Coastal ecosystems are increasingly dominated by humans. Consequently, the human dimensions of sustainability science have become an integral part of emerging coastal governance and management practices. But if we are to avoid the harsh lessons of land management, coastal decision makers must recognize that humans are one of the more coastally dependent species in the biosphere. Management responses must therefore confront both the temporal urgency and the very real compromises and sacrifices that will be necessary to achieve a sustainable coastal (...) ecosystem, one that is economically feasible, socially just, and ecologically sound. (shrink)

This article provides ethical guidance on using race in health research as a variable or in defining the study population. To this end, a plain, non-exhaustive checklist is provided for researchers and research ethics committees, preceded by a brief introduction on the need for justification when using race as a variable or in defining a study population, the problem of exoticism, that distinctions pertain between race, ethnicity and ancestry, the problematic naming of races, and that race does not serve well (...) as a presumed biological construct in genetic research. (shrink)

In the Netherlands, the legalization of assisted suicide for persons with a death wish without severe illness, often referred to as persons with “completed life” or “tiredness of life,” is intensel...

People who work and live in a certain moral practice usually possess a specific form of moral wisdom. If we manage to incorporate their moral intuitions in ethical reasoning, we can arrive at judgements and theories that grasp a moral experience that generally cannot be found outside the said practice. To achieve this goal, we need a legitimate way to balance moral intuitions, ethical principles and general theories. In the present contribution, we describe a version of the model of Reflective (...) Equilibrium, which we call the Normative-Empirical Reflective Equilibrium . RE provides a framework for ethical thinking that includes both moral experience and normative theory.After an outline of the model, we focus on the role of empirical research and illustrate how empirical data on moral intuitions can add to the comprehensiveness of the set of moral beliefs in NE-RE. Subsequently, we describe how coherence among the elements of an NE-RE can be understood and measured. Finally, we address an important question for any method of moral reasoning: what is the status of the outcome of the reasoning process? This is a matter of justification. We argue for a so-called good reasoning-justified outcome strategy in NE-RE. This strategy is built on a reasoning process in which the reason-giving force of each element is tested and weighed. The thinker has to work towards a coherent view in which only the elements with sufficient justificatory power are retained. If the thinker decides that the elements fit together into a coherent view, a reflective equilibrium is reached. NE-RE is an attempt to describe a model for moral reasoning that can profit from the moral wisdom present among experienced agents through the use of empirical research. (shrink)

A richly detailed history of French secular thought in the seventeenth and early eighteenth centuries. A wealth of material is introduced from unpublished manuscripts. Spink's stress on the clandestine spread of the enlightenment, in spite of official suppression, is interesting and sobering.--J. M. W.

Miles traces the transmission of the Platonic tradition from the Florentine Platonists to Colet. Although he finds Colet more guarded than Ficino and Mirandola in his assimilation of Platonism to Christianity, he shows that Platonic and Neoplatonic themes pervade almost every aspect of Colet's thought. This is the first of a projected series of three volumes on the relations of the Oxford Reformers to the Platonic tradition.--J. M. W.

This eighth volume of the Collected Works of Jung comprises a collection of essays in which Jung struggles with the basic theoretical problems of his psychology. He brings an impressive erudition to his search for concepts, models and explanatory principles adequate to the refractory psychic phenomena with which he deals. In keeping with Jung's conviction that the psyche is "a thing of such infinite complexity that it can be observed and studied from a great many sides," the essays exhibit a (...) variety of approaches, from the relatively empirical to the frankly speculative. The essays span some forty years of Jung's reflection and, thanks to their arrangement in thematic groupings by the editors, present an interesting study in the refinement of his thought and statement.--J. M. W. (shrink)

A revised edition of this translation which was first published in 1934. Silber has added a vigorous and provocative essay focusing attention on the importance of the Religion for understanding Kant's ethics.--J. M. W.

A new and simplified edition of Myers' major work, originally published in 1903. Previous editions had relegated all illustrative case material to cumbersome appendices. The editor of this edition has abridged this material and integrated it into the body of the text. The result is a more manageable and readable volume.--J. M. W.

The author regards faith as a restless quest for that which can save man from his self-destructive tendencies and allow him to actualize most completely his constructive potentialities. Wieman critically examines several answers to this quest of faith, including those of Dewey, Tillich, and Barth. In contrast he develops the view of "liberal religion," which finds the answer in a divine creativity fostered by communication, and is productive of fresh insights which transform human ideals.--J. M. W.

