Die Autoren stellen eine psychohistorische Studie vor, deren Ziel es war, die Verarbeitungsmodi traumatischer Erfahrungen aus dem Zweiten Weltkrieg in einem überwiegend psychoanalytischen Forschungsdesign zu untersuchen. An ausgewähltem Forschungsmaterial wird der Prozess der transgenerationalen Weitergabe aufgezeigt und als Performance konzeptualisiert. Zugleich legen die Autoren den Erkenntnisweg und Erkenntniswert der psychoanalytischen Methode dar, arbeiten den Wert der »Forschungsmethode Gruppe« heraus und treten für ihre selbstbewusste systematische Anwendung in der Sozialforschung ein.

Hugh of Saint-Victor's De Sacramentis is usually regarded as an early summa of theology. As such it has been regarded as not totally satisfying, lacking a clearness of its conceptual system when compared with the work of e.g. Peter the Lombard. What may make up for this lack of system and even confer coherence, be it on a different level, is Hugh's pedagogical view of creation and salvation history, as it shows most clearly in his tropological digressions. In his exposition (...) of the history of salvation as it unfolds since the very beginning, Hugh incorporates the process by which the monk can not only follow the story of the macrocosm, but at the same time can read his self into being, allowing recognition of ambivalence from the start, and thus presenting a multi-demensional view of being human. In the same way as, on the cosmic level, any pre-lapsarian state of innocence exhibits a flaw from the very beginning, so the life of man is in a permanent state of ambiguity. This ambiguity is the framework for man as a moral being. Only within the possibility of choice can man be just or happy, without choice justus and beatus have no real significance. Matters are shown to be even more complicated when, in the story of Eve Hugh draws attention to her doubtful interpretation of God's command, as a factor which precedes her choice. In this way, De Sacramentis is not only a doctrina in our sense of the content of Christian dogma, but it offers the monk a point to which he can attach and conform his intentio: by bringing his intentio in form with the story about creation and fall and reparation, the reader can in fact effect the necessary reparatio, consisting of knowledge of truth and love of virtue. (shrink)

Since 1968, the French intelligentsia has almost unanimously deserted left positions in favor of either apolitical or diaper-soft liberal alternatives. What is interesting here is that virtually no change of personnel has taken place and that this change has come about with all the noise usually accompanying conversions of this type. The rejection of the figure of the engaged left intellectual typified, for example, by Sartre in 1968, was only apparently a retreat, since the very same intellectuals have stepped into (...) the gap they created and are now posing either as disengaged intellectuals or paroaying engagement. That is no doubt quite a trick. (shrink)

De filosofie van Schopenhauer is nu van een verbijsterende actualiteit. Om weg te komen uit onze ondergangsstemming, waanzinnig politiek beleid en de 2030 Agenda biedt Schopenhauer een stevig handvat. De weg vooruit is de weg terug. Joris van Rossum is filosoof en Schopenhauer-expert."--Publisher information.

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As Chinese Studies in Philosophy enters its twenty-fifth year, we wish to thank the editor since its inception, Professor Cheng Chung-ying of the University of Hawaii, for his many years of service, and to welcome with this issue our new editor, Professor Michael Schoenhals of Stockholm University.

Background Genuine uncertainty on superiority of one intervention over the other is called equipoise. Physician-investigators in randomized controlled trials need equipoise at least in studies with more than minimal risks. Ideally, this equipoise is also present in patient-participants. In pediatrics, data on equipoise are lacking. We hypothesize that 1) lack of equipoise at enrolment among parents may reduce recruitment; 2) lack of equipoise during participation may reduce retention in patients assigned to a less favoured treatment-strategy. Methods We compared preferences of (...) parents/patients at enrolment, documented by a questionnaire, with preferences developed during follow-up by an interview-study to investigate equipoise of child-participants and parents in the BeSt-for-Kids-study. This trial in new-onset Juvenile Idiopathic Arthritis-patients consists of three strategies. One strategy comprises initial treatment with a biological disease-modifying-antirheumatic-drug, currently not standard-of-care. Semi-structured interviews were conducted with 23 parents and 7 patients, median 11 months after enrolment. Results Initially most parents and children were not in equipoise. Parents/patients who refused participation, regularly declined due to specific preferences. Many participating families preferred the biological-first-strategy. They participated to have a chance for this initial treatment, and would even consider stopping trial-participation when not randomized for it. Their conviction of superiority of the biological-first strategy was based on knowledge from internet and close relations. According to four parents, the physician-investigator preferred the biological-first-strategy, but the majority stated that she had no preferred strategy. In phase 2, preferences tended to change to the treatment actually received. Conclusions Lack of equipoise during enrolment did not reduce study recruitment, mainly due to the fact that preferred treatment was only available within the study. Still, when developing a trial it is important to evaluate whether the physicians’ research question is in line with preferences of the patient-group. By exploring so-called ‘informed patient-group’-equipoise, successful recruitment may be enhanced and bias avoided. In our study, lack of equipoise during trial-participation did not reduce retention in those assigned to a less favoured option. We observed a change for preference towards treatment actually received, possibly explained by comparable outcomes in all three arms. (shrink)

