Especially today, the central theme of the book is relevant, in an era of worldwide cultural diffusion, and a longing for authenticity and romanticized ...

This paper is one of four interrelated papers resulting from the National Summit on Legal Preparedness for Obesity Prevention and Control convened in June 2008 by the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, and the American Society of Law, Medicine, Ethics. Each of the papers deals with one of the four core elements of legal preparedness: laws and legal authorities for public health practitioners; legal competencies public health practitioners and legal and policy decision makers need (...) for use of these laws and authorities; crossdisciplinary and cross-jurisdiction coordination of law-based public health actions; and information on public health law best practices. Collectively, they are referenced as the “white papers.”Our purpose is to offer action options that will help to improve the legal competencies of public health practitioners and policy decision makers with respect to drafting, interpreting. (shrink)

This paper is one of four interrelated papers resulting from the National Summit on Legal Preparedness for Obesity Prevention and Control convened in June 2008 by the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, and the American Society of Law, Medicine, Ethics. Each of the papers deals with one of the four core elements of legal preparedness: laws and legal authorities for public health practitioners; legal competencies public health practitioners and legal and policy decision makers need (...) for use of these laws and authorities; crossdisciplinary and cross-jurisdiction coordination of law-based public health actions; and information on public health law best practices. Collectively, they are referenced as the “white papers.”Our purpose is to offer action options that will help to improve the legal competencies of public health practitioners and policy decision makers with respect to drafting, interpreting. (shrink)

This study aims to investigate how teachers’ citizenship beliefs relate to the way they teach citizenship in the classroom. Semi-structured interviews were conducted with 65 sixth-grade primary sch...

As thousands of healthy research participants are being included in small and large imaging studies, it is essential that dilemmas raised by the detection of incidental findings are adequately handled. Current ethical guidance indicates that pathways for dealing with incidental findings should be in place, but does not specify what such pathways should look like. Building on an interview study of researchers’ practices and perspectives, we identified key considerations for the set-up of pathways for the detection, management and communication of (...) incidental findings in imaging research. We conducted an interview study with a purposive sample of researchers at research facilities across the Netherlands. Based on a qualitative analysis of these interviews and on existing guidelines found in the literature, we developed a prototype ethical framework, which was critically assessed and fine-tuned during a two-day international expert meeting with bioethicists and representatives from large population-based imaging studies from the United Kingdom, Germany, Sweden and Belgium. Practices and policies for the handling of incidental findings vary strongly across the Netherlands, ranging from no review of research scans and limited feedback to research participants, to routine review of scans and the arrangement of clinical follow-up. Respondents felt that researchers do not have a duty to actively look for incidental findings, but they do have a duty to act on findings, when detected. The principle of reciprocity featured prominently in our interviews and expert meeting. We present an ethical framework that may guide researchers and research ethics committees in the design and/or evaluation of appropriate pathways for the handling of incidental findings in imaging studies. The framework consists of seven steps: anticipation of findings, information provision and informed consent, scan acquisition, review of scans, consultation on detected abnormalities, communication of the finding, and further clinical management and follow-up of the research participant. Each of these steps represents a key decision to be made by researchers, which should be justified not only with reference to costs and/or logistical considerations, but also with reference to researchers’ moral obligations and the principle of reciprocity. (shrink)

This interview study investigates the short- and long-term implications of incidental findings detected through brain imaging on research participants’ lives and their surroundings. For this study, nine participants of the Rotterdam Scan Study with an incidental finding were approached and interviewed. When examining research participants’ narratives on the impact of the disclosure of incidental findings, the authors identified five sets of tensions with regard to motivations for and expectations of research participation, preferences regarding disclosure, short- and long-term impacts and impacts (...) on self and others. The paper shows: that the impact of incidental findings may be greater than participants at first let on; incidental findings can have significant effects on participants’ social environment; and participants may not feel prepared for disclosure even if incidental findings have been discussed during the informed consent process. The authors call for investigators to be aware of research participants’ experiences and these short- and long-term impacts when designing suitable courses of action for the detection and management of incidental findings in research settings. (shrink)

Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between (...) studies, replication of studies, as well as enhancing study participant safety. We systematically reviewed the existing tVNS literature to evaluate current reporting practices. Based on this review, and consensus among participating authors, we propose a set of minimal reporting items to guide future tVNS studies. The suggested items address specific technical aspects of the device and stimulation parameters. We also cover general recommendations including inclusion and exclusion criteria for participants, outcome parameters and the detailed reporting of side effects. Furthermore, we review strategies used to identify the optimal stimulation parameters for a given research setting and summarize ongoing developments in animal research with potential implications for the application of tVNS in humans. Finally, we discuss the potential of tVNS in future research as well as the associated challenges across several disciplines in research and clinical practice. (shrink)

Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between (...) studies, replication of studies, as well as enhancing study participant safety. We systematically reviewed the existing tVNS literature to evaluate current reporting practices. Based on this review, and consensus among participating authors, we propose a set of minimal reporting items to guide future tVNS studies. The suggested items address specific technical aspects of the device and stimulation parameters. We also cover general recommendations including inclusion and exclusion criteria for participants, outcome parameters and the detailed reporting of side effects. Furthermore, we review strategies used to identify the optimal stimulation parameters for a given research setting and summarize ongoing developments in animal research with potential implications for the application of tVNS in humans. Finally, we discuss the potential of tVNS in future research as well as the associated challenges across several disciplines in research and clinical practice. (shrink)

Standardisation is increasingly seen as a means to insert ethics in innovation processes. We examine the institutionalisation of responsible innovation in de jure standardisation as this is an important but unexplored research area. In de jure standardisation, stakeholders collaborate in committees to develop standards. We adopt the anticipation, inclusion, reflexivity, and responsiveness responsible innovation framework as our theoretical lens. Our study suggests that responsible standardisation processes should embody forms of these four dimensions. We investigate the institutionalisation of these dimensions and (...) identify 96 factors that can motivate, hinder, or facilitate responsible standardisation. Factors were found through in-depth interviews with managers of a standard developing organisation. These are subsequently validated/rejected using surveys completed by committee representatives. The results suggest that the social desirability of standards is not self-evident. This study could pave the way for future research on responsible standardisation processes, complementing research on legitimacy, responsible innovation, and standardisation. (shrink)

Featuring a unique systematic approach to dealing with ethical problems known as the 'ethical cycle, ' the book utilizes an abundance of real-life case studies ...

Samenvatting van de grote wijsgerige systemen van Plato tot en met Hegel, gevolgd door een kritische analyse van de metafysica als uitingsvorm van westers intellectualisme.

In this article, we develop an approach for the moral assessment of research and development networks on the basis of the reflective equilibrium approach proposed by Rawls and Daniels. The reflective equilibrium approach aims at coherence between moral judgments, principles, and background theories. We use this approach because it takes seriously the moral judgments of the actors involved in R & D, whereas it also leaves room for critical reflection about these judgments. It is shown that two norms, namely reflective (...) learning and openness and inclusiveness, which are used in the literature on policy and technological networks, contribute to achieving a justified overlapping consensus. We apply the approach to a case study about the development of an innovative sewage treatment technology and show how in this case the two norms are or could be instrumental in achieving a justified overlapping consensus on relevant moral issues. (shrink)

There is no agreement on how nanoethics should proceed. In this article I focus on approaches for discerning ethical issues in nanotechnology, which is as of yet one of the most difficult and urging tasks for nanoethics. I discuss and criticize two existing approaches for discerning ethical issues in nanotechnology and propose a network approach as alternative. I discuss debates in nanoethics about the desirable role of ethics in nanotechnological development and about the newness of ethical issues in nanotechnology. On (...) basis of a critical analysis of both debates, I formulate a number of desiderata for a method for discerning ethical issues in nanotechnology and argue that the network approach that my colleagues and I have developed for ethical issues in research and development networks is also appropriate in nanotechnology. (shrink)

