Results of two survey studies are presented. It is shown that attitudes of the public about "technology in general" are not stable and can easily be affected by how the subject is introduced. Eight areas of technology are compared on the basis of empirical relations in attitudinal judgments, in attribute ratings, in self- assigned importance weights of attributes, and in importance of reference groups and persons. On the basis of similarities in these four kinds of judgments, three clusters of technology (...) areas were identified: a cluster of modern reproductive technologies, an information cluster containing automation, computer, and communication technologies, and a cluster containing nuclear energy and military technology. The attitude toward "technology in general" can not be considered as an aggregation of attitudes toward these areas of technology: The relations between general attitude and specific attitudes are only moderate to negligible. (shrink)

BackgroundPregnant people have been overlooked or excluded from clinical research, resulting in a lack of scientific knowledge on medication safety and efficacy during pregnancy. Thus far, both the opportunities to generate evidence-based knowledge beyond clinical trials and the role of pregnant people in changing their status quo have not been discussed. Some scholars have argued that for rare disease patients, for whom, just like pregnant people, a poor evidence base exists regarding treatments, solidarity has played an important role in addressing (...) the evidence gap. This paper explores whether and how the enactment of solidarity among pregnant people can be stimulated to help address the poor evidence base on medications used during pregnancy.MethodWe use the concept of solidarity formulated by Prainsack and Buyx and enrich their concept by providing an account for stimulating the enactment of solidarity. Then we apply this account to the case of pregnant people who use medication.ResultsSolidarity means enacted commitment on the part of an individual to assisting others with whom the person recognizes a similarity in a relevant respect. Although solidarity cannot be imposed, we argue that the empowerment of people is a crucial concept in understanding how solidarity can be stimulated. Empowerment in the context of pregnant people means creating awareness about their status quo, explaining how scientific research can help close the knowledge gap, and how pregnant people can themselves contribute. In particular, how pregnant people can contribute to the collection of health data to strengthen the evidence base for medications used during pregnancy.ConclusionsWe conclude that acting in solidarity can help change the status quo for pregnant people. Furthermore, we argue that the empowerment of pregnant people and other relevant stakeholders is a way to stimulate the enactment of solidarity. The process of empowerment starts by raising awareness about the lack of evidence on medications used during prengnacy and by explaining to pregnant people how they can contribute to changing the way knowledge is being generated by, for example, sharing data on the health effects of medications. (shrink)

OBJECTIVES: To identify the factors that influence the assessment of reported cases of physician-assisted death by members of the public prosecution. DESIGN/SETTING: At the beginning of 1996, during verbal interviews, 12 short case-descriptions were presented to a representative group of 47 members of the public prosecution in the Netherlands. RESULTS: Assessment varied considerably between respondents. Some respondents made more "lenient" assessments than others. Characteristics of the respondents, such as function, personal-life philosophy and age, were not related to the assessment. Case (...) characteristics, i.e. the presence of an explicit request, life expectancy and the type of suffering, strongly influenced the assessment. Of these characteristics, the presence or absence of an explicit request was the most important determinant of the decision whether or not to hold an inquest. CONCLUSIONS: Although the presence of an explicit request, life expectancy and the type of suffering each influenced the assessment, each individual assessment was dependent on the assessor. The resulting danger of legal inequality and legal uncertainty, particularly in complicated cases, should be kept to a minimum by the introduction of some form of protocol and consultation in doubtful or boundary cases. The notification procedure already promotes a certain degree of uniformity in the prosecution policy. (shrink)

