Purpose This paper aims to formalize long-term trajectories of human civilization as a scientific and ethical field of study. The long-term trajectory of human civilization can be defined as the path that human civilization takes during the entire future time period in which human civilization could continue to exist. -/- Design/methodology/approach This paper focuses on four types of trajectories: status quo trajectories, in which human civilization persists in a state broadly similar to its current state into the distant future; catastrophe (...) trajectories, in which one or more events cause significant harm to human civilization; technological transformation trajectories, in which radical technological breakthroughs put human civilization on a fundamentally different course; and astronomical trajectories, in which human civilization expands beyond its home planet and into the accessible portions of the cosmos. -/- Findings Status quo trajectories appear unlikely to persist into the distant future, especially in light of long-term astronomical processes. Several catastrophe, technological transformation and astronomical trajectories appear possible. -/- Originality/value Some current actions may be able to affect the long-term trajectory. Whether these actions should be pursued depends on a mix of empirical and ethical factors. For some ethical frameworks, these actions may be especially important to pursue. (shrink)

Introduction: The Dutch Euthanasia Act states that euthanasia is not punishable if the attending physician acts in accordance with the statutory due care criteria. These criteria hold that: there should be a voluntary and well-considered request, the patient’s suffering should be unbearable and hopeless, the patient should be informed about their situation, there are no reasonable alternatives, an independent physician should be consulted, and the method should be medically and technically appropriate. This study investigates whether physicians experience problems with these (...) criteria in medical practice.Methods: In 2006, questionnaires were sent to a random, stratified sample of 2100 Dutch physicians . Physicians were asked about problems in their decision-making related to requests for euthanasia or assisted suicide after enforcement of the 2002 Euthanasia Act.Results: Of all physicians who had received a request for euthanasia or assisted suicide , 25% had experienced problems in the decision-making with regard to at least one of the criteria of due care. Physicians who had experienced problems mostly indicated to have had problems related to evaluating whether or not the patient’s suffering was unbearable and hopeless and whether or not the patient’s request was voluntary or well considered .Discussion: Physicians in The Netherlands most frequently reported problems related to aspects in which they have to evaluate the patient’s subjective perspective. However, it can be questioned whether placing emphasis on these subjective aspects is an adequate fulfilment of the duties imposed on physicians, as laid down in the Dutch Euthanasia Act. (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)

Artificial intelligence (AI) is increasingly expected to disrupt the ordinary functioning of society. From how we fight wars or govern society, to how we work and play, and from how we create to how we teach and learn, there is almost no field of human activity which is believed to be entirely immune from the impact of this emerging technology. This poses a multifaceted problem when it comes to designing and understanding regulatory responses to AI. This article aims to: (i) (...) defend the need for a novel conceptual model for understanding the systemic legal disruption caused by new technologies such as AI; (ii) to situate this model in relation to preceding debates about the interaction of regulation with new technologies (particularly the ‘cyberlaw’ and ‘robolaw’ debates); and (iii) to set out a detailed model for understanding the legal disruption precipitated by AI, examining both pathways stemming from new affordances that can give rise to a regulatory ‘disruptive moment’, as well as the Legal Development, Displacement or Destruction that can ensue. The article proposes that this model of legal disruption can be broadly generalisable to understanding the legal effects and challenges of other emerging technologies. (shrink)

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)

Three arguments are given to show that neural constructivism lacks an essential ingredient to explain cognitive development. Based on results in the theory of adaptive signal analysis, adaptive biological pattern information and self-organization in nonlinear systems of information processing, it is concluded that neural constructivism should be further extended to accommodate the occurrence of phase transitions generating qualitative development in the sense of Piaget.