In Printing Spinoza Jeroen van de Ven systematically examines all seventeenth-century printed editions of Spinoza's writings, published between 1663 and 1694, as well as their variant 'issues'. In focus are Spinoza's 1663 adumbration of René Descartes's 'Principles of Philosophy' with his own 'Metaphysical Thoughts', the 'Theological-Political Treatise' (1670), and the posthumous writings (1677), including the famously-known 'Ethics'. Van de Ven's descriptive bibliography studies, contextualizes, and records all aspects of the publication history of Spinoza's writings from manuscript to print and assesses (...) their immediate reception. It discusses the printed books' codicology, philology, typographical and textual relationships, illustration programmes, as well as their dissemination in early Enlightenment Europe, in view of the physical aspects of 1,246 extant copies and their provenance. (shrink)

As artefacts, the worlds of digital games are designed and developed to fulfil certain expressive, functional, and experiential objectives. During play, players infer these purposes and aspirations from various aspects of their engagement with the gameworld. Influenced by their sociocultural backgrounds, sensitivities, gameplay preferences, and familiarity with game conventions, players construct a subjective interpretation of the intentions with which they believe the digital game in question was created. By analogy with the narratological notion of the implied author, we call the (...) figure to which players ascribe these intentions ‘the implied designer’. In this article, we introduce the notion of the implied designer and present an initial account of how appreciators ascribe meaning to interactive, fictional gameworlds and act within them based on what they perceive to be the designer’s intentions. (shrink)

It often appears that leading politicians in Belgium consider the results of the municipal elections in the light of national polities. They stick to the thesis that the municipal poll-results, at least in the bigger towns, are more and more influenced by the constellation of the nation's politics.Is it really so that the municipal elections indicate the hearings of the national political situation? Can one draw conclusions from the results of these elections as if they were national ones? And can (...) one,any how, compare municipal to parliamentary elections? By comparison of the results of municipal elections 1964 and of parliamentary elections 1965 it was checked which shifts in party-choice havehappened during this short period of eight months. If no oscillations, or only a few, were detected between both elections, one could conclude that the municipal elections 1964 indicated indeed the hearings of the parliamentary elections 1965.Successively, the national and provincial results of these elections were compared and the party-shifts on national and provincial level were calculated.To make a relevant comparison between the election-results on a lower level, a comparable basic unity had to be found. As there were no municipal data available at parliamentary elections on one side, andonly municipal results at the municipal elections on the other side, the least possible unity for which parliamentary election-results are known, the electoral canton namely, was chosen as a comparison-basis. For that purpose however the results per party had to be additioned in all municipalities belonging to one canton.Part of the electoral cantons was unfit for use as comparison-material for two reasons : the highly varied and often strongly local-coloured political party-structure on one hand, the big number of municipalitieswithout elections on the other hand. So we were bound to make a choice out of 212 electoral cantons. Finally the cantons with a maximum of 4 municipalities were chosen, which limited the number of cantons to 28. These cantons were classified by degree of urbanisation according to the typology of W. Van Waelvelde and H. Van der Haegen.In that classification the percentages of votes in favour of the political parties, at the occasion of these elections, were tabulated and compared.The participating parties and lists were grouped as much as possible around the traditional parties to which they were most related. So we distinguish in Flanders : CVP, BSP, PVV, VU, CPB and other parties ;in the Walloon region: PSC, PSB, PLP PCB, French-speaking lists and other parties.For this analysis we also thought it was relevant to control separately the shifts of the electoral corps in the Flemish, the Walloon and the Brussels cantons. These shifts were then specified according to thedegree of urbanisation.To measure the size of the party-shifts for these elections, the external election-shift standard was calculated for the chosen Flemish, Walloon and Brussels cantons, with a special attention for the degree of urbanisation. Finally we examined which attitude was assumed by the government, the governmental and the opposition parties, in relation to the results of the municipal 1964 elections.It appeared that some notable party-shifts had been realized during the short period between the municipal elections of 1964 and the legislative elections of 1965. In general, a certain polarization has taken place due to a centrifugal vote-shift to the left and still more to the right. The direction of vote-shifts, which had shown at the municipal elections of 1964, was affirmed at the legislative elections of 1965 and for some parties, CVP and PVV namely, it was even accentuated. The parallelism between both elections in relation to the direction of the vote-shifts did not mean however that the size of these shifts was the same everywhere. The image of the shifts was different according to linguistic region and degree of urbanisation.The analysis of the urbanisation-degree showed that the level of oscillations grew higher as the urbanisation-degree grew lower. Seen per linguistic region, the largest shifts had taken place in the Walloon cantons. According to the calculations of the electoral shift standards during the period 1964-1965, the lowest oscillations were noted in the Flemish and Brussels cantons, i.e. the voting-behaviour of the big agglomerations during the municipal elections of 1964 were the closest to the national electoral pattern. Seen that way they were, up to a certain degree, a value-measure for the general policy.Finally the remark should be made that the limitation to the two above-mentioned elections does not allow any generalization of the obtained conclusions. The short period between those elections was itself an exceptional situation which may have been of influence on the results of the comparisons. (shrink)

