Health authorities increasingly request that general practitioners use information and communication technologies such as electronic patient records for accountability purposes. This article deals with the use of EPRs among general practitioners in Britain. It examines two ways in which GPs use the EPR for accountability purposes. One way is to generate audit reports on the basis of the information that has been entered into the record. The other is to let the computer intervene in the clinical process through prompts. The (...) article argues that GPs' ambivalence toward using the EPR makes them active in finding ways that turn the EPR into a meaningful tool for them, that is, a tool that helps them provide what they see as good care. The article's main contribution is to show how accountability and autonomy are coproduced; less professional autonomy does not follow from more requests to document one's work. Instead, new forms of autonomy are produced in the sociotechnical network that is made up by health policy and local engagements with patients and technology. (shrink)

To what extent can politics be part of education? Recent incidents indicate how educational activities aimed at raising political awareness are perceived by some as forms of ‘indoctrination’. This article explores, firstly, how philosophical perspectives might help us understand the notion of indoctrination in education. Drawing on the work of Hannah Arendt and Michael Hand, two notions of ‘indoctrination’ are discussed and subsequently problematized in light of classroom practices. Expanding our perspective to the larger historical context of reflections on education (...) and democracy, we then show how the dilemma of indoctrination should be understood as part of a tradition in pedagogical thinking that emphasizes the complex dynamics of socialization and critical thinking in education. Finally, we argue that from a pedagogical perspective, the issue is not whether or not certain educational activities might be forms of indoctrination, but to what extent these activities provide students an opportunity for both socialization and critical inquiry. (shrink)

Medical reproductive technologies have generated two new types of patients: ‘couples’ in infertility treatment and ‘fetuses’ in prenatal medicine. Using concepts from science and technology studies, specifically Latour’s (1993) notions of hybridity, mediation and purification, this article argues that these new patients are constructed in the very process of technological intervention in women’s bodies, while at the same time their constitutive role is erased from the medico-scientific accounts of these practices. Focusing on two discursive patterns found in the scientific discourses (...) on IVF as a treatment for male infertility, and fetal surgery for various congenital problems, the article shows how conceiving of couples and fetuses as patients allows many of the actual interventions on women to be ‘deleted’ from the accounts, while simultaneously presenting these interventions as being primarily about the treatment of men and children. The article exemplifies how a (feminist) constructivist analysis of the co-constitutive relation between technology and bodies (‘nature’) can avoid essentalism while retaining a critical perspective. (shrink)

In the medical-technological practice of in vitro fertilization, it is increasingly the couple, rather than an individual patient, that is considered the unit of treatment. This article traces some mechanisms involved in the construction of medical interventions on female bodies as appropriate and effective therapeutic solutions to problems and diagnoses pertaining to male bodies. It traces the transformation of male infertility through shifts in localization and definition of the problem, concomitant reconceptualizations of the techniques involved, redistributions of properties, and specific (...) ways of constructing "success. " It is argued that both the notion of the couple as the patient in cases of male infertility and the claim that IVF techniques are appropriate solutions to this couple's problem simultaneously presuppose and legitimize medical interventions on women's bodies. This double movement is produced by leaving exactly the required material work of physical interventions—and, consequently, the uneven distribution of costs between the sexes—out of scientific accounts of these practices. (shrink)

Biometrics is often described as `the next big thingin information technology'. Rather than IT renderingthe body irrelevant to identity – a mistaken idea tobegin with – the coupling of biometrics with ITunequivocally puts the body center stage. The questions to be raised about biometrics is howbodies will become related to identity, and what thenormative and political ramifications of this couplingwill be. Unlike the body rendered knowable in thebiomedical sciences, biometrics generates a readable body: it transforms the body's surfaces andcharacteristics into (...) digital codes and ciphers to be`read' by a machine. ``Your iris is read, in the sameway that your voice can be printed, and yourfingerprint can be read'', by computers that, in turn,have become ``touch-sensitive'', and endowed with seeingand hearing capacities. Thus transformed into readable``text'', the meaning and significance of the biometricbody will be contingent upon ``context'', and therelations established with other ``texts''. Thesemetaphors open up ways to investigate the differentmeanings that will become attached to the biometricbody and the ways in which it will be tied toidentity. This paper reports on an analysis of plans andpractices surrounding the `Eurodac' project, aEuropean Union initiative to use biometrics (specif.fingerprinting) in controlling illegal immigration andborder crossings by asylum seekers. (shrink)

