ZusammenfassungPatientenmobilität und grenzüberschreitende Gesundheitsversorgung sind alltägliche Phänomene in der Europäischen Union. Im Jahr 2011 hat die EU eine Richtlinie erlassen, um in diesem Kontext Rechtssicherheit herzustellen. Bisher gibt es keine umfassenden systematischen Studien über ethische Aspekte grenzübergreifender Gesundheitsversorgung. In dieser Arbeit werden die rechtlichen Entwicklungen der grenzübergreifenden Gesundheitsversorgung dargestellt und die in der Literatur vereinzelt erwähnten ethisch relevanten Aspekte heuristisch und auf Patiententypologien aufbauend systematisch inventarisiert und diskutiert. Es zeigt sich, dass die Möglichkeit der Patientenmobilität und die damit vor allem (...) verbundenen Finanzierungsregelungen die Autonomie einiger Patienten sicherlich verbessern kann. Allerdings können wohl nicht alle Patienten Versorgungsverbesserungen erwarten. Im Gegenteil können sogar negative Konsequenzen für einige Patienten folgen, was vor allem aus gerechtigkeitstheoretischen Überlegungen kritisch zu sehen ist. (shrink)
Patientenmobilität und grenzüberschreitende Gesundheitsversorgung sind alltägliche Phänomene in der Europäischen Union (EU). Im Jahr 2011 hat die EU eine Richtlinie erlassen, um in diesem Kontext Rechtssicherheit herzustellen. Bisher gibt es keine umfassenden systematischen Studien über ethische Aspekte grenzübergreifender Gesundheitsversorgung. In dieser Arbeit werden die rechtlichen Entwicklungen der grenzübergreifenden Gesundheitsversorgung dargestellt und die in der Literatur vereinzelt erwähnten ethisch relevanten Aspekte heuristisch und auf Patiententypologien aufbauend systematisch inventarisiert und diskutiert. Es zeigt sich, dass die Möglichkeit der Patientenmobilität und die damit vor (...) allem verbundenen Finanzierungsregelungen die Autonomie einiger Patienten sicherlich verbessern kann. Allerdings können wohl nicht alle Patienten Versorgungsverbesserungen erwarten. Im Gegenteil können sogar negative Konsequenzen für einige Patienten folgen, was vor allem aus gerechtigkeitstheoretischen Überlegungen kritisch zu sehen ist. (shrink)
The sixteenth-century Dutch spiritualist and controversialist, Dirck Volckertszoon Coornhert (1522-1590), is increasingly recognized as a pivotal figure in the cultural and political life of the early Dutch Republic. With the appearance of Henk Bonger's widely acclaimed biography (1978), the first complete account of Coornhert's life became available in the Dutch language. Today this biography is still the starting point of any serious research on Coornhert and his circle. This translation now makes this standard biography available in English for the first (...) time. References have been updated and some explanatory remarks intended for a non-Dutch readership were added. The translation is complemented with a full bibliography of Coornhert's writings, as well as an up-to-date bibliography of the secondary literature; with 25 illustrations. (shrink)
The capacity of contemporary forensic genetics has rendered “race” into an interesting tool to produce clues about the identity of an unknown suspect. Whereas the conventional use of DNA profiling was primarily aimed at the individual suspect, more recently a shift of interest in forensic genetics has taken place, in which the population and the family to whom an unknown suspect allegedly belongs, has moved center stage. Making inferences about the phenotype or the family relations of this unknown suspect produces (...) suspect populations and families. We discuss the criminal investigation following the Marianne Vaatstra murder case in the Netherlands and the use of forensic technologies therein. It is in many ways an interesting case, but in this paper, we focus on how race surfaced in science and society. We show that race materializes neither in the technologies used nor in the bodies at stake. Rather, race emerges through a material semiotic relation that surfaces in the translation that occurs as humans and things move across sites. We argue that race is enacted, firstly, in the context of legislation as biology reduced to bodily characteristics; secondly, in the forensic analyses as patterns of absent presence; and, thirdly, in society as a process of phenotypic othering. (shrink)
In everyday life it is often important to have a mental model of the knowledge, beliefs, desires, and intentions of other people. Sometimes it is even useful to to have a correct model of their model of our own mental states: a second-order Theory of Mind. In order to investigate to what extent adults use and acquire complex skills and strategies in the domains of Theory of Mind and the related skill of natural language use, we conducted an experiment. It (...) was based on a strategic game of imperfect information, in which it was beneficial for participants to have a good mental model of their opponent, and more specifically, to use second-order Theory of Mind. It was also beneficial for them to be aware of pragmatic inferences and of the possibility to choose between logical and pragmatic language use. We found that most participants did not seem to acquire these complex skills during the experiment when being exposed to the game for a number of different trials. Nevertheless, some participants did make use of advanced cognitive skills such as second-order Theory of Mind and appropriate choices between logical and pragmatic language use from the beginning. Thus, the results differ markedly from previous research. (shrink)