BackgroundThe European Union aims to optimize patient protection and efficiency of health-care research by harmonizing procedures across Member States. Nonetheless, further improvements are required to increase multicenter research efficiency. We investigated IRB procedures in a large prospective European multicenter study on traumatic brain injury, aiming to inform and stimulate initiatives to improve efficiency.MethodsWe reviewed relevant documents regarding IRB submission and IRB approval from European neurotrauma centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury. Documents included detailed (...) information on IRB procedures and the duration from IRB submission until approval. They were translated and analyzed to determine the level of harmonization of IRB procedures within Europe.ResultsFrom 18 countries, 66 centers provided the requested documents. The primary IRB review was conducted centrally or locally and primary IRB approval was obtained after one, two or three review rounds with a median duration of respectively 50 and 98 days until primary IRB approval. Additional IRB approval was required in 55% of countries and could increase duration to 535 days. Total duration from submission until required IRB approval was obtained was 114 days and appeared to be shorter after submission to local IRBs compared to central IRBs.ConclusionWe found variation in IRB procedures between and within European countries. There were differences in submission and approval requirements, number of review rounds and total duration. Research collaborations could benefit from the implementation of more uniform legislation and regulation while acknowledging local cultural habits and moral values between countries. (shrink)

The participation of vulnerable patients in clinical research poses apparent ethical dilemmas. Depending on the nature of the vulnerability, their participation may challenge the ethical principles of autonomy, non-maleficence, or justice. On the other hand, non-participation may preclude the building of a knowledge base that is a prerequisite for defining the optimal clinical management of vulnerable patients. Such clinical uncertainty may also incur substantial economic costs. We present the participation of pre-menopausal women with atrial fibrillation in trials of novel oral (...) anticoagulant drugs as a case study. Due to their non-participation in pivotal trials, it is uncertain whether for them, the risks that are associated with these drugs are outweighed by the advantages compared with conventional treatment. We addressed the question whether research of this new class of drugs in this subgroup would be appropriate from both, an ethical as well an economic perspective. We used the method of specifying norms as a wider framework to resolve the apparent ethical dilemma, while incorporating the question whether research of oral anticoagulants in premenopausal women with atrial fibrillation can be justified on economic grounds. For the latter, the results of a value-of-information analysis were used. Further clinical research on NOACs in premenopausal women with atrial fibrillation can be justified on both, ethical and economic grounds. Addressing apparent ethical dilemmas by invoking a method such as specifying norms can improve the quality of public practical reasoning. As such, the method should also prove valuable to committees that have formally been granted the authority to review trial protocols and proposals for scientific research. (shrink)

Histories of literature tend to treat Stesichorus as just one of the lyric poets, like Alcman or Anacreon. But the vast scale of his compositions puts him in a category of his own. It has always been known that his Oresteia was divided into more than one book; P. Oxy, 2360 gave us fragments of a narrative about Telemachus of a nearly Homeric amplitude; and from P. Oxy. 2617 it was learned that the Geryoneis contained at least 1,300 verses, the (...) total being perhaps closer to two thousand. Even allowing for the shorter lines, this was as long as many an epic poem. Indeed, these were epic poems, in subject and style as well as in length: epics to be sung instead of recited. What was behind them ? Who was this Stesichorus, and how did he come to be, in Quintilian's phrase, ‘sustaining on the lyre the weight of epic song’ ? The biographical problem must be tackled first. The question of Stesichorus’ historical setting and date is confused by legendary elements as well as by contradiction in the sources. On the whole scholars remain spellbound by the specious precision of the Suda's dates , although it has long been realized that they are founded on nothing but the assumption that Stesichorus was younger than Alcman and older than Simonides. There have been excellent discussions by Wilamowitz and Maas, but they seem to have had little influence. (shrink)