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)

ABSTRACTAccording to many governments and educationalists, education should aim to develop dispositions conducive to political participation and solidarity, because democratic citizenship presupposes participation and solidarity. But there are radically different views on the nature of good citizenship. We examine the implications of this dissensus for citizenship education. Education, we contend, should involve and develop autonomy and open-mindedness. We argue that this requires a more critical approach than is possible when political participation and solidarity are conceived of as goals of education.

In this paper we discuss expected and reported effects on care provider-patient relations of the introduction of electronic patient records (EPRs) in consultation settings by reviewing exemplary studies and literature on the subject from the past decade. We argue that in order for such assessments to be meaningful, talk of effects of “the” EPR needs to be replaced by an “unpacking” of EPR systems into their constituent parts and functionalities, the effects of which need to be assessed individually. Following from (...) this principle, the paper discusses EPR systems ranging from simple data entry and retrieval systems to more sophisticated multi-user and multifunctional on-line systems. On a second level, our analysis of the literature is informed by the question which model of ideal patienthood underlies the assessment of effects of EPRs. To this end, we identify three “models of patienthood” implicit in writing about benefits and drawbacks of EPRs for patients: the autonomy, the consumer, and the holistic models, and argue that assumptions concerning these models need to be reflected upon more critically to improve understanding of what exactly EPR use does to the doctor-patient relationship. (shrink)

This work details the theological sources and moral significance of the life and work of the Scottish moral philosopher Adam Smith (1723-1790). The panel of contributors deepen our understanding of Adam Smith in his religious and theological context and the significance of this understanding for contemporary moral, economic, and political challenges to modern social life. The chapters cover a broad range of disciplinary and historical concerns, from Smith's view of providence and his famous "invisible hand" to the role of self-interest (...) and benevolence in Smith's social and economic thought. A better appreciation for the moral and theological dimensions of Smith's thought provides not only a better understanding of Smith's own context and significance in the Scottish Enlightenment, but also promises to assist in meeting the perennial challenges of properly connecting economic realities to moral responsibility. The book is of interest to advanced students and scholars of the history of economic thought, historical and moral theology, intellectual history, political science and philosophy. (shrink)

The paper discusses ten philosophical problems in deontic logic: how to formally represent norms, when a set of norms may be termed ‘coherent’, how to deal with normative conflicts, how contraryto-duty obligations can be appropriately modeled, how dyadic deontic operators may be redefined to relate to sets of norms instead of preference relations between possible worlds, how various concepts of permission can be accommodated, how meaning postulates and counts-as conditionals can be taken into account, and how sets of norms may (...) be revised and merged. The problems are discussed from the viewpoint of input/output logic as developed by van der Torre & Makinson. We argue that norms, not ideality, should take the central position in deontic semantics, and that a semantics that represents norms, as input/output logic does, provides helpful tools for analyzing, clarifying and solving the problems of deontic logic. (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)

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)

According to the logic of collective action, mere awareness of the causes of environmental degradation will not motivate rational agents to reduce pollution. Yet some government policies aim to enlist citizens in schemes of voluntary cooperation, drawing on an ethos of collective responsibility. Are such policies doomed to failure? This book provides a novel application of rational choice theory to a large-scale survey of environmental attitudes in The Netherlands. Its main findings are that rational citizens are motivated to cooperate towards (...) a less polluted environment to a large extent, but that their willingness to assume responsibility depends on the social context of the collective action problem they face. This empirical study is an important volume in the development of a more consistent foundation for rational choice theory in policy analysis, which seeks to clarify major theoretical issues concerning the role of moral commitment, self-interest and reciprocity in environmental behaviour. (shrink)

