, in both countries, the association between group-level variables and pro-environmental behaviour was weaker than for personal-level variables, and partly overlapped with personal-level variables. Our findings show the relevance of personal- and group-level factors in understanding pro-environmental behaviour in both individualistic and collectivistic countries, which has strong theoretical and practical implications, particularly for developing international strategies to promote pro-environmental actions across the world. (shrink)

To realize the full potential of solar photovoltaics (PV), PV adopters need to adapt their energy demand to the production of self-generated solar energy as much as possible (i.e., use their PV sustainably). In a longitudinal questionnaire study (N = 74) in the Netherlands, we compared the intention to use PV in a sustainable way before the installation of PV with actual PV use. Wave 1 took place before respondents adopted PV, while Wave 2 took place after they installed PV. (...) We examined whether potential differences between actual sustainable PV use and initial intentions may have implications for how people see themselves and for the motivation they ascribe to their decision to adopt PV. Our results show that the vast majority of people use their PV in a less sustainable way than they anticipated. Furthermore, after the installation of PV, respondents are less likely to see themselves as a sustainable PV user and less likely to believe that PV have positive environmental consequences than before the installation, while environmental self-identity did not differ pre and post-installation of PV. Moreover, the stronger the discrepancy between intended and actual sustainable use of the PV, the less likely people were to see themselves as a sustainable PV user and as a person who acts pro-environmentally in general. These findings suggest that it is important to support people to use their PV in a sustainable way to facilitate them to act upon their intentions. (shrink)

This document presents the Bonn PRINTEGER Consensus Statement: Working with Research Integrity—Guidance for research performing organisations. The aim of the statement is to complement existing instruments by focusing specifically on institutional responsibilities for strengthening integrity. It takes into account the daily challenges and organisational contexts of most researchers. The statement intends to make research integrity challenges recognisable from the work-floor perspective, providing concrete advice on organisational measures to strengthen integrity. The statement, which was concluded February 7th 2018, provides guidance on (...) the following key issues: § 1.Providing information about research integrity § 2.Providing education, training and mentoring § 3.Strengthening a research integrity culture § 4.Facilitating open dialogue § 5.Wise incentive management § 6.Implementing quality assurance procedures § 7.Improving the work environment and work satisfaction § 8.Increasing transparency of misconduct cases § 9.Opening up research § 10.Implementing safe and effective whistle-blowing channels § 11.Protecting the alleged perpetrators § 12.Establishing a research integrity committee and appointing an ombudsperson § 13.Making explicit the applicable standards for research integrity. (shrink)

The European Union Commission’s whitepaper on Artificial Intelligence proposes shaping the emerging AI market so that it better reflects common European values. It is a master plan that builds upon the EU AI High-Level Expert Group guidelines. This article reviews the masterplan, from a culture cycle perspective, to reflect on its potential clashes with current societal, technical, and methodological constraints. We identify two main obstacles in the implementation of this plan: the lack of a coherent EU vision to drive future (...) decision-making processes at state and local levels and the lack of methods to support a sustainable diffusion of AI in our society. The lack of a coherent vision stems from not considering societal differences across the EU member states. We suggest that these differences may lead to a fractured market and an AI crisis in which different members of the EU will adopt nation-centric strategies to exploit AI, thus preventing the development of a frictionless market as envisaged by the EU. Moreover, the Commission aims at changing the AI development culture proposing a human-centred and safety-first perspective that is not supported by methodological advancements, thus taking the risks of unforeseen social and societal impacts of AI. We discuss potential societal, technical, and methodological gaps that should be filled to avoid the risks of developing AI systems at the expense of society. Our analysis results in the recommendation that the EU regulators and policymakers consider how to complement the EC programme with rules and compensatory mechanisms to avoid market fragmentation due to local and global ambitions. Moreover, regulators should go beyond the human-centred approach establishing a research agenda seeking answers to the technical and methodological open questions regarding the development and assessment of human-AI co-action aiming for a sustainable AI diffusion in the society. (shrink)