Histories of literature tend to treat Stesichorus as just one of the lyric poets, like Alcman or Anacreon. But the vast scale of his compositions puts him in a category of his own. It has always been known that his Oresteia was divided into more than one book; P. Oxy, 2360 gave us fragments of a narrative about Telemachus of a nearly Homeric amplitude; and from P. Oxy. 2617 it was learned that the Geryoneis contained at least 1,300 verses, the (...) total being perhaps closer to two thousand. Even allowing for the shorter lines, this was as long as many an epic poem. Indeed, these were epic poems, in subject and style as well as in length: epics to be sung instead of recited. What was behind them? Who was this Stesichorus, and how did he come to be, in Quintilian's phrase, ‘sustaining on the lyre the weight of epic song’? The biographical problem must be tackled first. The question of Stesichorus’ historical setting and date is confused by legendary elements as well as by contradiction in the sources. On the whole scholars remain spellbound by the specious precision of the Suda's dates, although it has long been realized that they are founded on nothing but the assumption that Stesichorus was younger than Alcman and older than Simonides. There have been excellent discussions by Wilamowitz and Maas, but they seem to have had little influence. (shrink)

Burns, C. R. Introduction.--Antiquity: Margalith, D. The ideal doctor as depicted in ancient Hebrew writings. Edelstein, L. The Hippocratic oath. Edelstein, L. The professional ethics of the Greek physician. Michler, M. Medical ethics in Hippocratic bone surgery. Maas, P. L., Oliver, J. H. An ancient poem on the duties of a physician.--The medieval era: Levey, M. Medical deontology in ninth century Islam. Bar-Sela, A., Hoff, H. E. Isaac Israeli's fifty admonitions of the physicians. Rosner, F. The physician's prayer attributed (...) to Moses Maimonides. MacKinney, L. C. Medical ethics and etiquette in the early middle ages, the persistence of Hippocratic ideals. Welborn, M. C. The long tradition, a study in fourteenth-century medical deontology.--The modern period: Larkey, S. V. The Hippocratic oath in Elizabethan England. Pleadwell, F. L. Samuel Sorbiere and his Advice to a young physician. Clark, G. Bernard Mandeville, M.D., and eighteenth-century ethics. Burns, C. R. Thomas Percival, medical ethics or medical jurisprudence? Burns, C. R. Reciprocity in the development of Anglo-American medical ethics, 1765-1865. Williams, T. F. Cabot, Peabody, and the care of the patient. (shrink)

This article offers an institutional explanation for the conflicting trends in income inequality both across the Eurozone and within its member states. It argues that the euro’s introduction created different economic policy incentives for peripheral and core members. First, the euro’s design was a political choice skewed toward deflationary adjustment policies in hard times, leading to falling incomes and employment in the periphery. Second, the institutional incentives of the Eurozone are the opposite for export-driven coordinated market economies and demand-led mixed (...) market economies during booms and downturns, respectively. During the euro crisis, the Eurozone’s Northern countries gained at the expense of the Southern ones, while at the same time seeing lower domestic inequality compared to increased inequality in the periphery. This diverging pattern of European inequality was exacerbated by EU economic policy drift, the lack of any real national democratic choice in the periphery, and the growing importance of organized financial interests in Brussels. (shrink)

Over the course of the twentieth century, hydraulic engineering has come to rely primarily on the use of computational models. Disco and van den Ende hint towards the reasons for widespread adoption of computational models by pointing out that such models fulfill a crucial role as management tools in Dutch water management, and meet a more general desire to quantify water-related phenomena. The successful application of computational models implies blackboxing : “[w]hen a machine runs efficiently … one need focus only (...) on its inputs and outputs and not on its internal complexity. Thus, paradoxically, the more science and technology succeed, the more opaque and obscure they become”.. (shrink)

Drawing a framework from institutional and legitimacy theory, supplemented by concepts from the accounting literature, this study uses longitudinal crosssectional and cross-national data on over 500 firms listed in the Dow Jones Sustainability Index (DJSI) to empirically test whether these firms are strategic in their philanthropy as indicated by their measurement of the impact of their philanthropic activities along three dimensions -society, business, and reputation and stakeholder satisfaction. It is predicted that the variables' company size, amount of philanthropic expenditure, region (...) and industry influence the extent to which the various impact dimensions of philanthropy are measured. Though unexpected considering the lack of common practice in impact measurement, it is found that between 62 and 76% of the DJSI firms measure some sort of impact of their philanthropic activities, mostly impact on society and impact on reputation and stakeholder satisfaction. The number of firms that measure impact increases over the years and so does the number of firms that measure multiple dimensions of impact. Consist with our predictions, we find that larger firms and firms with relatively higher philanthropic expenditures are more likely to measure impact. Moreover, firms in the financial sector and firms from Europe and North America are also more likely to measure impact of their philanthropic activities. (shrink)