The aim of this research was to gain insight into the experiences and perspectives of individual members of a Medical Research Ethics Committee regarding their individual roles and possible tensions within and between these roles. We conducted a qualitative interview study among members of a large MREC, supplemented by a focus group meeting. Respondents distinguish five roles: protector, facilitator, educator, advisor and assessor. Central to the role of protector is securing valid informed consent and a proper risk-benefit analysis. The role (...) of facilitator implies that respondents want to think along with and assist researchers in order to help medical science progress. As educators, the respondents want to raise ethical and methodological awareness of researchers. The role of advisor implies that respondents bring in their own expertise. The role of assessor points to contributing to the overall evaluation of the research proposal. Various tensions were identified within and between roles. Within the role of protector, a tension is experienced between paternalism and autonomy. Between the role of protector and facilitator tensions occur when the value of a study is questioned while risks and burdens for the subjects are negligible. Within the role of assessor, a tension is felt between the implicit nature of judgments and the need for more explicit formulations. Awareness of various roles and responsibilities may prevent one-sided views on MREC work, not only by members themselves, but also by researchers. Tensions within and between the roles require reflection by MREC members. (shrink)

The European Clinical Trials Directive (EU 2001; 2001/20/EC) was introduced to improve the efficiency of commercial and academic clinical trials. Concerns have been raised by interested organizations and institutions regarding the potential for negative impact of the Directive on non-commercial European clinical research. Interested researchers within the European Group for Blood and Marrow Transplantation (EBMT) were surveyed to determine whether researcher experiences confirmed this view. Following a pilot study, an internet-based questionnaire was distributed to individuals in key research positions in (...) the European haemopoietic SCT community. Seventy-one usable questionnaires were returned from participants in different EU member states. The results indicate that the perceived impact of the European Clinical Trials Directive has been negative, at least in the research areas of interest to the EBMT. (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)

Background: Caring for terminally ill patients is a meaningful task, however the patient’s suffering can be a considerable burden and cause of frustration.Objectives: The aim of this study is to describe the experiences of general practitioners in The Netherlands in dealing with a request for euthanasia from a terminally ill patient.Methods: The data, collected through in-depth interviews, were analysed according to the constant comparative method.Results: Having to face a request for euthanasia when attempting to relieve a patient’s suffering was described (...) as a very demanding experience that GPs generally would like to avoid. Nearly half of the GPs strive to avoid euthanasia or physician assisted suicide because it was against their own personal values or because it was emotional burdening to be confronted with this issue. They explained that by being directed on promoting a peaceful dying process, or the quality of end-of-life of a patient by caring and supporting the patient and the relatives it was mainly possible to shorten patient’s suffering without “intentionally hastening a patient’s death on his request”. The other GPs explained that as sometimes the suffering of a patient could not be lessened they were open to consider a patient’s request for euthanasia or physician assisted suicide. They underlined the importance of a careful decision-making process, based on finding a balance between the necessity to shorten the patient’s suffering through euthanasia and their personal values.Conclusion: Dealing with requests for euthanasia is very challenging for GPs, although they feel committed to alleviate a patient’s suffering and to promote a peaceful death. (shrink)

Research on social influences often distinguishes between social and quality incentives to ascribe meaning to the value that popularity conveys. This study examines the neural correlates of those incentives through which popularity influences preferences. This research reports an functional magnetic resonance imaging experiment and a behavioral task in which respondents evaluated popular products with three focus perspectives; unspecified focus, focus on social aspects, and focus on quality. The results show that value derived with a social focus reflects inferences of approval (...) and reward value, and positively affects preferences. Value derived with a quality focus reflects inferences of quality and negatively affects preferences. This study provides evidence of two distinct inferential routes on both a neurological level, represented by different regions in the brain, and a behavioral level. These results provide the first evidence that a single popularity cue can in different ways influence the value derived from product popularity. (shrink)

After having defined the KARO logic for specifying intelligent agents in earlier work we now turn to the question how to realise agents specified in the KARO framework. To this end we look at agent programming languages that we have defined, and investigate how programs in these languages can be linked to the KARO logic.