IntroductionYounger age at diagnosis is a risk factor for poor health-related quality of life in long-term breast cancer survivors. However, few studies have specifically addressed HRQOL in young adults with breast cancer, nor have early changes in HRQOL been fully characterized.MethodsEligible female patients with breast cancer were identified through our local cancer center. To establish HRQOL, patients completed the Functional Assessment of Cancer Therapy-Breast around diagnosis and 12 months later. Sociodemographic factors, genetic susceptibility to cancer, tumor- and treatment-related factors, and (...) comorbidities were abstracted from medical records and the local oncology registry. Mixed-effects models were used to identify changes in FACT-B scores during the first year of treatment and to determine whether any demographic/treatment-related factors modulated changes in scores.ResultsHealth-related quality of life in young patients with breast cancer was within normal limits at baseline, with a FACT-B overall well-being score of 108.5. Participants reported slight improvements over a 12-month period: FACT-B overall well-being scores increased 6.6 points, functional well-being improved 3.0 points, emotional well-being improved 1.9 points, and physical well-being improved 1.5 points, on average. Participants with anxiety/depression at baseline reported greater improvements in FACT-B overall well-being and functional well-being than participants who did not have anxiety/depression at baseline. Marital status, reconstructive surgery, and baseline clinical staging were also significantly associated with changes in aspects of HRQOL, although their impact on change was relatively minimal.ConclusionYoung women with breast cancer do not report HRQOL concerns during the first year of treatment. Improvements in HRQOL during the first year of treatment may be attributable to a sense of relief that the cancer is being treated, which, in the short run, may outweigh the negative late effects of treatment. (shrink)

The Russian invasion of Ukraine on February 24, 2022, has already caused large amounts of greenhouse gas (GHG) emissions and will continue to do so for manyyears after hostilities have ceased mainly because of the emissions linked to the rebuilding of destroyed or damaged housing, public buildings, infrastructure, factories, and the like. My aim in this paper is to discuss how in a time of climate emergency such emissions of war should impact the political morality of states initiating, continuing, and (...) ending war (through a just and enduring peace) as understood by just war theory (JWT). My point of departure is a study by Lennard de Klerk and six co-authors detailing the emissions of the first year of the Russo-Ukrainian war. (shrink)

In many European countries the question of cultural identity has gained special importance due to the increase of globalization, the position of the United States, and the European unification. How can political leaders deal with these developments without alienating their people? In what ways do they express national identity in popular communication? Is nationalism a characteristic of their rhetoric? These questions are asked in regard to thirty-six New Year's speeches held by the last five French presidents. By answering these questions (...) we will develop a perspective on the concepts of national identity and nationalism. Discourse analysis shows a typical discourse for every president, in which nationalist rhetoric appears to play a role. Above all, differences between three structures of significance, or frames, are distinguished, which can be described as ‘sense of belonging’ or ‘paternal protection’, ‘the myth of French values’, and ‘the significant other’. (shrink)

To understand pre-Fregean theories of judgment and proposition, such as those found in Locke and the Port-Royal logic, it is important to distinguish between propositions in the modern sense and propositions in the pre-Fregean sense. By making this distinction it becomes clear that these pre-Fregean theories cannot be meant to solve the propositional attitude problem. Notwithstanding this fact, Locke and Arnauld are able to make a distinction between asserted and unasserted propositions (in their sense). The way Locke makes this distinction (...) turns out to be very different from the way it is made by Arnauld. (shrink)

Ernest Mandel theorised the capitalist world economy as an articulated system of capitalist, semi-capitalist and precapitalist relations of production, linked to each other by capitalist relations of exchange and domination by the capitalist world market. This seems to be an interesting starting point for an historically well-founded theory, building on and going beyond Marx's work, of the worldwide expansion of the capitalist mode of production from its origins to the present. In his attempt to formulate his theory, Mandel did not (...) succeed in resolving all difficulties, however. His main works – Marxist Economic Theory and Late Capitalism – show a number of dangling loose ends. The central question is whether these loose ends are merely technical difficulties or whether they reveal fatal flaws in the theory as a whole. In order to come a step closer to answering this question, a conference was organised in Amsterdam, November 2003. This introduction formulates the five, closely interrelated issues that were highlighted at this conference. (shrink)

