In this article, the authors present several topics related to the nascent development of a merit-based hiring system in North Macedonia. This paper employs a normative approach. We advocate for a merit-based hiring system, similar to the American model. First, we explore the pressure exerted by the European Commission to adopt a merit-based system at all levels of government as a condition for entry into the European Union. Second, we delve into the patronage system in North Macedonia. Third, we provide (...) a short history of patronage in the United States and the difficulty that nation had in curbing its entrenched patronage system. Fourth, we discuss the advantages of a merit-based hiring system, namely the creation of good governance, the improvement of employee morale, the development of more public confidence in government, the reduction of the influence of ethnic politics and the furtherance of the rule of law. Finally, we present an example drawn from the American federal government about the basic procedures of a merit-based hiring process. (shrink)

Cartwright and Munro argued that extrapolation of findings from randomized controlled trials to other settings can be difficult because information about the underlying causal structure and subgroups is often not available. They advocated the use of ‘capacities’ – that is fixed causal contributions – in predicting effects of interventions. In psychiatry, it is often not possible to determine what the fixed causal contributions are and one can only establish ‘approximate capacities’. However, using ‘approximate capacities’ does imply a different way of (...) evaluating health services, especially combined interventions. In health service research, if different studies, randomized controlled trials or other designs, have given different outcomes, the best way to investigate the effectiveness of a particular way of service organization is not to conduct more randomized controlled trials. It is preferable to study the effects of certain elements of the complex intervention, which have been tested before in other settings, that is investigating ‘approximate capacities’. One should check whether the separate elements do form a part of the complex intervention in practice and whether they have the same effect as in other studies and if not, why not. This enhances knowledge about the underlying causal structure and increases the possibility of extrapolation of the findings. (shrink)

This paper addresses the concept of moral luck. Moral luck is discussed in the context of medical error, especially an error of omission that occurs frequently, but only rarely has adverse consequences. As an example, a failure to compare the label on a syringe with the drug chart results in the wrong medication being administered and the patient dies. However, this error may have previously occurred many times with no tragic consequences. Discussions on moral luck can highlight conflicting intuitions. Should (...) perpetrators receive a harsher punishment because of an adverse outcome, or should they be dealt with in the same way as colleagues who have acted similarly, but with no adverse effects? An additional element to the discussion, specifically with medical errors, is that according to the evidence currently available, punishing individual practitioners does not seem to be effective in preventing future errors. The following discussion, using relevant philosophical and empirical evidence, posits a possible solution for the moral luck conundrum in the context of medical error: namely, making a distinction between the duty to make amends and assigning blame. Blame should be assigned on the basis of actual behavior, while the duty to make amends is dependent on the outcome. (shrink)

Een van de kenmerken van de wijsgerige theologie zoals die in de Utrechtse school wordt beoefend, is de nadruk op een persoonlijk Godsbegrip. Daarom wordt voor de bijdragen gebundeld in Hoe is uw Naam? Opstellen over de eigenschappen van God geclaimd ‘dat over de eigenschappen van God niet op abstracte wijze wordt gespeculeerd, maar dat zij afgelezen worden uit het persoonlijk handelen van God jegens mens en wereld’. In het artikel ‘Conceptuele analyse en christelijk geloof. Over de wijsgerige theologie in (...) Utrecht’ heb ik geprobeerd aan te tonen dat deze claim slechts in beperkte mate wordt waar gemaakt. (shrink)

Crisis resolution and home treatment teams have been introduced into mental health care in the UK because, in general, patients do not want to be admitted to hospital, treatment at home is cheaper and in the only randomized controlled trial conducted so far there was no difference in symptomatic outcome. However, because of compulsory gate-keeping by CRHT teams, some patients no longer have the option of going to hospital if they want to. This aspect of the introduction of CRHT teams (...) has not been discussed so far, but it certainly warrants further examination. Intervention through CRHT teams may in fact increase compulsory admissions and serious and untoward incidents, although this is not certain. Sufferers from psychosis are the patient group most likely to be compulsorily admitted to hospital and they are generally considered less responsible for serious and untoward incidents. Therefore, a possible solution could be to offer a choice to some patients, namely those with a psychotic disorder, on whether they want to be admitted or not. At least one should investigate what the consequences of this policy would be, if it were to be adopted in a test region. This example shows that in developing policies for rationing health care, it can be important to look at subgroups and not just at average results when determining the best course of action. (shrink)

In an era of climate change, deforestation, melting ice caps, poisoned environments, and species loss, many people are turning to the power of the arts and humanities for sustainable solutions to global ecological problems. Introduction to the Environmental Humanities offers a practical and accessible guide to this dynamic and interdisciplinary field. This book provides an overview of the Environmental Humanities' evolution from the activist movements of the early and mid-twentieth century to more recent debates over climate change, sustainability, energy policy, (...) and habitat degradation in the Anthropocene era. The text introduces readers to seminal writings, artworks, campaigns, and movements while demystifying important terms such as the Anthropocene, environmental justice, nature, ecosystem, ecology, posthuman, and non-human. Emerging theoretical areas such as critical animal and plant studies, gender and queer studies, Indigenous studies, and energy studies are also presented. Organized by discipline, the book explores the role that the arts and humanities play in the future of the planet. Including case studies, discussion questions, annotated bibliographies, and links to online resources, this book offers a comprehensive and engaging overview of the Environmental Humanities for introductory readers. For more advanced readers, it serves as a foundation for future study, projects, or professional development. (shrink)

(2001). Looking toward the future of clinical trials: The application of communication variables to the recruitment of women into breast cancer clinical trials. World Futures: Vol. 57, Future Trends in Communications Strategies, pp. 599-613.

In this article the author shows that we must distinguish between criterion as a characteristic in a definition and as a norm for truth and ethical values. He shows that we must accept a hierarchy of such criteria, But that this hierarchy is not absolute. He also discusses and solves the 'paradox of the publican'.