Although law is established on a strong presumption that persons younger than a certain age are not competent to consent, statutory age limits for asking children’s consent to clinical research differ widely internationally. From a clinical perspective, competence is assumed to involve many factors including the developmental stage, the influence of parents and peers, and life experience. We examined potential determining factors for children’s competence to consent to clinical research and to what extent they explain the variation in competence judgments.

BackgroundFor many decades, the debate on children’s competence to give informed consent in medical settings concentrated on ethical and legal aspects, with little empirical underpinnings. Recently, data from empirical research became available to advance the discussion. It was shown that children’s competence to consent to clinical research could be accurately assessed by the modified MacArthur Competence Assessment Tool for Clinical Research. Age limits for children to be deemed competent to decide on research participation have been studied: generally children of 11.2 (...) years and above were decision-making competent, while children of 9.6 years and younger were not. Age was pointed out to be the key determining factor in children’s competence. In this article we reflect on policy implications of these findings, considering legal, ethical, developmental and clinical perspectives.DiscussionAlthough assessment of children’s competence has a normative character, ethics, law and clinical practice can benefit from research data. The findings may help to do justice to the capacities children possess and challenges they may face when deciding about treatment and research options. We discuss advantages and drawbacks of standardized competence assessment in children on a case-by-case basis compared to application of a fixed age limit, and conclude that a selective implementation of case-by-case competence assessment in specific populations is preferable. We recommend the implementation of age limits based on empirical evidence. Furthermore, we elaborate on a suitable model for informed consent involving children and parents that would do justice to developmental aspects of children and the specific characteristics of the parent-child dyad.SummaryPrevious research outcomes showed that children’s medical decision-making capacities could be operationalized into a standardized assessment instrument. Recommendations for policies include a dual consent procedure, including both child as well as parents, for children from the age of 12 until they reach majority. For children between 10 and 12 years of age, and in case of children older than 12 years in special research populations of mentally compromised patients, we suggest a case-by-case assessment of children’s competence to consent. Since such a dual consent procedure is fundamentally different from a procedure of parental permission and child assent, and would imply a considerable shift regarding some current legislations, practical implications are elaborated. (shrink)

The theme of Aesthetics in Present Future concerns the new chances the arts have and the deep changes they are undergoing, due to the new media, and the digital world in which we are growingly immersed. That this world is to be understood from an aesthetic point of view, become clear if we think of how much of what we produce, and observe and study is offered through images in particular and perceptual means in general.

Advances in multiagent simulation techniques make it possible to study more realistic dynamics of complex systems and allow evolutionary theories to be tested. Here I use simulations to assess the relative importance of reproductive systems (haplodiploidy vs. diploidy), mate selection (assortative mating vs. random mating) and social economics (pay-off matrices of evolutionary games) in the evolutionary dynamics leading to the emergence of social cooperation in the provision of parental care. The simulations confirm that haplo-diploid organisms and organisms mating assortatively have (...) a higher probability for fixing alleles and require less favorable conditions for their fixation, than diploids or organisms mating randomly. The simulations showed that social behavior was most likely to emerge a) when the cost for parental investment was much lower than the benefits to the offspring, b) when cooperation improved synergistically the fitness of offspring compared to the corresponding egoistic behavior and c) when alleles coding for altruistic or social behavior could be rapidly fixed in the population, thanks to mechanisms such as haplo-diploidy and/or assortative mating. Cooperative social behavior always appeared if sociality conferred much higher fitness gains compared to non cooperative alternatives suggesting that the most important factors for the emergence and maintenance of social behavior are those based on energetic or efficiency considerations. The simulations, in congruence with the scant experimental evidence available, suggest that economic considerations rather than genetic ones are critical in explaining the emergence and maintenance of sociality. (shrink)

This collection of essays, offered in honor of the distinguished career of prominent political philosophy professor Clifford Orwin, brings together internationally renowned scholars to provide a wide context and discuss various aspects of the virtue of “humanity” through the history of political philosophy.

This collection of essays, offered in honor of the distinguished career of prominent political philosophy professor Clifford Orwin, brings together internationally renowned scholars to provide a wide context and discuss various aspects of the virtue of “humanity” through the history of political philosophy.

Background The COVID-19 pandemic has influenced the approach to the health-disease system, raising the question about the principles of bioethics present in physician–patient relations. The principles while widely accepted may not be sufficient for a comprehensive ethical analysis. Therefore, the aim of this study was to explore the perception of these principles and the physician–patient relationship during a hospital stay through a qualitative approach. Method Sixteen semi-structured interviews took place to know the patients’ perception during their 2020 hospitalization for COVID-19. (...) The data was analyzed through the constant comparison method, creating categories and comparing them. In the end, seven categories were established and were grouped in three: bioethical principles (dignity, charity, vulnerability, autonomy), doctor-patient relationship (participant commitment, informed consent, health staff-patient relationship) and the experience of the disease (illness, the role of the family). Results The research found that most patients described a positive experience, with the feeling of having been well cared for with no sense of discrimination or injustice done. The majority also reported that their autonomy was respected in the treatment decisions. The evaluation of these attitudes is an area of opportunity, especially when the patients' vulnerability is at risk. Conclusions The ethics of virtue offers a better reflection of how human beings manifest themselves by emphasizing the development of virtuous character and behaviors that allow them to realize their values in life. Authorized by the Research Ethics Committee with registration: DI/18/105-B/3/308. (shrink)

