Summary In 1874, the Dutch chemist and Nobel prizewinner Jacobus Henricus van 't Hoff (1852?1911) laid the foundations for stereochemistry with a publication in which he openly suggested that molecules were real physical entities with a three-dimensional structure. He visualized this new spatial concept with illustrations, but also with the help of small cardboard molecular models, which he made himself. Some of these models have survived the ravages of time and are among the oldest molecular models in the world still (...) in existence. What is more, they are the first material models of a three-dimensional molecular structure ever made. This article describes the surviving Van 't Hoff models, kept in Museum Boerhaave in Leiden and in the Deutsches Museum in Munich. Special attention is paid to the use of these models and the specific purposes they served. A closer examination of the models and their context reveals that they had an essential part to play in the early development and spread of Van 't Hoff's stereochemistry theory: he put his molecular models not only to versatile use as didactic tools, scientific instruments, and precursors to experimental proof, but also as devices to persuade other scientists of the usefulness of his theory. (shrink)

New and Emerging Science and Technology (NEST) based innovations, e.g. in the field of Life Sciences or Nanotechnology, frequently raise societal and political concerns. To address these concerns NEST researchers are expected to deploy socially responsible R&D practices. This requires researchers to integrate social and ethical aspects (SEAs) in their daily work. Many methods can facilitate such integration. Still, why and how researchers should and could use SEAs remains largely unclear. In this paper we aim to relate motivations for NEST (...) researchers to include SEAs in their work, and the requirements to establish such integration from their perspectives, to existing approaches that can be used to establish integration of SEAs in the daily work of these NEST researchers. Based on our analyses, we argue that for the successful integration of SEAs in R&D practice, collaborative approaches between researchers and scholars from the social sciences and humanities seem the most successful. The only way to explore whether that is in fact the case, is by embarking on collaborative research endeavours. (shrink)

In response to an increasing amount of policy papers stressing the need for integrating social and ethical aspects in Research and Development (R&D) practices, science studies scholars have conducted integrative research and experiments with science and innovation actors. One widely employed integration method is Midstream Modulation (MM), in which an ‘embedded humanist’ interacts in regular meetings with researchers to engage them with the social and ethical aspects of their work. While the possibility of using MM to enhance critical reflection has (...) been demonstrated in academic settings, few attempts have been made to examine its appropriateness in industry. This paper describes the outcomes of a case study aiming to find out firstly whether MM can effectively be deployed to encourage and facilitate researchers to actively include social and ethical aspects in their daily R&D practice, and secondly to what extent the integration activities could form an integral part of the engaged industrial researchers’ professional activities. Our data show that after MM, researchers display increased reflexive awareness on the social and ethical aspects of their work and acknowledge the relevance and utility of such aspects on their daily practice. Also, all participants considered actively reflecting on social and ethical aspects to be part of their work. Future research on the role of MM in industrial settings could focus on how to embed social and ethical integration as a regular part of innovation practice. We suggest that one possibility would be through aligning social and ethical aspects with innovation Key Performance Indicators. (shrink)

In this paper, we introduce the methodology and techniques of metaargumentation to model argumentation. The methodology of meta-argumentation instantiates Dung's abstract argumentation theory with an extended argumentation theory, and is thus based on a combination of the methodology of instantiating abstract arguments, and the methodology of extending Dung's basic argumentation frameworks with other relations among abstract arguments. The technique of meta-argumentation applies Dung's theory of abstract argumentation to itself, by instantiating Dung's abstract arguments with meta-arguments using a technique called flattening. (...) We characterize the domain of instantiation using a representation technique based on soundness and completeness. Finally, we distinguish among various instantiations using the technique of specification languages. (shrink)

Thanks to the exchange of arguments, groups outperform individuals on some tasks, such as solving logical problems. However, these results stem from experiments conducted among Westerners and they could be due to cultural particularities such as tolerance of contradiction and approval of public debate. Other cultures, collectivistic cultures in particular, are said to frown on argumentation. Moreover, some influential intellectual movements, such as Confucianism, disapprove of argumentation. In two experiments, the hypothesis that Easterners might not share the benefits of argumentation (...) was tested. In Experiment 1, Japanese participants had to solve a standard logical problem individually and then in groups. They performed significantly better in groups. In Experiment 2, Japanese participants had to estimate the weight of various animals. They did so individually, then after learning of another participant's estimates, then after discussing these estimates with the other participant, and then indi.. (shrink)

In this paper, we introduce the methodology and techniques of meta-argumentation to model argumentation. The methodology of meta-argumentation instantiates Dung’s abstract argumentation theory with an extended argumentation theory, and is thus based on a combination of the methodology of instantiating abstract arguments, and the methodology of extending Dung’s basic argumentation frameworks with other relations among abstract arguments. The technique of meta-argumentation applies Dung’s theory of abstract argumentation to itself, by instantiating Dung’s abstract arguments with meta-arguments using a technique called flattening. (...) We characterize the domain of instantiation using a representation technique based on soundness and completeness. Finally, we distinguish among various instantiations using the technique of specification languages. (shrink)