To deal with potential conflicts between the triple-bottom-line expectations of investors and the performance of executives, firms can use incentives by integrating corporate social performance targets into executive compensation. No evidence yet exists that CSP targets in executive compensation actually lead to an improvement of CSP results. Using a panel data set of 400 firms for the years 2008–2012 leading to 1846 firm-year observations, the relationships between CSP targets and CSP results and CSP improvements are analyzed. The results show that (...) the level of CSP has no effect on the use of CSP targets, the use of CSP targets in general does not automatically lead to better CSP results, and the use of quantitative, hard CSP targets is an effective way to improve CSP results, especially to lower CSP weaknesses. (shrink)

Gender discrimination continues to be a problem in organizations. It is therefore important that organizations use performance evaluation methods that ensure equal opportunities for men and women. This article reports the results of an experiment to investigate whether and, if so, how the gender of the rater and that of the ratee moderate the relationship between the level of subjectivity in performance appraisals and organizational attractiveness. Participants in the experiment were 313 undergraduate students. We predicted, and indeed established, that as (...) the probability increases that employee performance is evaluated by a female manager, women expect more positive outcomes of subjective, but not objective evaluation processes. Our data did not support our expectation that as the probability of being evaluated by a female manager increases, men expect less positive outcomes of subjective evaluation processes. The findings of this study contribute to our understanding of why women are over-represented in jobs with objective formula-based reward systems, such as piece-rate systems. They are also of interest to organizations that are looking for more ethical human resource management practices. (shrink)

Research Objective: This study focuses on ADs in the Netherlands and introduces a cross-cultural perspective by comparing it with other countries. Methods: A questionnaire was sent to a panel comprising 1621 people representative of the Dutch population. The response was 86%. Results: 95% of the respondents didn't have an AD, and 24% of these were not familiar with the idea of drawing up an AD. Most of those familiar with ADs knew about the Advanced Euthanasia Directive (AED, 64%). Both low (...) education and the presence of a religious conviction that plays an important role in one's life increase the chance of not wanting to draw up an AD. Also not having experienced a request for euthanasia from someone else, and the inconceivability of asking for euthanasia yourself, increase the chance of not wanting to draw up an AD. Discussion: This study shows that the subjects of palliative care and end-of-life-decision-making were very much dominated by the issue of euthanasia in the Netherlands. The AED was the best known AD; and factors that can be linked to euthanasia play an important role in whether or not people choose to draw up an AD. This differentiates the Netherlands from other countries and, when it comes to ADs, the global differences between countries and cultures are still so large that the highest possible goals, at this moment in time, are observing and possibly learning from other cultural settings. (shrink)

Because it promises to benefit business and society simultaneously, strategic philanthropy might be characterized as a “happy marriage” of corporate social responsibility behavior and corporate financial performance. However, as evidence so far has been mostly anecdotal, it is important to understand to what extent empirics support the actual practice as well as value of a strategic approach, which creates both business and social impacts through corporate philanthropic activities. Utilizing data from the years 2006 to 2009 for a sample of the (...) Dow Jones Sustainability Index, which monitors the world’s most sustainable companies, the authors test a model of strategic philanthropy in which the dependent variable is evidence that a firm does or does not measure business and social impacts simultaneously. From the DJSI data, the authors find a proposed measure of overall corporate social performance to be the most important explanatory factor for engagement in strategic philanthropy. Moreover, this measure of CSP has a mediating effect on the relations between certain independent variables and strategic philanthropy. Other important findings provide support for the influence of the institutional factors industry and region on the likelihood that companies are practicing strategic philanthropy, but little effect of the business characteristics company size and profitability on that likelihood. (shrink)