Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of this study was to evaluate one way of organizing MCD in two Dutch nursing homes. In both of these nursing homes the MCD groups had a heterogeneous composition and were organized (...) apart from existing institutional communication structures. As part of a naturalistic evaluation, systematic observations, interviews and focus groups were completed. The findings indicate that the heterogeneous composition and MCD meetings separate from existing structures have benefits. However, the participants also reported negative experiences. This gives rise to the question whether a mixed MCD group which meets separately is an effective way to embed MCD as an instrument for reflection on moral issues in daily practice. We conclude that there is no single answer to that question. In the end, the two implementation strategies (i.e. within existing communication structures and a mixed MCD group) can be complementary to each other. (shrink)

Our study presents an overview of the issues that were brought forward by participants of a moral case deliberation (MCD) project in two elderly care organizations. The overview was inductively derived from all case descriptions (N = 202) provided by participants of seven mixed MCD groups, consisting of care providers from various professional backgrounds, from nursing assistant to physician. The MCD groups were part of a larger MCD project within two care institutions (residential homes and nursing homes). Care providers are (...) confronted with a wide variety of largely everyday ethical issues. We distinguished three main categories: ‘resident’s behavior’, ‘divergent perspectives on good care’ and ‘organizational context’. The overview can be used for agendasetting when institutions wish to stimulate reflection and deliberation. It is important that an agenda is constructed from the bottom-up and open to a variety of issues. In addition, organizing reflection and deliberation requires effort to identify moral questions in practice whilst at the same time maintaining the connection with the organizational context and existing communication structures. Once care providers are used to dealing with divergent perspectives, inviting different perspectives (e.g. family members) to take part in the deliberation, might help to identify and address ethical ‘blind spots’. (shrink)

Ethics support is called for to improve the quality of care in elderly institutions. Various forms of ethics support are presented, but the needs for ethics support remain unknown. Using a mixed-methods design, this article systematically investigates the specific needs for ethics support in elderly care. The findings of two surveys, two focus groups and 17 interviews demonstrate that the availability of ethics support is limited. There is a need for ethics support, albeit not unconditionally. Advice-based forms of ethics support (...) are less appropriate as they are removed from practice. Ethics support should be tailored to the often mundane and easily overlooked moral issues that arise in long-term care. Attention should also be given to the learning styles of nurses who favour experiential learning. Raising awareness and developing a climate of openness and dialogue are the most suitable ways to deal with the mundane moral issues in elderly care. (shrink)

Research on self-agency emphasizes the importance of a comparing mechanism, which scans for a match between anticipated and actual outcomes, in the subjective experience of doing.This study explored the “feeling of doing” in individuals with checking symptoms by examining the mechanism involved in the experienced agency for outcomes that matched expectations. This mechanism was explored using a task in which the subliminal priming of potential action-effects generally enhances people’s feeling of causing these effects when they occur, due to the unconscious (...) perception of a match between primed and observed outcomes. The main result revealed a negative relationship between checking and self-agency for observed outcomes that were primed prior to actions. This suggests that checking individuals fail to grasp the correspondence between actual outcomes of their actions and expected ones. We discuss the possible role of undermined self-agency in checking phenomena and its relationship with cognitive dysfunction. (shrink)

Clinical ethics support mechanisms in healthcare are increasing but little is known about the specific developments in elderly care. The aim of this paper is to present a systematic literature review on the characteristics of existing ethics support mechanisms in institutional elderly care. A review was performed in three electronic databases . Sixty papers were included in the review. The ethics support mechanisms are classified in four categories: ‘institutional bodies’ ; ‘frameworks’ ; ‘educational programmes and moral case deliberation’; and ‘written (...) documents and policies’. For each category the goals, methods and ways of organising are described. Ethics support often serves several goals and can be targeted at various levels: case, professional or organisation. Over the past decades a number of changes have taken place in the development of ethics support in elderly care. Considering the goals, ethics support has become more outreaching and proactive, aiming to qualify professionals to integrate ethics in daily care processes. The approaches in clinical ethics support have become more diverse, more focused on everyday ethical issues and better adapted to the concrete learning style of the nursing staff. Ethics support has become less centrally organised and more connected to local contexts and primary process within the organisation. (shrink)