This book explores the complex nexus of discourses, principles and practices within which educators mobilise school-based health education. Through an interrogation of the ideas informing particular models and approaches to health education, the authors provide critical insights into the principles and practices underpinning approaches to health education policy, curriculum, pedagogy and assessment. Drawing on extensive literature and research, the book explores and considers what health education can and should do. Chapters examine the extent to which health education, past and present, (...) has attended to the needs and interests of young people in school environments, as well as assess common pedagogical approaches and whether the outcomes tally with expectations. By considering the problems in teaching health education, curriculum making, health education pedagogies and porous classrooms, the book offers a knowledge base from which educators can consider how theories and models can sit together to shape curriculum and influence practice. School Health Education in Changing Times will be of key interest to postgraduate students, researchers and academics in the field of health education. It will also be a valuable resource for teacher educators, current teachers, and those on professional development courses who want to navigate the moral minefield surrounding health education. (shrink)
In the present study it has been examined how children?s creative writing tasks may contribute to teachers? understanding of children?s values. Writings of 300 elementary school children about what they would do if they were the boss of The Netherlands were obtained and seemed to reflect different types of values. Most children were concerned with charity. Also, writings concerned materialist values and socio?political topics, such as human rights, power and tolerance. Analyses of group?specific differences showed girls to write more about (...) charity and health when compared to boys. Children from low socio?economic backgrounds wrote less about environmental issues compared to children from middle and high socio?economic backgrounds. Children from ethnic minority backgrounds who wrote more about obtaining goods for themselves and less about environmental issues than Dutch?origin children. In addition, age differences were found in line with an increase in social and moral development. These differences are discussed in light of differential socialisation practices. (shrink)
Quality of life is an important outcome measure in mental health care. Currently, QoL is mainly measured with paper and pencil questionnaires. To contribute to the evaluation of treatment, and to enhance substantiated policy decisions in the allocation of resources, a web-based, personalized, patient-friendly and easy to administer QoL instrument has been developed: the QoL-ME. While human values play a significant role in shaping future use practices of technologies, it is important to anticipate on them during the design of the (...) QoL-instrument. The value sensitive design approach offers a theory and method for addressing these values in a systematic and principled manner in the design of technologies. While the VSD approach has been applied in the field of somatic care, we extended the VSD approach to the field of mental healthcare with the aim to enable developers of the QoL-instrument to reflect on important human values and anticipate potential value conflicts in its design. We therefore explored how VSD can be used by investigating the human values that are relevant for the design of the QoL-ME. Our exploration reveals that the values autonomy, efficiency, empowerment, universal usability, privacy, redifinition of roles, of responsibilites, reliability, solidarity, surveillance and trust are at stake for the future users of the technology. However, we argue that theoretical reflections on the potential ethical impact of a technology in the design phase can only go so far. To be able to comprehensively evaluate the usability the VSD approach, a supplementary study of the use practices of the technology is needed. (shrink)
Most nurse leadership studies have concentrated on a classical, heroic, and hierarchical view of leadership. However, critical leadership studies have argued the need for more insight into leadership in daily nursing practices. Nurses must align their professional standards and opinions on quality of care with those of other professionals, management, and patients. They want to achieve better outcomes for their patients but also feel disciplined and controlled. To deal with this, nurses challenge the status quo by showing rebel nurse leadership. (...) In this paper, we describe 47 nurses’ experiences with rebel nurse leadership from a leadership-as-practice perspective. In eight focus groups, nurses from two hospitals and one long-term care organization shared their experiences of rebel nurse leadership practices. They illustrated the differences between “bad” and “good” rebels. Knowledge, work experience, and patient-driven motivation were considered necessary for “good” rebel leadership. The participants also explained that continuous social influencing is important while exploring and challenging the boundaries set by colleagues and management. Credibility, trust, autonomy, freedom, and preserving relationships determined whether rebel nurses acted visibly or invisibly. Ultimately, this study refines the concept of rebel nurse leadership, gives a better understanding of how this occurs in nursing practice, and give insights into the challenges faced when studying nursing leadership practices. (shrink)