The notion of cognitive act is of importance for an epistemology that is apt for constructive type theory, and for epistemology in general. Instead of taking knowledge attributions as the primary use of the verb 'to know' that needs to be given an account of, and understanding a first-person knowledge claim as a special case of knowledge attribution, the account of knowledge that is given here understands first-person knowledge claims as the primary use of the verb 'to know'. This means (...) that a cognitive act is an act that counts as cognitive from a first-person point of view. The method of linguistic phenomenology is used to explain or elucidate our epistemic notions. One of the advantages of the theory is that an answer can be given to some of the problems in modern epistemology, such as the Gettier problem. (shrink)

In this article, we sketch a new approach to law and ethics. The traditional paradigm, exemplified in the debate on liberal moralism, becomes increasingly inadequate. Its basic assumptions are that there are clear moral norms of positive or critical morality, and that making statutory norms is an effective method to have citizens conform to those norms. However, for many ethical issues that are on the legislative agenda, e.g. with respect to bioethics and anti-discrimination law, the moral norms are controversial, vague (...) or still evolving. Moreover, law proves not to be a very effective instrument. Therefore, we need a new paradigm, both for descriptive and for normative analysis. This interactive paradigm, as a normative position, can be summarised in two theses. The process of legislation on ethical issues should be structured as a process of interaction between the legislature and society or relevant sectors of society, so that the development of new moral norms and the development of new legal norms may reinforce each other. And legislation on ethical issues should be designed in such a way that it is an effective form of communication which, moreover, facilitates an ongoing moral debate and an ongoing reflection on such issues, because this is the best method to ensure that the practice remains oriented to the ideals and values the law tries to realise. (shrink)

Masters Thesis -- Stellenbosch University, 2019.

Abstract‘Social inclusion’ is the leading ideal in services and care for people with intellectual disabilities in most countries in the Global North. ‘Social inclusion’ can refer simply to full equal rights, but more often it is taken to mean something like ‘community participation’. This narrow version of social inclusion has become so ingrained that it virtually goes unchallenged. The presumption appears to be that there is a clear moral consensus that this narrow understanding of social inclusion is good. However, that (...) moral consensus is not clear in the case of people with profound intellectual and/or multiple disabilities (PIMD), who are not able to express their needs and preferences verbally. Moreover, social inclusion has proven to be difficult to conceptualize and implement for people with PIMD. Therefore, it becomes imperative to ask about the ethical rationale of the narrow understanding of social inclusion. For what reasons do we think social inclusion is good? And do those reasons also apply for people with PIMD? This article addresses these questions by providing an ethical analysis of the ideal of social inclusion for people with PIMD. It discusses four ethical arguments for social inclusion and probes their relevance for people with PIMD. The article argues that none of these arguments fully convince of the value of the narrow understanding of social inclusion for people with PIMD. It ends with advocating for an ethical space for imagining a good life for people with PIMD otherwise. (shrink)

Background Notwithstanding the need to produce evidence-based knowledge on medications for pregnant women, they remain underrepresented in clinical research. Sometimes they are excluded because of their supposed vulnerability, but there are no universally accepted criteria for considering pregnant women as vulnerable. Our aim was to explore whether and if so to what extent pregnant women are vulnerable as research subjects. Method We performed a conceptual and empirical analysis of vulnerability applied to pregnant women. Analysis A conceptual analysis supports Hurst's definition (...) of vulnerability. Consequently, we argue that pregnant women are vulnerable if they encounter an identifiably increased likelihood of incurring additional or greater wrong. According to the literature, this increased likelihood could exist of four alleged features for pregnant women's vulnerability: informed consent, susceptibility to coercion, higher exposure to risk due to lack of knowledge, vulnerability of the fetus. Discussion Testing the features against Hurst's definition demonstrates that they all concern the same issue: pregnant women are only vulnerable because a higher exposure to risk due to lack of scientific knowledge comprises an increased wrong. Research Ethics Committees have a responsibility to protect the vulnerable, but a higher exposure to risk due to lack of scientific knowledge is a much broader issue and also needs to be addressed by other stakeholders. Conclusions The only reason why pregnant women are potentially vulnerable is to the extent that they are increasingly exposed to higher risks due to a lack of scientific knowledge. Accordingly, the discussion can advance to the development of practical strategies to promote fair inclusion of pregnant women in clinical research. (shrink)

