Hooglands commentaar op mijn ‘Pluralisme’ komt hierop neer dat levensbeschouwelijke neutraliteit niet mogelijk is, noch voor de overheid, noch voor de individuele burger. We kunnen geen radicale buitenstaanderspositie innemen tegenover de levensbeschouwing die we erop nahouden. Dat zou een vorm van hybris zijn. Wie niettemin levensbeschouwelijke neutraliteit bepleit en deze identificeert met tolerantie voor de levensbeschouwingen van anderen, pretendeert in feite dat het eigen tolerante standpunt moreel superieur is aan het standpunt van al diegenen die aan hun levensbeschouwing vastgeklonken zitten. (...) Dat is moreel verwerpelijk. (shrink)

Objective: To audit doctors’ knowledge of informed consent.Design: 10 consent scenarios with “true”, “false”, or “don’t know” answers were completed by doctors who care for children at a large district general hospital. These questions tested clinicians’ knowledge of who could give consent in different clinical situations.Setting: Royal United Hospital, Bath, UK.Results: 51 doctors participated . Paediatricians scored higher than other clinicians . Only 36% of paediatricians and 8% of other clinicians realised that the biological father of a child born before (...) 1 December 2003 needed a court order or a parental responsibility agreement to acquire parental responsibility, and thus be able to consent on behalf of his child, if he was not married to the child’s mother. Non-paediatric clinicians were unsure or incorrect when tested on situations where people with parental responsibility do not agree, or where young people , who are Fraser competent do not want to consult their parents. Most clinicians did not know that the parents of a 20-year-old man with severe learning difficulties are unable to consent to surgery on his behalf, and many non-paediatricians were unclear on who could give consent when a child lived with foster parents.Conclusion: Clinicians who obtain consent for the treatment of children need to increase their knowledge on who is able to give informed consent to ensure best practice. (shrink)

This book explores the universe and its subsystems from the three lenses of evolutionary (diversifying), developmental (converging), and complex (adaptive) processes at all scales. It draws from prolific experts within the academic disciplines of complexity science, physical science, information and computer science, theoretical and evo-devo biology, cosmology, astrobiology, evolutionary theory, developmental theory, and philosophy. The chapters come from a Satellite Meeting, "Evolution, Development and Complexity" (EDC) hosted at the Conference on Complex Systems, in Cancun, 2017. The contributions will be peer-reviewed (...) and contributors from outside the conference will be invited to submit chapters to ensure full coverage of the topics. This book explores many issues within the field of EDC such as the interaction of evolutionary stochasticity and developmental determinism in biological systems and what they might teach us about these twin processes in other complex systems. This text will appeal to students and researchers within the complex systems and EDC fields.. (shrink)

Health care is provided in many contexts—not just hospitals, clinics, and community health settings. Different institutional settings may significantly influence the design and delivery of health care and the ethical obligations and practices of health care practitioners working within them. This is particularly true in institutions that are established to constrain freedom, ensure security and authority, and restrict movement and choice. We describe the results of a qualitative study of the experiences of doctors and nurses working within two women’s prisons (...) in the state of New South Wales (NSW), Australia. Their accounts make clear how the provision and ethics of health care may be compromised by the physical design of the prison, the institutional policies and practices restricting movement of prisoners and practitioners, the focus on maintaining control and security, and the very purpose of the prison and prison system itself. The results of this study make clear the impact that context has on professional practice and illustrate the importance of sociology and anthropology to bioethics and to the development of a more nuanced account of professional ethics. (shrink)

Context: The dominant approach to the study of perception is representational/computational, with an emphasis on the achievements of the brain and the nervous system, which are taken to construct internal models of the world. Alternatives include ecological, embedded, embodied, and enactivist approaches, all of which emphasize the centrality of action in understanding perception. Problem: Despite sharing many theoretical commitments that lead to a rejection of the classical approach, the alternatives are characterized by important contrasts and points of divergence. Here we (...) focus on the enactive and ecological approaches, in particular, on how they construe the status of the environment and the content of perception. Method: We begin with a review of James Gibson’s ecological psychology, highlighting it as a psychology for all organisms not just humans. Against this backdrop, we consider enactivist arguments against direct perception - a central assertion of the ecological approach - and in favor of interpreting the activity of perceptual agents as a kind of construction of a perceptually meaningful world. Results: We assess the merits of this interpretation and we conclude that it cannot be grounded on fundamental principles such as thermodynamics and organism-environment mutuality. Implications: As a consequence, enactivism remains close to representationalism and entails a form of dualism. Constructivist content: We advance a criticism of the constructivist foundations of the enactive approach to perception. Perception-action mutuality at the heart of enactivism does not require mental construction; indeed, perception-action mutuality obviates construction. (shrink)

