This book studies the interfaces of ethics, economics, and politics. Public policy issues involve all three of these subjects. Although it may be seen as suggesting the nucleus of a joint university course, the book is accessible to and should interest all those concerned with political decisions. Any such decision needs a criterion for judging whether one action or outcome is better than another. Even a dictator must to some extent be concerned about the economic elfare of the citizens; and (...) a democratic government more so. But how is a person's economic welfare to be judged? Furthermore, any political decision affects the economic welfare of different people differently. How then is the welfare of a community to be judged? This is an ethical question. Underlying any coherent public policy there must be a relevant moral code. (shrink)

This book studies the interfaces of ethics, economics, and politics. Public policy issues involve all three of these subjects. Although it may be seen as suggesting the nucleus of a joint university course, the book is accessible to and should interest all those concerned with political decisions. Any such decision needs a criterion for judging whether one action or outcome is better than another. Even a dictator must to some extent be concerned about the economic welfare of the citizens; and (...) a democratic government more so. But how is a person's economic welfare to be judged? Furthermore, any political decision affects the economic welfare of different people differently. How then is the welfare of a community to be judged? This is an ethical question. Underlying any coherent public policy there must be a relevant moral code. (shrink)

Ian Little has been one of the most significant British contributors to economics in the post-war era. His contributions to Welfare Economics and Development Economics have been highly influential and well-regarded throughout the world. This book is a fascinating insight into the personal and intellectual development of Professor Little, containing both the most important articles of his working life and autobiographical chapters.

BackgroundHuntington’s disease has a poor prognosis. For HD patients in the Netherlands, one way of dealing with their poor prognosis is by drawing up an advance euthanasia directive. Little is known about the perspectives of HD patients on their AED.AimTo gain insight into patients’ views on and attitudes towards their AED, and changes over time.MethodsA longitudinal qualitative interview study using 1 to 6 semi-structured interviews over a period of maximum three years. Nine HD patients who either had an AED (...) or were thinking about drawing it up participated in this study.ResultsWe identified two themes that characterize patients’ perspectives on their AEDs: general character of the AED; uncertainty around their AED. Ad The conditions that the participants described in their AED were generally not very specific for the person. Mostly they were general notions of unbearable suffering. Familiarity with HD in the family could play a role in drawing up an AED. Ad Participants generally were aware of the tentative character of their AED and could have doubts concerning their own willingness or the willingness of others in the future. Sometimes these doubts were so great, that it prevented them from drawing up an AED. However, patients did not alter their AED during the follow-up period or changed in their view or attitude on their AED.ConclusionHD patients that draw up an AED usually describe general conditions for euthanasia and recognize that these conditions may change as the disease progresses. An AED or the wish to draw one up may be a good conversation starter for conversations about goals and preferences for future care. (shrink)

Background In the EU, clinical assessors, rapporteurs and the Committee for Medicinal Products for Human Use are obliged to assess the ethical aspects of a clinical development program and include major ethical flaws in the marketing authorization deliberation processes. To this date, we know very little about the manner that these regulators put this obligation into action. In this paper, we intend to look into the manner and the extent that ethical issues discovered during inspection have reached the deliberation (...) processes. Methods To gather data, we used the Dutch Medicines Evaluation Board database and first searched for the inspections, and their accompanying site inspection reports and integrated inspection reports, related to central marketing authorization applications of drugs submitted to the European Medicines Agency from 2011 to 2015. We then extracted inspection findings that were purely of ethical nature, i.e., those that did not affect the benefit/risk balance of the study. Only findings graded at least major by the inspectorate were included. Lastly, to identify how many of the ethically relevant findings reach the application deliberation processes, we extracted the relevant joint response assessment reports and reviewed the sections that discussed inspection findings. Results From 2011 to 2015, there were 390 processed applications, of which 65 had inspection reports and integrated inspection reports accessible via the database of the Dutch Medicines Evaluation Board. Of the 65, we found ERFs in 37. The majority of the ERFs were graded as major and half of the time it was informed-consent related. A third of these findings were related to research ethics committee processes and requirements. Of the 37 inspections with ERFs, 30 were endorsed in the integrated inspection reports as generally GCP compliant. Day 150 joint response assessment reports and Day 180 list of outstanding issues were reviewed for all 37 inspections, and none of the ERFs were carried over in any of the assessment reports or list of outstanding issues. Conclusion None of the ethically relevant findings, all of which were graded as major or critical in integrated inspection reports, were explicitly carried over to the joint assessment reports. This calls for more transparency in EMA application deliberations on how ERFs are considered, if at all, in the decision-making processes. (shrink)

A countably infinite relational structure M is called absolutely ubiquitous if the following holds: whenever N is a countably infinite structure, and M and N have the same isomorphism types of finite induced substructures, there is an isomorphism from M to N. Here a characterisation is given of absolutely ubiquitous structures over languages with finitely many relation symbols. A corresponding result is proved for uncountable structures.