We present a Reformed view on the relation between Christianity and non-Christian religions. We then explore what this view entails for the question whether Christians and non-Christian religious believers refer to, believe in, and worship the same God. We first analyze the concepts of worship, belief-in, and reference, as well as their interrelations. We then argue that adherents of the Abrahamic religions plausibly refer to the same God, whereas adherents of non-Abrahamic religions do not refer to this God. Nonetheless, it (...) would be wrong to say that adherents of all Abrahamic religions believe in and worship the same God. (shrink)

Over 30 million people worldwide have taken a commercial at-home DNA test, because they were interested in their genetic ancestry, disease predisposition or inherited traits. Yet, these consumer DNA data are also increasingly used for a very different purpose: to identify suspects in criminal investigations. By matching a suspect’s DNA with DNA from a suspect’s distant relatives who have taken a commercial at-home DNA test, law enforcement can zero in on a perpetrator. Such forensic use of consumer DNA data has (...) been performed in over 200 criminal investigations. However, this practice of so-called investigative genetic genealogy raises ethical concerns. In this paper, we aim to broaden the bioethical analysis on IGG by showing the limitations of an individual-based model. We discuss two concerns central in the debate: privacy and informed consent. However, we argue that IGG raises pressing ethical concerns that extend beyond these individual-focused issues. The very nature of the genetic information entails that relatives may also be affected by the individual customer’s choices. In this respect, we explore to what extent the ethical approach in the biomedical genetic context on consent and consequences for relatives can be helpful for the debate on IGG. We argue that an individual-based model has significant limitations in an IGG context. The ethical debate is further complicated by the international, transgenerational and commercial nature of IGG. We conclude that IGG should not only be approached as an individual but also—and perhaps primarily—as a collective issue. There are no data in this work. (shrink)

Pediatric oncology has a strong research culture. Most pediatric oncologists are investigators, involved in clinical care as well as research. As a result, a remarkable proportion of children with cancer enrolls in a trial during treatment. This paper discusses the ethical consequences of the unprecedented integration of research and care in pediatric oncology from the perspective of parents and physicians. An empirical ethical approach, combining (1) a narrative review of (primarily) qualitative studies on parents' and physicians' experiences of the pediatric (...) oncology research practice, and (2) comparison of these experiences with existing theoretical ethical concepts about (pediatric) research. The use of empirical evidence enriches these concepts by taking into account the peculiarities that ethical challenges pose in practice. Analysis of the 22 studies reviewed revealed that the integration of research and care has consequences for the informed consent process, the promotion of the child's best interests, and the role of the physician (doctor vs. scientist). True consent to research is difficult to achieve due to the complexity of research protocols, emotional stress and parents' dependency on their child's physician. Parents' role is to promote their child's best interests, also when they are asked to consider enrolling their child in a trial. Parents are almost never in equipoise on trial participation, which leaves them with the agonizing situation of wanting to do what is best for their child, while being fearful of making the wrong decision. Furthermore, a therapeutic misconception endangers correct assessment of participation, making parents inaccurately attribute therapeutic intent to research procedures. Physicians prefer the perspective of a therapist over a researcher. Consequently they may truly believe that in the research setting they promote the child's best interests, which maintains the existence of a therapeutic misconception between them and parents. Due to the integration of research and care, their different ethical perspectives become intertwined in the daily practice of pediatric oncology. Increasing awareness of what this means for the communication between parents and physicians is essential. Future research should focus on efforts that overcome the problems that the synchronicity of research and care evokes. (shrink)