Human cognition is unique in the way in which it relies on combinatorial (or compositional) structures. Language provides ample evidence for the existence of combinatorial structures, but they can also be found in visual cognition. To understand the neural basis of human cognition, it is therefore essential to understand how combinatorial structures can be instantiated in neural terms. In his recent book on the foundations of language, Jackendoff described four fundamental problems for a neural instantiation of combinatorial structures: the massiveness (...) of the binding problem, the problem of 2, the problem of variables, and the transformation of combinatorial structures from working memory to long-term memory. This paper aims to show that these problems can be solved by means of neural “blackboard” architectures. For this purpose, a neural blackboard architecture for sentence structure is presented. In this architecture, neural structures that encode for words are temporarily bound in a manner that preserves the structure of the sentence. It is shown that the architecture solves the four problems presented by Jackendoff. The ability of the architecture to instantiate sentence structures is illustrated with examples of sentence complexity observed in human language performance. Similarities exist between the architecture for sentence structure and blackboard architectures for combinatorial structures in visual cognition, derived from the structure of the visual cortex. These architectures are briefly discussed, together with an example of a combinatorial structure in which the blackboard architectures for language and vision are combined. In this way, the architecture for language is grounded in perception. Perspectives and potential developments of the architectures are discussed. Key Words: binding; blackboard architectures; combinatorial structure; compositionality; language; dynamic system; neurocognition; sentence complexity; sentence structure; working memory; variables; vision. (shrink)

The concept of meaningful work is used to evaluate the quality of work. Typical cases of meaningless work that have been used to clarify this concept are assembly line work, and work involving other types of mindless tasks, but also David Graeber's ‘bullshit jobs’. I argue that there are at least two fundamental reasons to care about meaningful work: reasons from the wellbeing of the worker and reasons pertaining to meaningfulness of the worker's life. I first argue that a concept (...) of meaningful work needs to reflect these two values, but that these two values may come apart. Because of this, accounts that provide a single answer to the question to what extent a particular work context is meaningful work for a particular worker are unable to reflect these two values. I then survey three promising accounts of meaningful work: perfectionism, which captures the self-interested aspect of meaningful work well but fails to capture the meaningfulness aspect appropriately; consequentialism, which captures the meaningfulness aspect well but fails to capture the self-interested aspect; and Wolf's Fitting Fulfilment View of meaningful projects, which can be read as addressing both concerns but leads to implausible judgments about meaningful work. I then argue that we should conceive of the concerns that fall under the notion of meaningful work as two separate concepts and values. The best work incorporates both these dimensions but falling short on either dimension is problematic for different reasons. (shrink)

The contention in this paper is that the theological-political disputes Spinoza was concerned with 350 years ago are similar to the conspiratorial disputes we experience today. The world in Spinoza’s Tractatus theologico-politicus, a political intervention in his time, serves as a “mirror image”, that is to say, it deals with the same problem we face today albeit in a different mode. Understanding our contemporary condition under the auspices of a Spinozist perspective, problems in countermeasures to the conspiratorial disputes come to (...) light. Scholarly work and practice focus on the epistemological dimension of conspiracy theories, tying in the extent to which they are problematic to the degree in which they deal in untruth. However, the lesson from Spinoza’s analysis of the theological-political disputes is that such theories do not deal in truth, but, in affect, they do not spring from a lack of education but a lack of certainty. The work of Spinoza opens up a different approach, and if our aim is like that of the TTP, to defend political life against the threat of civil war, such a different approach is in order. (shrink)