Data from various settings suggest that there is an upper limit of about four on the number of individuals who can interact in spontaneous conversation. This limit appears to be a consequence of the mechanisms of speech production and detection. There appear to be no differences between men and women in this respect, other than those introduced by women’s lighter voices.

Nudges have gained popularity as a behavioral change tool that aims to facilitate the selection of the sensible choice option by altering the way choice options are presented. Although nudges are designed to facilitate these choices without interfering with people’s prior preferences, both the relation between individuals’ prior preferences and nudge effectiveness, as well as the notion that nudges ‘facilitate’ decision-making have received little empirical scrutiny. Two studies examine the hypothesis that a social proof nudge is particularly effective when (...) people have no clear prior preference, either because people are indifferent (in a colour-categorization task; Study 1, N = 255) or because people experience a choice conflict (making shopping decisions about meat products; Study 2, N = 97). Both studies employed a social proof nudge to steer participants’ choices. The potential facilitating effect of the nudge was tested using a mouse-tracker paradigm that implicitly assessed experienced uncertainty during decision-making. Results showed that the nudge was effective in steering participants’ decisions; the facilitation effect (i.e., reduced uncertainty regarding the decision) was only observed for conflicting preferences, but not under indifference. A better understanding of when and how nudges can influence individuals’ behavior may help in deciding whether nudges are an appropriate policy tool for changing particular undesirable behavior. (shrink)