In recent years, schools and education authorities world wide have been paying increasing attention to issues surrounding diversity and religious tolerance. The term 'tolerance' is, however, clouded by considerable confusion and vagueness. This article seeks to contribute to recent scholarly attempts at understanding tolerance and the term that denotes it. After a brief semantic analysis of the term 'tolerance', arguments concerning the onticity of tolerance as phenomenon or entity are discussed. By examining its onticity we explore and explain some of (...) the essential features of tolerance. The article ends with a brief discussion of some of the implications of our examination that we foresee for education. (shrink)

Research suggests that sedentary behavior is negatively associated with cognitive outcomes. Interrupting prolonged sitting has been shown to improve cognitive functions, including executive functioning, which is important for academic performance. No research has been conducted on the effect of standing on EF in VET students, who make up a large proportion of the adolescent population and who are known to sit more than other students of this age. In this study, we investigated the acute effects of reducing SB by short (...) time standing on EF in vocational education and training students. In a randomized crossover study, 165 VET students were first taught for 15 min in seated position. After this, they performed while seated the Letter Memory Test for updating, and the Color Shape Test for shifting and inhibition. Students were randomly assigned to a sitting or standing condition. All students were taught again for 15 min and then took the same tests in the condition they were allocated to, respectively, standing or seated. After 1 week, the test procedure was repeated, in which students switched conditions. Mixed model analyses showed no significant effect of sitting or standing on updating, shifting, or inhibition. Also, no significant differences were found for the order of condition on updating, shifting, or inhibition. Our results suggest that 40 min of standing does not significantly influence EF among VET students. (shrink)

This article reflects a conversation between Jan G. van der Watt and Stephan Joubert. The article serves as the introduction to the Special Collection: ‘From timely exegesis to contemporary ecclesiology: Relevant hermeneutics and provocative embodiment of faith in a Corona-defined world – Festschrift for Stephan Joubert, sub-edited by Willem Oliver ’. Following a brief bio-statement as introduction, the following issues are discussed: the collection for the Jerusalem church; relevance of theology for society; social-scientific exegesis; the ancient concept of grace; Bible (...) translation in South Africa; public theology on the electronic platform; biblical examples of leadership and electronic media in religious activities and education.Contribution: This Festschrift represents current trends in biblical scholarship and ecclesial leadership. It contributes to the public discourse in church and society, especially the role of the electronic media in current Fourth Industrial Revolution. (shrink)

Many authors have argued that the core of evolutionary biology as represented by the catchphrase 'The fittest survive' is tautological. Concerning the fitness concept of population genetics it is easy to rebut this charge by a proper explication of the term 'survival'. In biology and in the philosophy of biology, various fitness concepts over and above that of population genetics have been elaborated. These concepts, which are called 'supervenient' by some philosophers, have a limited usefulness. On some interpretations they do (...) lead to unacceptable tautologies and circular reasoning. The so-called propensity concept of fitness is problematic in this respect. If interpreted in a proper way, supervenient concepts appear not to allow the formulation of highly general explanations and theories; at best they reveal common patterns among diverse non-general explanations and theories. Philosophers cherishing supervenient fitness concepts are apparently motivated by a mistaken search for general theory. The fitness concept of population genetics may play a role in relatively general theories and explanations. Supervenient concepts cannot play such a role. They should rather help us recognize the value of natural history in biology. (shrink)

Published here in paperback for the first time is much of a final and long-anticipated work by R. G. Collingwood on philosophy of history, of which subject he was the greatest exponent in the English language. The original text of this work was only recently discovered. It is accompanied by shorter unpublished writings by Collingwood on historical knowledge and inquiry. A lengthy editorial introduction sets these writings in their context, and discusses philosophical questions to which they give rise.