The next World Congress of Bioethics will be held in Doha, Qatar. Although this location provides opportunities to interact with a more culturally diverse audience, to advance dialogue between cultures and religions, offer opportunities for mutual learning, there are also huge moral concerns. Qatar is known for violations of human rights ‐ including the treatment of migrant workers and the rights of women ‐ corruption, criminalization of LGBTQI+ persons, and climate impact. Since these concerns are also key (bio)ethical concern we (...) call for a broad debate within the bioethics community whether organizing and attending the World Congress in Qatar is ethically problematic and how ethical concerns should be dealt with. (shrink)

Spatial relations are central to geometrical thinking. With respect to the classical elementary geometry of Euclid’s Elements, a distinction between co-exact, or qualitative, and exact, or metric, spatial relations has recently been advanced as fundamental. We tested the universality of intuitions of these relations in a group of Senegalese and Dutch participants. Participants performed an odd-one-out task with stimuli that in all but one case display a particular spatial relation between geometric objects. As the exact/co-exact distinction is closely related to (...) Kosslyn’s categorical/coordinate distinction, a set of stimuli for testing all four types was used. Results suggest that intuitions of all spatial relations tested are universal. Yet, culture has an important effect on performance: Dutch participants outperformed Senegalese participants and stimulus layouts affect the categorical and coordinate processing in different ways for the two groups. Differences in level of education within the Senegalese participants did not affect performance. (shrink)

There is considerable support for the idea that an atmosphere of safety can foster learning in groups, especially during ethics training courses. However, the question how safety dynamics works during ethics courses is still understudied. This article aims to investigate safety dynamics by examining a critical incident during a military ethics train-the trainer course during which safety was threatened. We examine this incident by means of a four-factor analysis model from the field of Theme-Centered Interaction (TCI). We show that during (...) ethics training courses a safety paradox can occur, involving a tension between honesty and openness to other perspectives and values. Finally, we discuss how trainers can foster safety during ethics training. (shrink)

In this article ethical issues are discussed which play a role in pharmacogenetics. Developments in pharmacogenetics have a large impact on many different practices such as clinical trials, the practice of medicine and society at large. In clinical trials, questions rise regarding the exclusion of genetic subgroups that may be non- or poor-responders to the experimental drug. Also, the question is asked how pharmaceutical companies should deal with their growing knowledge about the relations between genetic variation and adverse effects. Moreover, (...) pharmacogenetics may provide disease-specific predictive information which may have a significant impact on the relations between physicians, patients and their relatives in the practice of medicine. Here, issues also arise regarding responsibility of patients and physicians for health and disease. In the society at large, the high costs of new pharmacogenetic possibilities lead to questions concerning solidarity and fair distribution on a national as well as an international level. It is concluded that in the near future, ethical research should be focused on the themes responsibility, inclusion and exclusion and global justice. (shrink)

The cognitive processing of spatial relations in Euclidean diagrams is central to the diagram-based geometric practice of Euclid's Elements. In this study, we investigate this processing through two dichotomies among spatial relations—metric vs topological and exact vs co-exact—introduced by Manders in his seminal epistemological analysis of Euclid's geometric practice. To this end, we carried out a two-part experiment where participants were asked to judge spatial relations in Euclidean diagrams in a visual half field task design. In the first part, we (...) tested whether the processing of metric vs topological relations yielded the same hemispheric specialization as the processing of coordinate vs categorical relations. In the second part, we investigated the specific performance patterns for the processing of five pairs of exact/co-exact relations, where stimuli for the co-exact relations were divided into three categories depending on their distance from the exact case. Regarding the processing of metric vs topological relations, hemispheric differences were found for only a few of the stimuli used, which may indicate that other processing mechanisms might be at play. Regarding the processing of exact vs co-exact relations, results show that the level of agreement among participants in judging co-exact relations decreases with the distance from the exact case, and this for the five pairs of exact/co-exact relations tested. The philosophical implications of these empirical findings for the epistemological analysis of Euclid's diagram-based geometric practice are spelled out and discussed. (shrink)