Objectives Access to healthcare in most western societies is based on equality. Rapidly rising costs have fuelled debates about differentiation in access to healthcare. We assessed the public's perceptions and attitudes about differentiation in healthcare according to lifestyle behaviour. Methods A vignette study was undertaken in participants in a colorectal cancer screening pilot programme in the Netherlands. Screenees with a negative test result received a questionnaire in which nine hypothetical situations were described: three different healthcare settings (screening, lung cancer, chronic (...) obstructive pulmonary disease) combined with three forms of differentiation each: a difference in premium, waiting list ordering or copayment according to lifestyle. We evaluated the responses using a general hierarchical linear model. Results The percentage of participants in agreement with differentiation varied from 20% to 58% (overall mean of 40%). Significantly more participants were in favour of giving a premium discount to those who do not engage in unhealthy behaviour compared with supporters for higher payments for those who do. More differentiation was supported for non-smoking versus smoking cessation than for participation versus non-participation in screening. We observed in-group favouritism in smokers, but no significant effects of age or disease. There was no support for waiting list ordering based on lifestyle. Conclusions Results of this study show that Dutch citizens eligible for colorectal cancer screening are in favour of some form of financial differentiation in the distribution of healthcare, but that significant differences exist between type of setting and the type of behaviour. Our study can be used in the ongoing discussion about solidarity and behaviour in healthcare. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 68J The Theology of Henri de Lubac: An Overview. By HANS URS VON BALTHASAR. Translated by Joseph Fessio, S. J., Michael M. Waldstein (Preface), and Susan Clements (Conclusion). San Fran· cisco: Ignatius Press/Communio, 1991. Pp. 127. $9.95 (paper). Except for the preface and conclusion, Hans Urs von Balthasar's The Theology of Henri de Lubac first appeared as the long essay, "Henri de Lubac-L'oeuvre organique d'une vie," in (...) Nouvelle Revue Theologique 97 (1975), 897-913 and 98 (1976), 33-59, and translated by Joseph Fessio, S.J., as "The Achievement of Henri de Luhac" in Thought 51 (1976), 7-49. The preface was added soon after for the German edition, Henri de Lubac: Sein organisches Lebenswerk (Frei· burg im Breisgau: Johannes Verlag, 1976). The conclusion was added for Balthasar's and Jesuit Georges Chantraine's Le Cardinal de Lubac: L'Homme et son oeuvre (Paris: Ed. Lethielleux, 1983). While de Lubac denied " a true, personal philosophical or theo· logical synthesis " in the multiplicity of his oeuvre, he did believe that there could he found " a pattern that constitutes its unity " (de Luhac on p. 10). A more systematic work had been planned with Bruno de Solages, Peres Congar, Chenu, and others. In de Luhac's words, " the lightning bolt of Humani Generis killed the project" (p. 11). We can only wonder at what might have been. At the center of de Lubac's thought is a spiritual perception of "the essence of Christian mysticism" (p. 11). A hook on this subject was planned hut never completed; its fundamental importance was indicated by de Luhac in 1956: "I believe my hook on mysticism has inspired me for a long time in everything I work on; in its light I make my judgments and gain the criteria for ordering my thoughts and ideas" (p. 11). The purpose of Balthasar's little book is to trace these "great spiritual options of the master" (p. 26). Balthasar wrote his preface after he had received from de Luhac the manuscript that would he published as his Memoire sur l'occasion de mes ecrits (1989; ET: At the Service of the Church (1993]). Accord· ing to Balthasar, this "meandering" text has great value in display· ing the organic unity of de Luhac's writings in the contexts which occasioned them-" as well as the legendary condemnations and banish· ments prepared for him by his order and by the Church" (p. 9). De Luhac adopted the " fundamental elan " (p. 13) of Blondel, Marechal, and Rousselot. They enabled de Lubac to see in Thomas Aquinas " the paradox of the spiritual creature that is ordained beyond itself by the innermost reality of its nature to a goal that is unreachable for it and that can only he given as a gift of grace " (p. 13). Balthasar is unambiguous in his belief in the correctness of their interpretation. 684 BOOK REVIEWS Blondel, Marechal, and de Lubac were " martyrs for truth " (p. 13). De Lubac " exposed himself to the attacks of a tutiorist scholastic theology, armed with nothing but the historical and theological truth" (p. 13). Of the three, de Lubac was the most persecuted. The conflict with scholasticism is presented in all its sharpness. One must go back to Thomas himself, over the commentatorial tradition of John of St. Thomas and Cajetan, whose work represents, in the words of Gilson, " a successful ' corruptorium Sanctae Thomae.'... Thomas has been castrated by it" (p. 14). Gilson's "unqualified assent" to de Lubac's Thomistic conclusions means much to Balthasar, because it is "the assent of the greatest authority in the field of the history of phi· losophy" (p. 15). Upon reading Sumaturel (1946), Gilson wrote to de Lubac that the difference between the scholastic and the humanist theologians, like de Lubac, in part lies in the way they understand propositions. The scholastics " understand only univocal propositions and those that seem to be univocal. The former [humanist theologiansJ, by contrast, are more interested in the truth that the proposition attempts to formulate and that partly escapes it" (p. 14). In their incomprehension and fear of analogy, the scholastics are represented as hankering after a security that... (shrink)

The research of the thermal state of workers is associated with s ome ethical difficulties. The research work uses the method of rewards and bonuses for respondents. This argues the relevance of the discussion about the ethical principles of conducting hygienic and physiological studies in conditions of manufacturing.

Literature for children is often designed to stimulate imagination through variants of the “real” world that we inhabit, expanding their potential for construing different possible worlds – variants that include imaginary characters like animals with human traits or toys that are somehow animated and conscious. Here we will examine one version of Margery William’s classic nursery tale The Velveteen Rabbit, or How Toys Become Real, where the theme of “real” and imaginary characters and worlds is construed both linguistically and pictorially. (...) We will show how the theme is construed in both text and image, and how the two complement one another, together keeping the two worlds apart while at the same time representing the Velveteen Rabbit’s transformation from toy rabbit to real rabbit. (shrink)

Citizens today are increasingly expected to be knowledgeable about and prepared to engage with biomedical knowledge. In this article, I wish to reframe this ‘public understanding of science’ project, and place fresh emphasis on public understandings of research: an engagement with the everyday laboratory practices of biomedicine and its associated ethics, rather than with specific scientific facts. This is not based on an assumption that non-scientists are ‘ignorant’ and are thus unable to ‘appropriately’ use or debate science; rather, it is (...) underpinned by an empirically-grounded observation that some individuals may be unfamiliar with certain specificities of particular modes of research and ethical frameworks, and, as a consequence, have their autonomy compromised when invited to participate in biomedical investigations. Drawing on the perspectives of participants in my own sociological research on the social and ethical dimensions of neuroscience, I argue that public understanding of biomedical research and its ethics should be developed both at the community level and within the research moment itself in order to enhance autonomy and promote more socially robust science. Public bioethics will have to play a key role in such an endeavour, and indeed will contribute in important ways to the opening up of new spaces of symmetrical engagement between bioethicists, scientists and wider publics—and hence to the democratisation of the bioethical enterprise. (shrink)