Does ethics have adequate general theories? Our analysis shows that this question does not have a straightforward answer since the key terms are ambiguous. So we should not concentrate on the answer but on the question itself. “Ethics” stands for many things, but we let that pass. “Adequate” may refer to varied arrays of methodological principles which are seldom fully articulated in ethics. “General” is a notion with at least three meanings. Different kinds of generality may be at cross-purposes, so (...) we must not expect theories to be general in sundry senses. “Theory,” for that matter, is itself ambiguous. Some thinkers say that ethics cannot have theories, while others deny it. We doubt whether opposing parties are talking about the same things.No wonder, then, that controversies in ethics are long-lasting and unproductive. We hope that the methodology we have presented will alleviate some of them. The examples we chose show that this is feasible. Views such as Hare's and Jonsen and Toulmin's which are seemingly wide apart, show convergence if we put them in a methodological perspective.Our analysis also suggests that many alleged differences between science and ethics could fade away if methodology is brought to bear on them. Specifically, the idea that ethics compares poorly with science in view of limited generality, or poor means of justification, is unfounded. Those who defend this view over-rate the powers of science. (shrink)

Science is not value-free and ethics is not fact-free. Science and ethics should be similar, but they are not. The author indicates how research in ethics is to change in the face of this. Ethicists should accommodate empirical work in their programs and they should take heed of methodologies developed in science and philosophy of science. They should abandon the search for a single overarching theory of morality. Controversies in ethics are often spurious for lack of articulate methodological key concepts. (...) For example, disagreements over the value of general theories are misguided since disputants implicitly use different notions of generality and different notions of theory. An appropriate methodology does not suffice for the resolution of controversies but it is indispensable for consensus. The book argues these theses in a general way and applies them to the subject of egoism and altruism in ethics. Further case studies concern the environment and psychiatric disorders. (shrink)

The pivotal problem of comorbidity research lies in the psychometric foundation it rests on, that is, latent variable theory, in which a mental disorder is viewed as a latent variable that causes a constellation of symptoms. From this perspective, comorbidity is a (bi)directional relationship between multiple latent variables. We argue that such a latent variable perspective encounters serious problems in the study of comorbidity, and offer a radically different conceptualization in terms of a network approach, where comorbidity is hypothesized to (...) arise from direct relations between symptoms of multiple disorders. We propose a method to visualize comorbidity networks and, based on an empirical network for major depression and generalized anxiety, we argue that this approach generates realistic hypotheses about pathways to comorbidity, overlapping symptoms, and diagnostic boundaries, that are not naturally accommodated by latent variable models: Some pathways to comorbidity through the symptom space are more likely than others; those pathways generally have the same direction (i.e., from symptoms of one disorder to symptoms of the other); overlapping symptoms play an important role in comorbidity; and boundaries between diagnostic categories are necessarily fuzzy. (shrink)

Lon Fuller, one of the great American jurists of this century, is often remembered only for his stand on the morality of law in the Fuller-Hart debate. Rediscovering Fuller considers the full range of Fuller's writings, from his early engagement with legal fictions and his critique of legal positivism to his later work on implicit law and the art of institutional design. Contributors from the fields of both civil law and common law argue that Fuller's insights are highly relevant to (...) contemporary concerns. The book contains essays by K. Winston, D. Dyzenhaus, P. Cliteur, F. Schauer ("Beyond the Fuller-Hart Debate"), P. Westerman, W. van der Burg, D. Luban ("Moralities of Law"), G. Postema, P. Teachout ("Implicit Law"), R. Macdonald, W. Witteveen, J. Allison, M. Hertogh, K. Soltan ("The Art of Institutional Design"), J. Allan, F. Mootz, J. Vining ("Law's Dialogue"), and a preface by Ph. Selznick. "At some point in the future, when we become more open to the moral relevance of social inquiry, more empirical in our study of philosophical issues, more capable of uniting moral and social theory, Lon Fuller's work will stand as a landmark. This volume will help show the way." —Ph. Selznick. (shrink)

The majority of commentators agree on one thing: Our network approach might be the prime candidate for offering a new perspective on the origins of mental disorders. In our response, we elaborate on refinements (e.g., cognitive and genetic levels) and extensions (e.g., to Axis II disorders) of the network model, as well as discuss ways to test its validity.

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)