Introduction - This paper is aimed at gaining more insight into the effects of camera-surveillance on behavior. This study investigates the effects of three different ways of ‘framing’ camera presence on cheating behavior and pro-social behavior. First, we explore the effect of presenting the camera as the medium through which an intimidating authority watches the participant. Second, we test the effect of presenting the camera as being a neutral, non-intimidating viewer. Third, we investigate whether a participant watching themselves via a (...) camera has an effect on their behavior. In contrast to most studies of camera surveillance, we will conduct our experiments in an indoor setting, enabling us to investigate behavior to a much greater detail. We will also explore possible moderating effects of personality traits. Methods - 86 students participated in this experiment, distributed over four conditions: three different ways of framing the camera presence, plus a control condition. Our main dependent variables were various kinds of cheating and pro-social behavior. We established the participant’s relevant personality traits in a separate session. Results - For cheating behavior, findings showed that the ‘authorative’ way of framing camera presence and the situation in which participants viewed themselves, differed significantly from a situation without camera-surveillance. We did not find significant effects of camera surveillance on pro-social behavior during the experiment. Looking at personality traits, we found an indication that people with an internal locus of control are more inclined to cheat when there is no camera present compared to people with an external locus of control. However, the effects of our manipulations were stronger. Conclusion - These results support the idea that the framing of a camera’s presence does indeed influence cheating behavior, adding to the preventive effects of camera-surveillance. Additionally, this study provides some valuable insights into the influence of camera presence on behavior in general. (shrink)

There is ambiguity with regard to what counts as an acceptable level of risk in clinical research in pregnant women and there is no input from stakeholders relative to such research risks. The aim of our paper was to explore what stakeholders who are actively involved in the conduct of clinical research in pregnant women deem an acceptable level of risk for pregnant women in clinical research. Accordingly, we used the APOSTEL VI study, a low-risk obstetrical randomised controlled trial, as (...) a case-study. We conducted a prospective qualitative study using 35 in-depth semi-structured interviews and one focus group. We interviewed healthcare professionals, Research Ethics Committee members and regulators who are actively involved in the conduct of clinical research in pregnant women, in addition to pregnant women recruited for the APOSTEL VI case-study in the Netherlands. Three themes characterise the way stakeholders view risks in clinical research in pregnant women in general. Additionally, one theme characterises the way healthcare professionals and pregnant women view risks with respect to the case-study specifically. First, ideas on what constitutes an acceptable level of risk in general ranged from a preference for zero risk for the foetus up to minimal risk. Second, the desirability of clinical research in pregnant women in general was questioned altogether. Third, stakeholders proposed to establish an upper limit of risk in potentially beneficial clinical research in pregnant women in order to protect the foetus and the pregnant woman from harm. Fourth and finally, the case-study illustrates that healthcare professionals’ individual perception of risk may influence recruitment. Healthcare professionals, RECs, regulators and pregnant women are all risk adverse in practice, possibly explaining the continuing underrepresentation of pregnant women in clinical research. Determining the acceptable levels of risk on a universal level alone is insufficient, because the individual perception of risk also influences behaviour towards pregnant women in clinical research. Therefore, bioethicists and researchers might be interested in changing the perception of risk, which could be achieved by education and awareness about the actual benefits and harms of inclusion and exclusion of pregnant women. (shrink)

In this paper, we examine the relationship between Christian religiosity, attitudes towards corporate social responsibility, and CSR behavior of executives. We distinguish four types of CSR attitudes and five types of CSR behavior. Based on empirical research conducted among 473 Dutch executives, we find that CSR attitudes mediate the influence of religiosity on CSR behavior. Intrinsic religiosity positively affects the ethical CSR attitude and negatively affects the financial CSR attitude, whereas extrinsic religiosity stimulates the philanthropic CSR attitude. Financial, ethical, and (...) philanthropic CSR attitudes significantly affect some types of CSR behaviors. However, because religiosity has opposing effects on the three attitudes, the joint mediation effect of the three attitudes is negligible. Furthermore, we find a direct negative influence of intrinsic religiosity on diversity and a direct positive influence on charity. (shrink)

Fabi and Goldberg have helpfully shed some light on the wrongs perpetuated by the current funding architecture on research, sponsorship, and career development in the field of bioethics. The...