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)

Route memory is frequently assessed in virtual environments. These environments can be presented in a fully controlled manner and are easy to use. Yet they lack the physical involvement that participants have when navigating real environments. For some aspects of route memory this may result in reduced performance in virtual environments. We assessed route memory performance in four different environments: real, virtual, virtual with directional information (compass), and hybrid. In the hybrid environment, participants walked the route outside on an open (...) field, while all route information (i.e., path, landmarks) was shown simultaneously on a handheld tablet computer. Results indicate that performance in the real life environment was better than in the virtual conditions for tasks relying on survey knowledge, like pointing to start and end point, and map drawing. Performance in the hybrid condition however, hardly differed from real life performance. Performance in the virtual environment did not benefit from directional information. Given these findings, the hybrid condition may offer the best of both worlds: the performance level is comparable to that of real life for route memory, yet it offers full control of visual input during route learning. (shrink)

We analyze the cognitive strategies underlying performance in the Number task, a Math game that requires both arithmetic fluency and mathematical creativity. In this game all elements in a set of numbers have to be used precisely once to create a target number with basic arithmetic operations. We argue that some instances of this game are NP complete, by showing its relation to the well-known Partition problem. We propose heuristics based on the distinction in forward and backward reasoning. The Number (...) Game is part of Math Garden, a popular online educational platform for practicing and monitoring math skills using innovations in computerized adaptive testing. These educational games generate enormous amounts of rich data on children's cognitive development. We found converging evidence for the use of forward proximity heuristics in the data of Math Garden, consisting of more than 20 million answers to 1,700 items. Item difficulties and the structure of correct answers were analyzed. (shrink)

AbstractWhen considering the manner of death, two categories can be distinguished, namely natural death and unnatural death. Though most physicians think that the distinction between the two is evident, this is not the case.When comparing the Netherlands, Belgium, England and Germany it is noticed that the terms natural and unnatural might be used in law but are not defined by law. In practice, the term unnatural death is used when there is an external cause of death, but even that turns (...) out to not be sufficient in making an obvious difference between the two terms. Different countries may even label the same death differently. A, at times philosophical and semantic, discussion shows that when it comes to causes of death a very large grey area exists between natural and unnatural causes of death. The Netherlands, Belgium and Germany even have the possibility to label a death as natural without actually knowing the cause of death.In conclusion, we recommend a new system in which the circumstances surrounding a death are properly investigated. This should lead to a report to an independent legal expert, who is able to decide if and what conclusion can be drawn, from a judicial and a public point of view, thereby, making the distinction and the use of the terms natural and unnatural/nonnatural obsolete. (shrink)