This study examined cognitive representations of routine action, through the assessment of level of agency, in individuals with sub-clinical checking. The level of agency stems from Action Identification Theory [Vallacher, R. R., Wegner, D. M. . Levels of personal agency: Individual variation in action identification. Journal of Personality and Social Psychology 57, 660–671], which states that how actions are usually identified reflects the predominant accessibility of internal representation . Furthermore, this framework proposed that altered action regulation is related to low-level (...) of agency . In the current study, the main result indicated that checking symptoms were related to a low-level of agency, that is, individuals with sub-clinical checking identified habitual actions on the basis of instrumental aspects. This seems to indicate that checkers may act with a lack of goal representations. The results are discussed in terms of the role of low-level of agency in checking phenomena and related cognitive dysfunction. (shrink)

Exploration of Alfred North Whitehead's influence on Maurice Merleau-Ponty's ontology of nature.

_Exploration of Alfred North Whitehead's influence on Maurice Merleau-Ponty's ontology of nature._.

In paediatric oncology, research and treatments are often closely combined, which may compromise voluntary informed consent of parents. We identified two key scenarios in which voluntary informed consent for paediatric oncology studies is potentially compromised due to the intertwinement of research and care. The first scenario is inclusion by the treating paediatric oncologist, the second scenario concerns treatments confined to the research context. In this article we examine whether voluntary informed consent of parents for research is compromised in these two (...) scenarios, and if so whether this is also morally problematic. For this, we employ the account of voluntary consent from Nelson and colleagues, who assert that voluntary consent requires substantial freedom from controlling influences. We argue that, in the absence of persuasion or manipulation, inclusion by the treating physician does not compromise voluntariness. However, it may function as a risk factor for controlling influence as it narrows the scope within which parents make decisions. Furthermore, physician appeal to reciprocity is not controlling as it constitutes persuasion. In addition, framing information is a form of informational manipulation and constitutes a controlling influence. In the second scenario, treatments confined to the research context qualify as controlling if the available options are restricted through manipulation of options. Although none of the influences is morally problematic in itself, a combination of influences may create morally problematic instances of involuntary informed consent. Therefore, safeguards should be implemented to establish an optimal environment for parents to provide voluntary informed consent in an integrated research-care context. (shrink)

In paediatric oncology, research and treatments are often closely combined, which may compromise voluntary informed consent of parents. We identified two key scenarios in which voluntary informed consent for paediatric oncology studies is potentially compromised due to the intertwinement of research and care. The first scenario is inclusion by the treating paediatric oncologist, the second scenario concerns treatments confined to the research context. In this article we examine whether voluntary informed consent of parents for research is compromised in these two (...) scenarios, and if so whether this is also morally problematic. For this, we employ the account of voluntary consent from Nelson and colleagues, who assert that voluntary consent requires substantial freedom from controlling influences. We argue that, in the absence of persuasion or manipulation, inclusion by the treating physician does not compromise voluntariness. However, it may function as a risk factor for controlling influence as it narrows the scope within which parents make decisions. Furthermore, physician appeal to reciprocity is not controlling as it constitutes persuasion. In addition, framing information is a form of informational manipulation and constitutes a controlling influence. In the second scenario, treatments confined to the research context qualify as controlling if the available options are restricted through manipulation of options. Although none of the influences is morally problematic in itself, a combination of influences may create morally problematic instances of involuntary informed consent. Therefore, safeguards should be implemented to establish an optimal environment for parents to provide voluntary informed consent in an integrated research-care context. (shrink)

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

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)

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

Critical Concepts for the Creative Humanities is the first book to outline and define the specific and evolving field of the creative humanities and provides the field's nascent bibliography.