Originally published in 1941, this book contains the French text of Jean-Jacques Rousseau's 1755 treatise Discours sur l'origine et les fondements de l'inégalité parmi les hommes, in which he examines the artificial origins of human social structures designed to keep one group elevated above another. The preface by F. C. Green provides the historical context for Rousseau's essay and explains its influence on the authors of the French Revolution. This book will be of value to anyone with an interest in (...) French history or political philosophy. (shrink)

Background: The American Medical Association, the British Medical Association and the Canadian Medical Association have guidelines that specifically discourage physicians from self-prescribing or prescribing to family members, but only the BMA addresses informal prescription requests between colleagues. Objective: To examine the practices of paediatric providers regarding self-prescribing, curbsiding colleagues, and prescribing and refusing to prescribe to friends and family. Methods: 1086 paediatricians listed from the American Academy of Paediatrics 2007 web-based directory were surveyed. Results: 44% of eligible survey respondents returned (...) usable surveys. Almost half of respondents had prescribed for themselves. An equal number had informally requested a prescription from a colleague. Three-quarters stated they had been asked to prescribe a prescription drug for a first-degree or second-degree relative, and 51% had been asked by their spouse. Eighty-six per cent stated that they had refused to write a prescription on at least one occasion for a friend or family member. The following reasons “strongly influenced” their decision to refuse a prescription request: outside of provider’s expertise ; patient’s need for his or her own physician ; not medically indicated ; need for a physical examination. Conclusion: These data confirm that most physicians have engaged in self-prescribing or curbside requests for prescriptions. It can be argued that curbsiding is more morally problematic than self-prescribing because it implicates a third party, and should be discouraged regardless of whether the requester is a colleague, family member or friend. (shrink)

The effect of uniform lighting on face identity processing is little understood, despite its potential influence on our ability to recognize faces. Here, we investigated how changes in uniform lighting level affected face identification performance during face memory tests. Observers were tasked with learning a series of faces, followed by a memory test where observers judged whether the faces presented were studied before or novel. Face stimuli were presented under uniform bright or dim illuminations, and lighting across the face learning (...) and the memory test sessions could be the same or different. This led to four experimental conditions: Bright/Dim ; Bright/Bright; Dim/Bright; and Dim/Dim. Our results revealed that incongruent lighting levels across sessions significantly reduced sensitivity to faces and introduced conservative biases compared to congruent lighting levels. No significant differences in performance were detected between the congruent lighting conditions and between the incongruent lighting conditions. Thus, incongruent lighting deteriorated performance in face identification. These findings implied that the level of uniform lighting should be considered in an illumination-specific face representation and potential applications such as eyewitness testimony. (shrink)

Current UK legislation is impacting upon the feasibility and cost-effectiveness of medical record-based research aimed at benefiting the NHS and the public heath. Whereas previous commentators have focused on the Data Protection Act 1998, the Health and Social Care Act 2001 is the key legislation for public health researchers wishing to access medical records without written consent. The Act requires researchers to apply to the Patient Information Advisory Group for permission to access medical records without written permission. We present a (...) case study of the work required to obtain the necessary permissions from PIAG in order to conduct a large scale public health research project. In our experience it took eight months to receive permission to access basic identifying information on individuals registered at general practices, and a decision on whether we could access clinical information in medical records without consent took 18 months. Such delays pose near insurmountable difficulties to grant funded research, and in our case £560 000 of public and charitable money was spent on research staff while a large part of their work was prohibited until the third year of a three year grant. We conclude by arguing that many of the current problems could be avoided by returning PIAG’s responsibilities to research ethics committees, and by allowing “opt-out” consent for many public health research projects. (shrink)