As we owe the division of ecology into autecology and synecology to botanists, the arguments for this subdivision and also the definitions and contents of both subsciences as given bySchröter, Flahault &Schröter, Gams andDu Rietz are communicated in full. The same is the case with the division of ecology given by the zoologistsAdams andChapman. Moreover the opinions of these authors in this respect are critisized in detail as well as in their general aspects. This critique is connected with the author's (...) own positive opinion, which is given at the end of the paper, where also the remarks covered by the first two papers of this series are summarised.In ecology as a biological science either the individual or the complex of individuals has to occupy a central position. Therefore science about the environment, especially the abiotic one, as well as science about a definite region or spot of the earth ought not to be incorporated in biology.In autecology the individual occupies a central position, it is one of the subsciences of idiobiology, it is a science about the relations to environment, taken in the broadest sense. Dependent upon the contents of this we have many definitions of ecology, the most important ones being: 1) ecology is a biogeographical subscience; 2) ecology is taken in the sense of ethology; 3) ecology is taken as a science of the teleological relations of the individual to its environment and the objects in it, thus of the non-causal relations, the causal ones being assigned to physiology. These non-causal relations appear under four aspects, all called teleological, i.e. the true purpose-notion, relation in the sense of requirement, that in the sense of wholeness, and of adaptation and the degree of adaptation. Adaptation is taken in a broad sense, covering as well the degree of adaptation , as the latitude of the possibility of adaptation and the degree of variability of the individual to adapt itself. The proposal is made to confine the term autecology to this teleological aspect of the relations of the individual, i.e. of all its characters, not of the epharmonic ones only, to environment.In synecology the complex of individuals, showing direct real connections during individual life, occupies a central position, with equal scientific interest for all members of the complex. Synecology contains all biological scientific contents about this matter. The application ofTschulok's system of subsciences to synecology is critisized and the development of the system of these subsciences is left to its developmental fate in time. Considering the importance of the knowledge of the tendencies of thought for the development of synecology an attempt is made to state those already applied in synecology; author distinguishes the systematical, the mathematical, the causal, the historical, the teleological and the essential tendency of thought. Also the difference in the tendencies of thought shows that autecology and synecology are to be separated in a logical system of biological subsciences.Puisque c'est aux botanistes que nous devons la division de l'écologie en autécologie et synécologie, l'auteur passe en revue tous les arguments qui ont amené les biologistes à faire cette subdivision, ainsi que les définitions de ces deux subsciences et les matières qu'elles comprennent, comme elles sont données parSchröter, Flahault &Schröter, Gams etdu Rietz. Il en fait de même pour la division de l'écologie faite par les zoologistesAdams etChapman. En outre il discute les opinions de ces auteurs sous ce rapport, dans leurs détails aussi bien que dans leurs aspects généraux. Cette discussion est en rapport avec l'opinion positive de l'auteur, qu'il expose à la fin de l'article, où se trouvent résumées également les remarques qui se trouvaient déjà dans les deux premiers articles de cette série.Dans l'écologie, en tant que science biologique, l'individu — ou bien l'ensemble des individus — doit occuper une position centrale. C'est pourquoi ni la science qui concerne le milieu, en particulier le milieu abiotique, ni la science qui se rapporte à une région ou un endroit défini de la terre, ne devrait être incorporée dans la biologie.Dans l'autécologie l'individu occupe une position centrale. Cette science est une des subsciences de l'idiobiologie; elle se rapporte aux relations entre le sujet et son milieu — „milieu” pris dans le sens le plus large du mot. Selon les significations diverses qu'on peut attacher aux termes „relations” et „milieu”, nous avons plusieurs définitions de l'écologie, parmi lesquelles les plus importantes suivent ci-dessous:1)L'écologie est une subscience biogéographique; 2) le terme „écologie” est pris dans le sens d'éthologie; 3) l'écologie est considérée comme la science des relations téléologiques entre l'individu et son milieu et les objets se trouvant dans ce milieu; elle est donc considérée comme la science des relations non-causales, les relations causales étant conférées à la physiologie. Ces relations non-causales se présentent sous quatre aspects, tous appelés téléologiques, c. à. d. la vraie notion de but, les relations dans le sens de besoins, les relations dans le sens de „tout” et les relations dans le sens d'adaptation et de degré d'adaptation.Le mot „adaptation” est pris dans un sens étendu, comprenant aussi bien le degré d'adaptation que l'amplitude de la possibilité d'adaptation et le degré de variabilité dans l'adaptation de l'individu à son milieu. L'auteur propose de restreindre le terme „autécologie” à cet aspect téléologique des relations entre l'individu et son milieu; il s'agit ici, bien entendu, de toutes les qualités de l'individu et non seulement des qualités epharmoniques.Dans la synécologie l'ensemble des individus montrant des rapports directs et réels durant la vie individuelle occupe une position centrale et offre un intérêt scientifique pareil pour tous les membres de l'ensemble. La synécologie comprend tout ce qu'il y a à dire sur cette matière par rapport à la science biologique. L'application du système des subsciences deTschulok à la synécologie est critiquée par l'auteur, qui juge prématuré de s'occuper déjà d'un tel système de subsciences: l'avenir seul nous apprendra quel système se développera ici. Vu l'importance d'une connaissance exacte des différentes tendances de penser pour le développement de la synécologie, l'auteur s'efforce de rassembler celles qui ont déjà été appliquées dans la synécologie; il distingue les tendances de penser systématique, mathématique, causale, historique, téléologique et essentielle . En outre les différences entre ces tendances de penser démontrent, que l'autécologie et la synécologie doivent être séparées dans un système logique de subsciences biologiques. (shrink)