Drawing from the Boulding''s (1956) framework for general systems theory, the need to employ richer paradigm in the study of organizations (Pondy and Mitroff, 1979) is reiterated. It is argued that a better understanding of organizational ethical behavior is contingent upon viewing organizations as symbol processing systems of shared language and meanings. Further, it is proposed that organizations, like individuals, develop into collectivities of shared cognitions and rationale, over a period of time. The study adapts Kohlberg''s (1983) model of moral (...) development to examine if organizations can be viewed as passing through different stages of moral development depending on the type of moral reasoning employed to explain their behaviors in the face of ethical crises. Several cases raising questions about the ethics of corporate behavior were researched. An instrument entitled Organization Response Analysis was constructed using statements made by various spokespersons representing five of these organizations. The instrument was administered to 246 graduate and undergraduate students of business (N = 246). Results indicated a great degree of concurrence among respondents of differing genders, levels of education and work experience in determining the stages of moral development of organizations. Limitations of the current study and implications for future research and practice are discussed. (shrink)

These days the two most popular approaches to belief ascription are Millianism and Contextualism. The former approach is inconsistent with the existence of ordinary Frege cases, such as Lois believing that Superman flies while failing to believe that Clark Kent flies. The Millian holds that the only truth-conditionally relevant aspect of a proper name is its referent or extension. Contextualism, as I will define it for the purposes of this essay, includes all theories according to which ascriptions of the form (...) ‘S believes that a is F’ and ‘S believes that b is F’, where ‘a’ and ‘b’ are coreferential proper names, may, depending on the context, differ in truth-value even though in those very contexts each ascription relates the same believer to the very same proposition. What the two theories have in common is the claim that names are Millian. What separates the two theories is what they say about belief contexts. In this essay I prove that Millianism is true, Contextualism is true, or our intuitions regarding belief ascriptions are hopelessly inaccurate. As a consequence, my argument is a proof that either names and many general terms are Millian or our intuitions regarding belief ascriptions are hopelessly inaccurate. (shrink)

Even after multiple cycles of ABET accreditation, many engineering programs are unsure of how much curriculum content is needed to meet the requirements of ABET’s Criterion 3.f (an understanding of professional and ethical responsibility). This study represents the first scholarly attempt to assess the impact of curriculum reform following the introduction of ABET Criterion 3.f. This study sought to determine how much professional and ethical responsibility curriculum content was used between 1995 and 2005, as well as how, when, why, and (...) to what effect changes in the amount of content occurred. Subsequently, the study sought to evaluate if different amounts of curriculum content generated differing student outcomes. The amount of curriculum content used by each of the participating programs was identified during semi-structured interviews with program administrators and a review of ABET Self-Study documents. Quantitative methods were applied to determine if a relationship existed between the curriculum content and performance on a nationally administered, engineering-specific standardized examination. The findings indicate a statistical relationship, but a lack of structure between the amount of required content in the curriculum and performance on the examination. Additional findings were also generated regarding the way that programs interpret the Criterion 3.f feedback generated during accreditation visits. The primary impact of this study is that it dispels the myth that more courses or course time on professionalism and ethics will necessarily lead to positive engineering education outcomes. Much of the impetus to add more curriculum content results from a lack of conclusive feedback during ABET accreditation visits. (shrink)

‘Ivravit in mea uerba tota Italia sponte sua et me belli quo uici ad Actium ducem depoposcit.’ In these words the Emperor Augustus clearly meant to suggest that the war in which he got rid of Mark Antony was none of his making, but was imposed upon him by the free and self-determined action of the Italian nation. Modern historians have unanimously refused to regard Augustus as a passive instrument in the hands of the Roman people at large; yet they (...) have generally accepted his account of the oath-taking of 32 B.C. as the outcome of a spontaneous burst of enthusiasm in his behalf, which they interpret as the reflex result of the nation's resentment against Antony's un-Roman and treasonable behaviour. (shrink)

Although a personal god of mixed moral character is logically possible, no personal god that has been represented as less than wholly good has gained more than a strictly local appeal. The Judaeo-Christian god is no exception. The god is represented as merciful, kind, longsuffering, forgiving, loving - in a word, wholly good. Of course, representing a god as wholly good is one thing; providing a convincing defence of his goodness is quite another. Indeed, many would contend that of all (...) the defences provided within the Judaeo-Christian system, the defence of the goodness of God is the least convincing. (shrink)

In a recent number of the CLASSICAL QUARTERLY , under the title ‘Neaera as a Common Name,’ Mr. Postgate writes: ‘There are two undoubted instances of this use of Neaera in Prudentius which are cited by Mr. Ullman.’ This is indeed a very welcome admission, for, unless I am greatly mistaken, Mr. Postgate was formerly of the opinion that such a usage or anything approaching it was unthinkable in Latin.1 But Mr. Postgate still feels uneasy about it, for he says: (...) ‘I imagine however that to an unprejudiced sense of Latin usage these instances will themselves seem to be strange and in need of explanation…. Now is there anything in Neaera or its history which will account for this ? Let us examine the possibilities. And first those offered by etymology…. But it may be thought that it acquired its objectionable colour through the reputed conduct of some particular Neaera of legend or history.’ We are now on common ground, for of course there can be no type-names or common names without some reason. (shrink)