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)

A systematic study of testimony rooted in contemporary continental philosophy and drawing on literary case studies. From analytic epistemology to gender theory, testimony is a major topic in philosophy today. Yet, one distinctive approach to testimony has not been fully appreciated: the recent history of contemporary continental philosophy offers a rich source for another approach to testimony. In this book, Gert-Jan van der Heiden argues that a continental philosophy of testimony can be developed that is guided by those forms of (...) bearing witness that attest to limit experiences of human existence, in which the human is rendered mute, speechless, or robbed of a common understanding. In the first part, Van der Heiden explores this sense of testimony in a reading of several literary texts, ranging from Plato’s literary inventions to those of Kierkegaard, Melville, Soucy, and Mortier. In the second part, based on the orientation offered by the literary experiments, Van der Heiden offers a more systematic account of testimony in which he distinguishes and analyzes four basic elements of testimony. In the third part, he shows what this analysis implies for the question of the truth and the truthfulness of testimony. In his discussion with philosophers such as Heidegger, Derrida, Lyotard, Agamben, Foucault, Ricoeur, and Badiou, Van der Heiden also provides an overview of how the problem of testimony emerges in a number of thinkers pivotal to twentieth- and twenty-first-century thought. “The Voice of Misery is a special book. Van der Heiden has presented an argument that is poised to challenge discourse in analytic philosophy, reshape approaches in continental philosophy, and give new orientation to interdisciplinary research in continental philosophy and literary theory. The book will find a large readership across the discipline of philosophy and in several areas of the humanities.” — Theodore George, author of Tragedies of Spirit: Tracing Finitude in Hegel’s Phenomenology. (shrink)

L'empirisme transcendantal élaboré par Gilles Deleuze n'est pas le fruit du hasard : il résulte de lectures critiques et d'un véritable remaniement de concepts, notamment dans ses monographies des années cinquante et soixante. Or on lit généralement les œuvres de maturité de Deleuze sans trop s'attarder sur ces premiers écrits. De même, la question de la subjectivité dans son œuvre est souvent laissée au second plan, et l'on constate dans la littérature secondaire des opinions diamétralement opposées quant au statut du (...) sujet chez Deleuze. Le présent ouvrage reconstruit la notion deleuzienne de subjectivité à partir des premières monographies que le philosophe a consacrées à Hume, Kant, Nietzsche et Bergson. Il confronte les œuvres de ces auteurs aux monographies de Deleuze, et réarticule les concepts de la période de 'Différence et répétition' (singularités, habitudes, champ transcendantal, etc.) autour des questions sur la genèse et le statut de la subjectivité."--Page 4 of cover. (shrink)

We investigated how the perception of being dissimilar to others at work relates to employees’ felt inclusion, distinguishing between surface-level and deep-level dissimilarity. In addition, we tested the indirect relationships between surface-level and deep-level dissimilarity and work-related outcomes, through social inclusion. Furthermore, we tested the moderating role of a climate for inclusion in the relationship between perceived dissimilarity and felt inclusion. We collected survey data from 891 employees of a public service organization. An ANOVA showed that felt inclusion was lower (...) for individuals who perceived themselves as deep-level dissimilar compared to individuals who perceived themselves as similar, while felt inclusion did not differ among individuals who perceived themselves as surface-level similar or dissimilar. Furthermore, a moderated mediation analysis showed a negative conditional indirect relationship between deep-level dissimilarity and work-related outcomes through felt inclusion. Interestingly, while the moderation analysis showed that a positive climate for inclusion buffered the negative relationship between deep-level dissimilarity and felt inclusion, it also positively related to feelings of inclusion among all employees, regardless of their (dis)similarity. This research significantly improves our understanding of how perceived dissimilarity affects employees by distinguishing between surface-level and deep-level dissimilarity and by demonstrating the importance of a climate for inclusion. (shrink)