A thoughtful Christian counter-offensive on the popular interpretation of Marxism as the absolute antithesis of all that is Christian and democratic. The author's explicit intention is to break down the barrier to understanding and communication constituted by that image. He examines the Judeo-Christian heritage of Marxism and traces the influences which led to Marx's estrangement from that heritage. Elements of the heritage which survived the estrangement are then elucidated and the author concludes with an eminently reasonable appraisal of the legitimate (...) points of contact and conflict between the two doctrines.--J. M. W. (shrink)

Combining an appreciation of recent analyses of "types" of scientific explanation with a detailed knowledge of contemporary biological investigations, Goudge examines the theory of evolution since Darwin. He argues that twentieth century evolutionary theory gives rise to philosophical questions whose importance rivals anything that physics has to offer. After showing how "modern selectionist theory" differs from Darwin's view of evolution, he asks: "Has evolutionary theory metaphysical implications?" The answer--a tentative "yes"--is so carefully qualified that one wonders whether new contributions to (...) the theory of evolution have the philosophic import that Goudge claims for them.--J. M. W. (shrink)

In this brief work of modest pretensions, the author brings together Islamic texts relevant to freedom from a great variety of sources. He ventures very little analysis or interpretation. Each chapter is copiously footnoted. Given its purely scholarly intentions and limitations, the work should provide a valuable aid for those interested in the study of this field.--J. M. W.

Dicke discusses the metamorphosis of Hegelianism in Feuerbach and Marx through an examination of the concept of identity in the three philosophers. He demonstrates the persistence of this concept as a decisive theme in both Feuerbach and Marx, and shows how Hegel's doctrine of identity is transformed and adulterated in the process of adaptation. A primary consequence of Marx's modification of this doctrine is the philosophical sacrifice of the individual to the collective, which has its practical consequences in contemporary communist (...) states.--J. M. W. (shrink)

An authorized, eminently readable translation of a work first published in German in 1957. Martin leads his reader into the problems of metaphysics by tracing the development of Plato's thought and Aristotle's criticism of Plato, focusing throughout on the question, "What is unity?" Although the book is introductory in intent and tone, it offers its own interpretation of Plato and Aristotle.--J. M. W.

A short dictionary of quotations from Kierkegaard, Jaspers, Marcel, Heidegger, Sartre and de Beauvoir provides the reader with some idea of peculiarly existentialist understandings of standard philosophical terms as well as of terms which are more especially associated with existential thought. At times the selection seems rather arbitrary in some cases.--J. M. W.

Bahm surveys three types of intuition and three corresponding types of conflicting theories of intuition. He argues for an organic theory which views intuition as a dialectical synthesis of the oppositions discussed.--J. M. W.

Worries about safety of approved drugs have pushed post registration research to become the fastest growing drug research phase. Until recently, phase IV studies were mainly conducted for marketing purposes and run much like a phase III trial—at institutions with experienced investigators and a list of inclusion and exclusion criteria. Innovative phase IV studies involve ordinary physicians in research naïve communities. This brings ethical issues familiar to medical research into clinical practice. As a consequence, individual physicians are challenged to protect (...) scientific integrity and to secure the ethical conduct of research. Several ethical issues need to be addressed in the process of developing a scientifically sound and ethically high principled practice of phase IV research.PHASE IVEssential to phase IV research is the focus on how drugs work in the real world. The research goal may be to explore a specific pharmacological effect, to establish the incidence of adverse reactions, or to determine the effects of long-term administration of a drug. They may also be designed to establish a new clinical indication for a drug.1 Subjects may or may not be randomised, and the studies typically involve large numbers of patient-subjects and physicians.Doubts concerning the scientific rigor and clinical value have put postmarketing research in a poor light. However, high quality phase IV research is badly needed to further pharmaceutical science. First, because it can provide reliable data on the effectiveness, safety and optimal use of a drug in treated populations.2 3 In pre-registration clinical trials , a pharmaceutical product is studied under unrealistic circumstances. Under-representation of women and elderly are common and the concomitant use of medicines is usually extremely restrictive in these trials.4 Second, phase IV can provide much needed data for evidence-based …. (shrink)

A recurrent issue in the vast amount of literature on reasoning models in ethics is the role and nature of moral intuitions. In this paper, we start from the view that people who work and live in a certain moral practice usually possess specific moral wisdom. If we manage to incorporate their moral intuitions in ethical reasoning, we can arrive at judgements and (modest) theories that grasp a moral experience that generally cannot be found outside the practice. Reflective equilibrium (RE) (...) provides a framework for balancing moral intuitions, ethical principles and general theories. Nevertheless, persisting problems associated with the use of intuitions need to be addressed. One is the objection that moral intuitions lack the credibility necessary to guide moral reasoning. Ethicists have tried to solve this problem by formulating criteria to separate the “bad” intuitions from the “good” ones at the beginning of the reasoning process. We call this the credible input-justified outcome strategy. An example is the appeal to the common morality by Beauchamp and Childress. We think this approach is unsuccessful. As an alternative, we outline the good reasoning-justified outcome strategy. It connects to a variant of RE in which intuitions from different sources are incorporated. We argue that the elements of RE have different levels of justificatory power at the start of reasoning. In our strategy, each element can gain or lose justificatory power when it is tested in a reasoning process that meets several criteria. (shrink)

Book reviewed in this article: Just War Tradition and the Restraint of War: A Moral and Historical Inquiry. By James Turner Johnson.