In this paper, we give an axiomatization of the ordinal number system, in the style of Dedekind’s axiomatization of the natural number system. The latter is based on a structure $(N,0,s)$ consisting of a set N, a distinguished element $0\in N$ and a function $s\colon N\to N$. The structure in our axiomatization is a triple $(O,L,s)$, where O is a class, L is a class function defined on all s-closed ‘subsets’ of O, and s is a class function $s\colon O\to (...) O$. In fact, we develop the theory relative to a Grothendieck-style universe (minus the power set axiom), as a way of bringing the natural and the ordinal cases under one framework. We also establish a universal property for the ordinal number system, analogous to the well-known universal property for the natural number system. (shrink)

This study investigated the relationship between the development of students? self-regulated learning and students? perceptions of the learning environment in terms of autonomy support, the emphasis on relevance and collaborative learning. In addition, we compared innovative learning environments that aim to enhance self-regulated learning with traditional learning environments. Questionnaires for measuring self-regulated learning and perceptions of the learning environment were administered by 648 students. Self-regulated learning was measured at the start of secondary education and again half way through the first (...) year. The results point to the importance of how students perceive the learning environment for self-regulated learning. There was a positive relationship between autonomy support and relevance and self-regulated learning. Furthermore, students in innovative environments perceived more autonomy support, more emphasis on relevance and more collaborative learning than those in traditional environments. Students in innovative environments, however, reported no more self-regulated learning than students in traditional environments. (shrink)

Despite the reported limited success of conventional treatments and growing evidence of the effectiveness of adult bariatric surgery, weight loss operations for (morbidly) obese children and adolescents are still considered to be controversial by health care professionals and lay people alike. This paper describes an explorative, qualitative study involving obesity specialists, morbidly obese adolescents, and parents and identifies attitudes and normative beliefs regarding pediatric bariatric surgery. Views on the etiology of obesity—whether it should be considered primarily a medical condition or (...) more a psychosocial problem—seem to affect the specialists’ normative opinions concerning the acceptability of bariatric procedures as a treatment option, the parents’ feelings regarding both being able to influence their child’s health and their child being able to control their own condition, and the adolescents’ sense of competence and motivation for treatment. Moreover, parents and adolescents who saw obesity as something that they could influence themselves were more in favor of non-surgical treatment and vice versa. Conflicting attitudes and normative views—e.g., with regard to concepts of disease, personal influence on health, motivation, and the possibility of a careful informed consent procedure—play an important role in the acceptability of bariatric surgery for childhood obesity. (shrink)

With technological possibilities in healthcare steadily increasing, more tools for digital cognitive rehabilitation become available. Acceptance of such technological advances is crucial for successful implementation. Therefore, we examined technology acceptance specifically for this form of rehabilitation in a sample of healthcare providers involved in cognitive rehabilitation. An adjusted version of the Technology Acceptance Model questionnaire was used, including the subscales for perceived usefulness, perceived ease of use, subjective norm, and intention to use, which all contribute to actual use of a (...) specific technology. Results indicate a generally favorable attitude toward the use of digital cognitive rehabilitation and positive responses toward the TAM constructs. Only for subjective norm, a neutral mean response was found, indicating that this could pose a potential obstacle toward implementation. Potential differences between subgroups of different age, gender, and professional background were assessed. Age and gender did not affect the attitude toward digital cognitive rehabilitation. Occupational therapists showed lower scores than healthcare psychologists and physiatrists with regard to perceived usefulness, possibly linked to a difference in operational and managerial tasks. The findings of his study stimulate further implementation of digital cognitive rehabilitation, where the role of subjective norms should be specifically considered. (shrink)