Few assumptions, argues Mara van der Lugt, are so stagnant, so rigid, so deeply walled in as the assumption that the decision to have children is by default a good thing; that having children is one of the most elevated aspects of human activity, and, indeed, of the human condition. This book is conceived as an open and reflective challenge to that assumption. The author argues that there are two questions in life that every person needs to answer for themselves: (...) one is the question of religion; the other is the question of begetting, a term which she chooses deliberately to restore a sense of 'strangeness and magnitude' to the idea. What does it mean to bring a new creature into the world? Or rather what does it mean to decide to perform an act of creation? What does it mean to make the decision that life is worth living on behalf of a person who cannot be consulted? To ask this question is to interrogate one's own responsibility and commitments, morally, philosophically, and personally. The question of begetting can never be purely one of preference or inclination, however we might wish it to be. This book is the author's attempt to raise some of these questions, if not fully to answer them. It is both a personal and philosophical exercise of filling out that moral background, in full awareness of the things that are at stake, and not in judgment but out of concern and compassion both for creators and created, and for those who are not yet created and those who are not (or not yet) creators. (shrink)

Edith Stein is widely known as a historical figure, a victim of the Holocaust and a saint, but still unrecognised as a philosopher. It was philosophy, however, that constituted the core of her life. Today her complete writings are available to scholars and therefore her thinking can be properly investigated and evaluated. In the final parts of the book, the author shows how Stein's ideas are relevant today, in particular to the ongoing doctrinal and legal debates over the concept of (...) human dignity. (shrink)

This text explores a set of key concepts in Marxist theory as developed and read by Lacan, demonstrating links and connections between Marxist thought and Lacanian practice. The book examines the complexity of these encounters through the structure of a comprehensive vocabulary which covers diverse areas, from capitalism and communism to history, ideology, politics, work, and family. Offering new perspectives on these concepts in psychoanalysis, as well as in the fields of political and critical theory, the book brings together contributions (...) from a range of international experts to demonstrate the dynamic relationship between Marx and Lacan, as well as illuminating 'untranslatable points' which may offer productive tension between the two. The entries trace the trajectory of Lacan's appropriation of Marx's concepts and analyses how they were questioned, criticized and reworked by Lacan, accounting for the wide reach of two thinkers and worlds in constant homology. Each entry also discusses psychoanalytic debates relating to the concept and seeks to refine the clinical scope of Marx's work, demonstrating its impact on the social and individual dimensions of Lacanian clinical practice. With a practical and structured approach, The Marx Through Lacan Vocabulary will appeal to psychoanalysts and researchers in a range of fields, including political science, cultural studies, and philosophy. (shrink)

A study of the philosophical and theological thought of Henry Cornelius Agrippa of Nettesheim (1486-1535). It contains new perspectives on Agrippa's place in the world of humanism and offers a new approach to the interpretation of Renaissance declamations.

The precautionary principle is often invoked in relation to pregnant women and may be one of the underlying reasons for their continuous underrepresentation in clinical research. The principle is appealing, because potential fetal harm as a result of research participation is considered to be serious and irreversible. In our paper, we explore through conceptual analysis whether and if so how the precautionary principle should apply to pregnant women. We argue that the principle is a decision-making strategy underlying risk-benefit decisions in (...) clinical research, which can be applied to pregnant women. However, the current application is a strong one, leading to the promotion of absolute exclusion or, less often, absolute inclusion of pregnant women. In order to change this paralyzing situation, a shift toward weak precautionary thinking is necessary. Instead of automatic extreme precaution, a balance will be found between harms and potential benefits of including pregnant women in clinical research. (shrink)

This edited volume looks at whether it is possible to be more transparent about uncertainty in scientific evidence without undermining public understanding and trust. With contributions from leading experts in the field, this book explores the communication of risk and decision-making in an increasingly post-truth world. Drawing on case studies from climate change to genetic testing, the authors argue for better quality evidence synthesis to cut through the noise and highlight the need for more structured public dialogue. For uncertainty in (...) scientific evidence to be communicated effectively, they conclude that trustworthiness is vital: the data and methods underlying statistics must be transparent, valid, and sound, and the numbers need to demonstrate practical utility and add social value to people's lives. Presenting a conceptual framework to help navigate the reader through the key social and scientific challenges of a post-truth era, this book will be of great relevance to students, scholars and policy makers with an interest in risk analysis and communication. (shrink)