The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia.

Pure Type Systems, PTSs, were introduced as a generalization of the type systems of Barendregt's lambda cube and were designed to provide a foundation for actual proof assistants which will verify proofs. Systems of illative combinatory logic or lambda calculus, ICLs, were introduced by Curry and Church as a foundation for logic and mathematics. In an earlier paper we considered two changes to the rules of the PTSs which made these rules more like ICL rules. This led to four kinds (...) of PTSs. Most importantly PTSs are about statements of the form M:A, where M is a term and A a type. In ICLs there are no explicit types and the statements are terms. In this paper we show that for each of the four forms of PTS there is an equivalent form of ICL, sometimes if certain conditions hold. (shrink)

Large-scale linkage of international clinical datasets could lead to unique insights into disease aetiology and facilitate treatment evaluation and drug development. Hereto, multi-stakeholder consortia are currently designing several disease-specific translational research platforms to enable international health data sharing. Despite the recent adoption of the EU General Data Protection Regulation, the procedures for how to govern responsible data sharing in such projects are not at all spelled out yet. In search of a first, basic outline of an ethical governance framework, we (...) set out to explore relevant ethical principles and norms. We performed a systematic review of literature and ethical guidelines for principles and norms pertaining to data sharing for international health research. We observed an abundance of principles and norms with considerable convergence at the aggregate level of four overarching themes: societal benefits and value; distribution of risks, benefits and burdens; respect for individuals and groups; and public trust and engagement. However, at the level of principles and norms we identified substantial variation in the phrasing and level of detail, the number and content of norms considered necessary to protect a principle, and the contextual approaches in which principles and norms are used. While providing some helpful leads for further work on a coherent governance framework for data sharing, the current collection of principles and norms prompts important questions about how to streamline terminology regarding de-identification and how to harmonise the identified principles and norms into a coherent governance framework that promotes data sharing while securing public trust. (shrink)

Decentralized clinical trials (DCTs) have the potential to advance the conduct of clinical trials, but raise several ethical issues, including obtaining valid informed consent. The debate on the ethical issues resulting from digitalization is predominantly focused on direct risks relating to for example data protection, safety, and data quality. We submit however, that a broader view on ethical aspects of DCTs is needed to touch upon the new challenges that come with the DCT practice. Digitalization has impacts that go beyond (...) its direct purposes, by shaping behaviors, experiences, social relations, and values. We examine four elements of the informed consent procedure that are affected by DCTs, while taking these soft impacts of technologies into account: (i) informing participants and testing understanding, (ii) freedoms in relation to responsibilities and burdens, (iii) trust in participant-researcher relations, and (iv) impacts on the concept of privacy. Our analysis reveals that a broad view is key for optimal conduct of DCTs. In addition, it provides insight into the ethical impacts of DCTs on informed consent. Technologies such as DCTs potentially have profound impacts which are not immediately addressed by the existing regulatory frameworks, but nonetheless important to recognize. These findings can guide future practices of DCTs to foster the important values of clinical research in this novel approach for conducting clinical trials. (shrink)

BackgroundThe rise of Big Data-driven health research challenges the assumed contribution of medical research to the public good, raising questions about whether the status of such research as a common good should be taken for granted, and how public trust can be preserved. Scandals arising out of sharing data during medical research have pointed out that going beyond the requirements of law may be necessary for sustaining trust in data-intensive health research. We propose building upon the use of a social (...) licence for achieving such ethical governance.Main textWe performed a narrative review of the social licence as presented in the biomedical literature. We used a systematic search and selection process, followed by a critical conceptual analysis. The systematic search resulted in nine publications. Our conceptual analysis aims to clarify how societal permission can be granted to health research projects which rely upon the reuse and/or linkage of health data. These activities may be morally demanding. For these types of activities, a moral legitimation, beyond the limits of law, may need to be sought in order to preserve trust. Our analysis indicates that a social licence encourages us to recognise a broad range of stakeholder interests and perspectives in data-intensive health research. This is especially true for patients contributing data. Incorporating such a practice paves the way towards an ethical governance, based upon trust. Public engagement that involves patients from the start is called for to strengthen this social licence.ConclusionsThere are several merits to using the concept of social licence as a guideline for ethical governance. Firstly, it fits the novel scale of data-related risks; secondly, it focuses attention on trustworthiness; and finally, it offers co-creation as a way forward. Greater trust can be achieved in the governance of data-intensive health research by highlighting strategic dialogue with both patients contributing the data, and the public in general. This should ultimately contribute to a more ethical practice of governance. (shrink)