Background Massively parallel sequencing techniques, such as whole exome sequencing (WES) and whole genome sequencing (WGS), may reveal unsolicited findings (UFs) unrelated to the diagnostic aim. Such techniques are frequently used for diagnostic purposes in pediatric cases of developmental delay (DD). Yet policy guidelines for informed consent and return of UFs are not well equipped to address specific moral challenges that may arise in these children’s situations. Discussion In previous empirical studies conducted by our research group, we found that it (...) is sometimes uncertain how children with a DD will develop and whether they could come to possess capacities for autonomous decision-making in the future. Parents sometimes felt this brought them into a Catch-22 like situation when confronted with choices about UFs before undergoing WES in trio-analysis (both the parents’ and child’s DNA are sequenced). An important reason for choosing to consent to WES was to gain more insight into how their child might develop. However, to make responsible choices about receiving or declining knowledge of UFs, some idea of their child’s future development of autonomous capacities is needed. This undesirable Catch-22 situation was created by the specific policy configuration in which parents were required to make choices about UFs before being sequencing (trio-analysis). We argue that this finding is relevant for reconfiguring current policies for return of UFs for WES/WGS and propose guidelines that encompass two features. First, the informed consent process ought to be staged. Second, differing guidelines are required for withholding/disclosing a UF in cases of DD appropriate to the level of confidence there is about the child’s future developmental of autonomous capacities. Conclusion When combined with a dynamic consent procedure, these two features of our guidelines could help overcome significant moral challenges that present themselves in the situations of children undergoing genomic sequencing for clarifying a DD. (shrink)

Esta es una reseña de dos volúmenes sobre la herencia antillana: Antilliaans erfgoed, volumen 1: Toen en un y volumen 2: Nu en verder, editados por Gert Oostindie & Alex van Stipriaan, en Leiden, Países Bajos, por Leiden University Press, en 2021. El primero consta de 288 páginas y el segundo de 282 páginas, cuentan con el ISBN 978 90 8728 355 1+2.

Review of Georges Didi-Huberman (2022) Het Voortleven van de Vuurvliegjes. Vertaling: Ineke van der Burg. Amsterdam: Octavo Publicaties.

The use of psychopharmaceuticals to enhance human mental functioning such as cognition and mood has raised a debate on questions regarding identity and authenticity. While some hold that psychopharmaceutical substances can help users to ‘become who they really are’ and thus strengthen their identity and authenticity, others believe that the substances will lead to inauthenticity, normalization, and socially-enforced adaptation of behaviour and personality. In light of this debate, we studied how persons who actually have experience with the use of psychopharmaceutical (...) medication would view their ‘self’ or their authentic personal identity in relation to the use of medication. We have interviewed a number of adults diagnosed with ADHD and discussed their experiences with medication use in relation to their conceptions of self and identity. In the first part of this paper we illustrate that the concepts of identity and authenticity play an important and sometimes problematic role in experiences of ADHD adults. This shows that the question about identity and psychopharmacology is not merely an ‘academic’ issue, but one that influences everyday lives of real people. In order to answer the question whether psychopharmaceuticals threaten personal identity and authenticity, more than empirical research is needed. We also need to analyse the concepts of personal identity, authenticity and self: what do we mean when we are using statements as ‘a way of living that is uniquely our own’, ‘our true self’, or ‘who we really are’? In the second part of this paper we discuss two important philosophical views on personal identity, authenticity and self: the self-control view as elaborated by Frankfurt, and the self-expression view as proposed by Schechtman. We compare these with the experiences of our respondents to see which view can help us to understand the diverse and often conflicting experiences that people have with medication for ADHD. This will contribute to a better understanding of whether and in which cases personal identity and authenticity are threatened by psychopharmacology. (shrink)

Epigenetic markers could potentially be used for risk assessment in risk-stratified population-based cancer screening programmes. Whereas current screening programmes generally aim to detect existing cancer, epigenetic markers could be used to provide risk estimates for not-yet-existing cancers. Epigenetic risk-predictive tests may thus allow for new opportunities for risk assessment for developing cancer in the future. Since epigenetic changes are presumed to be modifiable, preventive measures, such as lifestyle modification, could be used to reduce the risk of cancer. Moreover, epigenetic markers (...) might be used to monitor the response to risk-reducing interventions. In this article, we address ethical concerns related to personal responsibility raised by epigenetic risk-predictive tests in cancer population screening. Will individuals increasingly be held responsible for their health, that is, will they be held accountable for bad health outcomes? Will they be blamed or subject to moral sanctions? We will illustrate these ethical concerns by means of a Europe-wide research programme that develops an epigenetic risk-predictive test for female cancers. Subsequently, we investigate when we can hold someone responsible for her actions. We argue that the standard conception of personal responsibility does not provide an appropriate framework to address these concerns. A different, prospective account of responsibility meets part of our concerns, that is, concerns about inequality of opportunities, but does not meet all our concerns about personal responsibility. We argue that even if someone is responsible on grounds of a negative and/or prospective account of responsibility, there may be moral and practical reasons to abstain from moral sanctions. (shrink)