The theme of the 6th biennial Radical Philosophy Association Conference, held at Howard University in Washington, D.C. in November 2004, was "Philosophy Against Empire." The U.S. imperial project, pursued by both Republican and Democratic administrations, has many dimensions, including military force and the mechanisms for its legitimation; the global economy and flows of money and people across borders; and biopolitics, or the disciplining of bodies through the micro-mechanisms of power apart from traditional forms of sovereignty. These issues are explored in (...) depth in these collected and revised essays from the Conference, along with the forms of subjectivity that can resist and respond to the alienation produced within and by the imperial project, toward the creation of an alternative global order. Authors include Karsten Struhl, Ann Ferguson, Edmund Byrne, David Cormier, Harry Targ, Jo-Ann Pilardi, Lucinda Joy Peach, Devin Zane Shaw, Tzuchien Tho, Eduardo Mendieta, Richard Schmitt, Richard Jones, Richard Peterson, Peter Amato, William McBride, Omar Dahbour, Kory Schaff, David Schweickart, and Carol Gould. (shrink)

Slavoj Zizek ist einer der prominentesten linken Intellektuellen. Der Sammelband lädt ein, Zizeks Ideen kritisch zu diskutieren, insbesondere sein Verständnis von Politik, politischen Organisationen und dem (vergangenen, gegenwärtigen und zukünftigen) Staat.

As early as 2002, CIOMS stated that pregnant women should be presumed eligible for participation in research. Despite this position and calls of other well‐recognized organizations, the health needs of pregnant women in research remain grossly under‐researched. Although the presumption of eligibility remains unchanged, the revision of the 2002 CIOMS International ethical guidelines for biomedical research involving human subjects involved a substantive rewrite of the guidance on research with pregnant women and related guidelines, such as those on fair inclusion and (...) vulnerability. However, close reading of the guidelines reveals morally relevant different approaches to fair inclusion of pregnant women and other under‐represented groups, such as children and incompetents. Where CIOMS sets out that children and adolescents must be included unless a good scientific reason justifies their exclusion, no such claim of having to justify exclusion appears in the guideline on pregnant women. Instead, CIOMS claims that research relevant to pregnant women’s health needs must be promoted. This paper analyses how and to what extent the guideline on pregnant women differs from other guidance on fair inclusion in the document. Accordingly, the paper evaluates to what extent the current phrasing may contribute to fair inclusion of pregnant women in research. We will conclude that a system change towards a learning health system is essential to break down the status quo of knowledge generation in the field of medication use during pregnancy and argue that the CIOMS guidelines allow for this system change. (shrink)

As early as 2002, CIOMS stated that pregnant women should be presumed eligible for participation in research. Despite this position and calls of other well‐recognized organizations, the health needs of pregnant women in research remain grossly under‐researched. Although the presumption of eligibility remains unchanged, the revision of the 2002 CIOMS International ethical guidelines for biomedical research involving human subjects involved a substantive rewrite of the guidance on research with pregnant women and related guidelines, such as those on fair inclusion and (...) vulnerability. However, close reading of the guidelines reveals morally relevant different approaches to fair inclusion of pregnant women and other under‐represented groups, such as children and incompetents. Where CIOMS sets out that children and adolescents must be included unless a good scientific reason justifies their exclusion, no such claim of having to justify exclusion appears in the guideline on pregnant women. Instead, CIOMS claims that research relevant to pregnant women’s health needs must be promoted. This paper analyses how and to what extent the guideline on pregnant women differs from other guidance on fair inclusion in the document. Accordingly, the paper evaluates to what extent the current phrasing may contribute to fair inclusion of pregnant women in research. We will conclude that a system change towards a learning health system is essential to break down the status quo of knowledge generation in the field of medication use during pregnancy and argue that the CIOMS guidelines allow for this system change. (shrink)