In lieu of an abstract, here is a brief excerpt of the content: Classics and Complexity in Walden’s “Spring” M. D. USHER In 1843, two years before Henry Thoreau built his cabin at Walden Pond, the Fitchburg Railroad laid down tracks through the woods near the Pond for its line connecting Boston to Fitchburg. The original Fitchburg Line, at 54 miles long, was, until 2010, the longest run in the present -day MBTA Commuter Rail system. And it is one of (...) the oldest railways in New England. By 1900, fortunes swelled and the Fitchburg’s Hoosac Tunnel Line took passengers and goods westward toward Chicago. The Lake Champlain Route connected Boston to points north like Burlington, Vermont. (See Figure 1.) arion 27.1 spring/summer 2019 Figure 1 (left): Advertisement for the Hoosac Tunnel Route in The New England Magazine (Vol. 21, Issue 6, February, 1900). Figure 2 (right): Herbert Wendell Gleason. The Fitchburg Railroad and Walden Pond in winter, Concord, Mass., March 24, 1920. Courtesy Concord Free Public Library. The Railroad was literally a fixture in Thoreau’s landscape. Its tracks pass remarkably close to Walden Pond (Figure 2), and the Fitchburg Line—both its reality and the specter of it—is practically a character in his writing: “I usually go to the village along its causeway, and am, as it were, related to society by this link,” Thoreau writes in “Sounds,” a chapter of Walden that contains what must be one of the most picturesque odes (or laments) to rail travel and commerce in all of American literature: The engine’s whistle, Thoreau complains, pierces the still silence of his idyllic retreat like a screaming hawk circling a farmer’s field, its billows of steam an ominous harbinger of “this travelling demi-god, this cloud-compeller.”1 Thoreau’s frequent, customary walks into Concord along the railroad tracks took him through a heavily excavated stretch of the line known as the Deep Cut, to which he returned again and again each year in early spring, even after leaving the cabin, to observe and to record his observations. The leaf-shaped sand flows and trickling surface erosion caused by melting frost in the banks of the Deep Cut are elaborately described in Thoreau’s chapter in Walden entitled “Spring,” what Laurence Buell calls the “high point of Thoreau’s epic.”2 And yet, in spite of the universal acclaim of this passage as a literary tour de force, it has not received the full attention it deserves. What warrants fresh consideration first and foremost is “Spring”’s deep-rootedness in classical sources. Many classical influences, allusions, and a good deal of etymological word play have gone so far unnoticed. The chapter is also important because it describes, by intimation, what contemporary scientists now call emergence. Emergent phenomena are properties or behaviors that arise in systems as a result of complex, dynamic interactions amongst constituent parts, including changes to a system brought about by human interventions3—not only, e.g., climate change and wildfires, but also traffic patterns and terrorist networks; kidney function in the body; the rings of Saturn. As he tries to capture the essence of the 114 classics and complexity in WALDEN’s “spring” Deep Cut and interpret its significance, Thoreau adumbrates this concept, but also grapples ingeniously with broader issues of perennial concern—the relationship of Nature to Culture, for example, of Wilderness to Civilization, of Science to the Humanities—making “Spring” not only a probing work of eco-criticism and environmental philosophy, but of scientific reflection and poetic experiment as well. In short, Thoreau’s “Spring” is that rare work of classical reception that transmits both literary and scientific insight. Perhaps at this point, in lieu of accolades, it is best to let Thoreau start speaking for himself. What I offer in the following pages is a commentary on the Deep Cut passage from “Spring.” Classical references and aspects of systems theory will be explained and contextualized as they emerge, as it were, from Thoreau’s text. The whole chapter corresponds to pages 289–308 in Cramer’s edition of Walden—26 paragraphs all told, of which only the relevant ones are printed and annotated here. (Transitions and extraneous material are briefly summarized, as needed, in paraphrase... (shrink)