We analyze the cognitive strategies underlying performance in the Number task, a Math game that requires both arithmetic fluency and mathematical creativity. In this game all elements in a set of numbers have to be used precisely once to create a target number with basic arithmetic operations. We argue that some instances of this game are NP complete, by showing its relation to the well-known Partition problem. We propose heuristics based on the distinction in forward and backward reasoning. The Number (...) Game is part of Math Garden, a popular online educational platform for practicing and monitoring math skills using innovations in computerized adaptive testing. These educational games generate enormous amounts of rich data on children's cognitive development. We found converging evidence for the use of forward proximity heuristics in the data of Math Garden, consisting of more than 20 million answers to 1,700 items. Item difficulties and the structure of correct answers were analyzed. (shrink)

This article provides an affirmative feminist reading of the philosophy of Henri Bergson by reading it through the work of Karen Barad. Adopting such a diffractive reading strategy enables feminist philosophy to move beyond discarding Bergson for his apparent phallocentrism. Feminist philosophy finds itself double bound when it critiques a philosophy for being phallocentric, because the setup of a master narrative comes into being with the critique. By negating a gender-blind or sexist philosophy, feminist philosophy only reaffirms its parameters, and (...) setting up a master narrative costs feminist philosophy its feminism. I thus propose and practice a different methodological starting point, one that capitalizes on “diffraction.” This article experiments with the affirmative phase in feminist philosophy prophesied by Elizabeth Grosz, among others. Working along the lines of the diffractive method, the article at the same time proposes a new reading of Bergson (as well as of Barad), a new, different metaphysics indeed, which can be specified as onto-epistemological or “new materialist.”. (shrink)

This paper is on the update semantics for might of Veltman. Threeconsequence relations are introduced and studied in an abstract setting.Next we present sequent-style systems for each of the consequence relations.We show the logics to be complete and decidable. The paper ends with asyntactic cut elimination result.

Dynamic Epistemic Logic This article tells the story of the rise of dynamic epistemic logic, which began with epistemic logic, the logic of knowledge, in the 1960s. Then, in the late 1980s, came dynamic epistemic logic, the logic of change of knowledge. Much of it was motivated by puzzles and paradoxes. The number … Continue reading Dynamic Epistemic Logic →.

Sound and complete axiomatizations are provided for a number of different logics involving modalities for the knowledge of multiple agents and operators for branching time, extending previous work of Halpern, van der Meyden and Vardi [to appear, SIAM Journal on Computing] for logics of knowledge and linear time. The paper considers the system constraints of synchrony, perfect recall and unique initial states, which give rise to interaction axioms. The language is based on the temporal logic CTL*, interpreted with respect to (...) a version of the bundle semantics. (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)

Dynamic Epistemic Logic This article tells the story of the rise of dynamic epistemic logic, which began with epistemic logic, the logic of knowledge, in the 1960s. Then, in the late 1980s, came dynamic epistemic logic, the logic of change of knowledge. Much of it was motivated by puzzles and paradoxes. The number … Continue reading Dynamic Epistemic Logic →.

Theoretical models for physician-patient communication in clinical practice are described in literature, but none of them seems adequate for solving the communication problem in clinical practice that emerges in case of factitious disorder. Theoretical models generally imply open communication and respect for the autonomy of the patient. In factitious disorder, the physician is confronted by lies and (self)destructive behaviour of the patient, who in one way or another tries to involve the physician in this behaviour. It is no longer controversial (...) that the physician should communicate his consideration of a factitious disorder without insistence that the patient accepts this diagnosis. However, the balance between patient autonomy and open communication on the one hand, and the preservation of the patient's health, physician integrity and of a constructive physician-patient relationship on the other is easily disrupted. In this article, an epistemological model is described to facilitate a positive outcome of confrontation in treatment of factitious disorder. Analysing the problem in terms of systems theory will help the physician to assess what information is appropriate to use in which phase of the patient's treatment, while preserving the physician-patient relationship. (shrink)