A brain-computer interface technology that can decode the neural signals associated with attempted but unarticulated speech could offer a future efficient means of communication for people with severe motor impairments. Recent demonstrations have validated this approach. Here we assume that it will be possible in future to decode imagined (i.e., attempted but unarticulated) speech in people with severe motor impairments, and we consider the characteristics that could maximize the social utility of a BCI for communication. As a social interaction, communication (...) involves the needs and goals of both speaker and listener, particularly in contexts that have significant potential consequences. We explore three high-consequence legal situations in which neurally-decoded speech could have implications:Testimony, where decoded speech is used as evidence;Consent and Capacity, where it may be used as a means of agency and participation such as consent to medical treatment; andHarm, where such communications may be networked or may cause harm to others. We then illustrate how design choices might impact the social and legal acceptability of these technologies. (shrink)

We were supposed to be in a 'postfeminist' age. But recently we've seen a resurgence of feminist campaigning among women (and some men). There's a new brand of feminism: young, social media savvy, militant. But there's also a new kind of backlash, driven by so-called fundamentalists and by increasingly overt misogyny. This book takes an international perspective on the new feminist movements.

Both the concept of a Darwinian tree of life (TOL) and the possibility of its accurate reconstruction have been much criticized. Criticisms mostly revolve around the extensive occurrence of lateral gene transfer (LGT), instances of uptake of complete organisms to become organelles (with the associated subsequent gene transfer to the nucleus), as well as the implications of more subtle aspects of the biological species concept. Here we argue that none of these criticisms are sufficient to abandon the valuable TOL concept (...) and the biological realities it captures. Especially important is the need to conceptually distinguish between organismal trees and gene trees, which necessitates incorporating insights into widely occurring LGT into modern evolutionary theory. We demonstrate that all criticisms, while based on important new findings, do not invalidate the TOL. After considering the implications of these new insights, we find that the contours of evolution are best represented by a TOL. (shrink)

Bijdragen over de actuele betekenis van de filosofie, met name de Reformatorische Wijsbegeerte.

In this dissertation, I defend a Russellian form of descriptivism. The main supporting argument invokes a relation between meaning and thought. I argue that the meanings of sentences are the thoughts people use them to express. This is part of a Gricean outlook on meaning according to which psychological intentionality is prior to, and determinative of, linguistic intentionality. The right approach to thought, I argue in Chapter 1, is a type of functionalism on which thoughts have narrow contents. On this (...) view, the attitude ascriptions of a regimented psychology capture what people really believe and desire. These attitude ascriptions have content clauses that are what David Lewis calls ‘modified Ramsey sentences.’ I then conclude that, since the meanings of sentences are the narrow contents of the thoughts speakers use them to express, the meanings of sentences can also be represented with such descriptive sentences. I extend the view so that it applies to individual words. The resulting view is a form of descriptivism. Referring, I claim in Chapter 2, is the expression of a de re attitude. I argue that the non-psychological, de re individuation of thoughts captures only contingent features of these thoughts. Furthermore, whether a thought counts as de re depends on the attributor’s context. These two characteristics carry over to reference. The referential properties of speech acts and expressions are merely contingent features. Furthermore, whether a speech act or expression counts as referring depends upon the attributor’s context. In Chapter 3, I apply this version of descriptivism to indexicals, demonstratives and names. Indexicals turn out to have non-descriptive, context-insensitive, semantically determined meanings. Demonstratives have descriptive, context-sensitive, pragmatically determined meanings. Names, finally, have descriptive, context-insensitive, semantically determined meanings. In the final chapter, I address Putnam's model-theoretic argument, the most formidable obstacle to the form descriptivism outlined here. I criticize Lewis's ‘magnetist’ solution that invokes primitive naturalness because it is committed to the existence of incorrigible error about the external world. I suggest an empiricist approach on which psychological intentionality, and so ultimately linguistic intentionality as well, is anchored in experience. (shrink)