In some situations in which undesirable collective effects occur, it is very hard, if not impossible, to hold any individual reasonably responsible. Such a situation may be referred to as the problem of many hands. In this paper we investigate how the problem of many hands can best be understood and why, and when, it exactly constitutes a problem. After analyzing climate change as an example, we propose to define the problem of many hands as the occurrence of a gap (...) in the distribution of responsibility that may be considered morally problematic. Whether a gap is morally problematic, we suggest, depends on the reasons why responsibility is distributed. This, in turn, depends, at least in part, on the sense of responsibility employed, a main distinction being that between backward-looking and forward-looking responsibility. (shrink)

Arriving at a moral judgment is not a straightforward or linear process in which ethical theories are simply applied to cases. Instead it is a process in which the formulation of the moral problem, the formulation of possible “solutions”, and the ethical judging of these solutions go hand in hand. This messy character of moral problems, however, does not rule out a systematic approach. In this article, we describe a systematic approach to problem solving that does justice to the complex (...) nature of moral problems and ethical judgment: the ethical cycle. Our goal is to provide a structured and disciplined method of addressing moral problems, which helps to guide a sound analysis of these problems. We will illustrate the usefulness of this cycle with an example. Further, we will discuss two general issues in applied ethics in relation to the proposed ethical cycle: the role of ethical theories and the place of individual judgment versus collective deliberation. (shrink)

Fundamentele filosofische studie over hermeneutiek, opgevat als het stem geven aan degene die niet (meer) zelf kan spreken, met beschouwingen over het betreffende gedachtegoed van enkele vooraanstaande denkers zoals Plato en Heidegger.

This article presents the attitudes of nurses towards three issues concerning their role in euthanasia and physician-assisted suicide. A questionnaire survey was conducted with 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The study was conducted in the Netherlands between January 2001 and August 2004. The results show that less than half of nurses would be willing to serve on committees reviewing cases of euthanasia and physician-assisted suicide. More than half of the nurses found it (...) too far-reaching to oblige physicians to consult a nurse in the decision-making process. The majority of the nurses stated that preparing euthanatics and inserting an infusion needle to administer the euthanatics should not be accepted as nursing tasks. The findings are discussed in the context of common practices and policies in the Netherlands, and a recommendation is made not to include these three issues in new regulations on the role of nurses in euthanasia and physician-assisted suicide. (shrink)

Deals with such questions as: What is engineering? In what respect does engineering differ from science? What ethical problems does engineering raise? By what ethical principles are engineers guided? How do engineers themselves conceive of their profession? What do they see as the main philosophical challenges confronting them in the 21st century?

In Belgium, as in most countries, each Minister or Secretary is assisted by a limited number of trusted collaborators who constitute the Ministerial Office.The article is an attempt to shed a light on the Chief Ministerial Officer who is the closest collaborator of the Minister.In order to show the role of the Chief Ministerial Officer, the article first describes the tasks, powers and composition of the Ministerial Office to proceed to a more extensive analysis of the functions, the appointment of (...) the Chief Ministerial Officer, and the question whether he can exercise executive power.The most important tasks of the Chief Ministerial Officer are: organization and coordination of the Office and its activities, acting as a «Liaison-Officer» with the Minister, passing on of information, exercising of a form of internal, political and administrative control.The article closes with some more personal remarks, pointing out a few guidelines which a Chief Ministerial Office, should keep in mind. (shrink)

Peterson's objection to my proposal to treat new technologies as social experiments seems straightforward. Doing so would replace the old question ‘Is technology X ethically acceptable?’ (Let us ca...