Background Genuine uncertainty on superiority of one intervention over the other is called equipoise. Physician-investigators in randomized controlled trials need equipoise at least in studies with more than minimal risks. Ideally, this equipoise is also present in patient-participants. In pediatrics, data on equipoise are lacking. We hypothesize that 1) lack of equipoise at enrolment among parents may reduce recruitment; 2) lack of equipoise during participation may reduce retention in patients assigned to a less favoured treatment-strategy. Methods We compared preferences of (...) parents/patients at enrolment, documented by a questionnaire, with preferences developed during follow-up by an interview-study to investigate equipoise of child-participants and parents in the BeSt-for-Kids-study. This trial in new-onset Juvenile Idiopathic Arthritis-patients consists of three strategies. One strategy comprises initial treatment with a biological disease-modifying-antirheumatic-drug, currently not standard-of-care. Semi-structured interviews were conducted with 23 parents and 7 patients, median 11 months after enrolment. Results Initially most parents and children were not in equipoise. Parents/patients who refused participation, regularly declined due to specific preferences. Many participating families preferred the biological-first-strategy. They participated to have a chance for this initial treatment, and would even consider stopping trial-participation when not randomized for it. Their conviction of superiority of the biological-first strategy was based on knowledge from internet and close relations. According to four parents, the physician-investigator preferred the biological-first-strategy, but the majority stated that she had no preferred strategy. In phase 2, preferences tended to change to the treatment actually received. Conclusions Lack of equipoise during enrolment did not reduce study recruitment, mainly due to the fact that preferred treatment was only available within the study. Still, when developing a trial it is important to evaluate whether the physicians’ research question is in line with preferences of the patient-group. By exploring so-called ‘informed patient-group’-equipoise, successful recruitment may be enhanced and bias avoided. In our study, lack of equipoise during trial-participation did not reduce retention in those assigned to a less favoured option. We observed a change for preference towards treatment actually received, possibly explained by comparable outcomes in all three arms. (shrink)
The sixteenth-century Dutch spiritualist and controversialist, Dirck Volckertszoon Coornhert, is increasingly recognized as a pivotal figure in the cultural and political life of the early Dutch Republic. With the appearance of Henk Bonger’s widely acclaimed biography, the first complete account of Coornhert’s life became available in the Dutch language. Today this biography is still the starting point of any serious research on Coornhert and his circle. This translation now makes this standard biography available in English for the first time. The (...) translator profited from Henk Bonger’s comments on the translated chapters, and the author approved of adaptations and changes where these were deemed necessary. The structure and most of the chapters of the book are as they were in the original. The chief changes are: the abridgment and combination into one chapter of the two original chapters on Coornhert’s creative work and his translations. The ample quotes from Coornhert contained in the text enable the reader to attain a first hand acquaintance with Coornhert’s profound thought and inimitable style. References have been updated and some explanatory remarks intended for a non-Dutch readership were added. The translation is complemented with a full bibliography of Coornhert’s writings, as well as an up-to-date bibliography of the secondary literature; with 25 illustrations. (shrink)
This title sees the re-emergence of the seminal 1970s magazine Curtains edited by Paul Buck. With its early promotion of French writers such as Georges Bataille, Maurice Blanchot, Jacques Derrida, Jean-Pierre Faye and Edmond Jabès, Curtains’ re-appearance in 2016 arrives after an exhibition at Focal Point Gallery in 2012 that was recreated from an earlier 1992 work at Cabinet Gallery around the concept of ‘disappearing’. The invited contributions come from thirteen artists with whom the editor has engaged over the years. (...) In addition, Buck has returned to pull threads from the earlier editions of his magazine to explore ideas with writers encountered in the intervening years, making all appear in a consolidated grouping as a final gesture, one that refuses to disappear. Contributions include those by: Kathy Acker, Anne-Marie Albiach, Mireille Andres, Stephen Barber, David Barton, Diane Bataille, Georges Bataille, Mathieu Bénézet, Jean-Pierre Bobillot, Joë Bousquet, Michael Camus, Danielle Collobert, David Coxhead, John Cussans, Tatjana Doll, Jerry Estrin, Ulli Freer, Margarita Gluzsberg, Paul Green, Anouchka Grose, Pierre Guyotat, Susan Hiller, Andrew Hunt, Franz Kamin, Chris Kraus, Liane Lang, Roger Laporte, Francesca Lisette, Lucy McKenzie, Bernard Noël, Hestia Peppe, Holly Pester, Perle Petit, Richard Prince, Pascal Quignard, Clunie Reid, Mitsou Ronat, Claude Royet-Journoud, Eugène Savitzkaya, Will Shutes, Sophie Sleigh-Johnson, Miroslav Tichy, Colette Thomas, Simon Thompson, Sophie von Hellermann, and Gabrielle Wittkop. (shrink)