Policy makers call upon researchers from the natural and social sciences to collaborate for the responsible development and deployment of innovations. Collaborations are projected to enhance both the technical quality of innovations, and the extent to which relevant social and ethical considerations are integrated into their development. This could make these innovations more socially robust and responsible, particularly in new and emerging scientific and technological fields, such as synthetic biology and nanotechnology. Some researchers from both fields have embarked on collaborative (...) research activities, using various Technology Assessment approaches and Socio-Technical Integration Research activities such as Midstream Modulation. Still, practical experience of collaborations in industry is limited, while much may be expected from industry in terms of socially responsible innovation development. Experience in and guidelines on how to set up and manage such collaborations are not easily available. Having carried out various collaborative research activities in industry ourselves, we aim to share in this paper our experiences in setting up and working in such collaborations. We highlight the possibilities and boundaries in setting up and managing collaborations, and discuss how we have experienced the emergence of ‘collaborative spaces.’ Hopefully our findings can facilitate and encourage others to set up collaborative research endeavours. (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)

Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of this study was to evaluate one way of organizing MCD in two Dutch nursing homes. In both of these nursing homes the MCD groups had a heterogeneous composition and were organized (...) apart from existing institutional communication structures. As part of a naturalistic evaluation, systematic observations, interviews and focus groups were completed. The findings indicate that the heterogeneous composition and MCD meetings separate from existing structures have benefits. However, the participants also reported negative experiences. This gives rise to the question whether a mixed MCD group which meets separately is an effective way to embed MCD as an instrument for reflection on moral issues in daily practice. We conclude that there is no single answer to that question. In the end, the two implementation strategies (i.e. within existing communication structures and a mixed MCD group) can be complementary to each other. (shrink)

Our study presents an overview of the issues that were brought forward by participants of a moral case deliberation (MCD) project in two elderly care organizations. The overview was inductively derived from all case descriptions (N = 202) provided by participants of seven mixed MCD groups, consisting of care providers from various professional backgrounds, from nursing assistant to physician. The MCD groups were part of a larger MCD project within two care institutions (residential homes and nursing homes). Care providers are (...) confronted with a wide variety of largely everyday ethical issues. We distinguished three main categories: ‘resident’s behavior’, ‘divergent perspectives on good care’ and ‘organizational context’. The overview can be used for agendasetting when institutions wish to stimulate reflection and deliberation. It is important that an agenda is constructed from the bottom-up and open to a variety of issues. In addition, organizing reflection and deliberation requires effort to identify moral questions in practice whilst at the same time maintaining the connection with the organizational context and existing communication structures. Once care providers are used to dealing with divergent perspectives, inviting different perspectives (e.g. family members) to take part in the deliberation, might help to identify and address ethical ‘blind spots’. (shrink)

Clinical ethics support mechanisms in healthcare are increasing but little is known about the specific developments in elderly care. The aim of this paper is to present a systematic literature review on the characteristics of existing ethics support mechanisms in institutional elderly care. A review was performed in three electronic databases . Sixty papers were included in the review. The ethics support mechanisms are classified in four categories: ‘institutional bodies’ ; ‘frameworks’ ; ‘educational programmes and moral case deliberation’; and ‘written (...) documents and policies’. For each category the goals, methods and ways of organising are described. Ethics support often serves several goals and can be targeted at various levels: case, professional or organisation. Over the past decades a number of changes have taken place in the development of ethics support in elderly care. Considering the goals, ethics support has become more outreaching and proactive, aiming to qualify professionals to integrate ethics in daily care processes. The approaches in clinical ethics support have become more diverse, more focused on everyday ethical issues and better adapted to the concrete learning style of the nursing staff. Ethics support has become less centrally organised and more connected to local contexts and primary process within the organisation. (shrink)

This article describes compassion as perceived within the relationship between nurses and older persons with a chronic disease. The aim of the study is to understand the benefit of compassion for nursing practice within the context of long-term care. The design of the study involves a qualitative analysis of in-depth interviews with nurses and patients in three different care-settings. Results show the nature of compassion in seven dimensions: attentiveness, listening, confronting, involvement, helping, presence and understanding. Analysis of the data also (...) shows in what way opinions of participants relate to issues raised in a previous literature study, for example the difference between pity and compassion. The conclusion states that compassion is a valuable process which motivates patients as well as nurses to cooperate in achieving relevant outcomes of care. The discussion involves some methodological issues. For one thing, further confirmation of the dimensions found is recommended. (shrink)

Background Notwithstanding the need to produce evidence-based knowledge on medications for pregnant women, they remain underrepresented in clinical research. Sometimes they are excluded because of their supposed vulnerability, but there are no universally accepted criteria for considering pregnant women as vulnerable. Our aim was to explore whether and if so to what extent pregnant women are vulnerable as research subjects. Method We performed a conceptual and empirical analysis of vulnerability applied to pregnant women. Analysis A conceptual analysis supports Hurst's definition (...) of vulnerability. Consequently, we argue that pregnant women are vulnerable if they encounter an identifiably increased likelihood of incurring additional or greater wrong. According to the literature, this increased likelihood could exist of four alleged features for pregnant women's vulnerability: informed consent, susceptibility to coercion, higher exposure to risk due to lack of knowledge, vulnerability of the fetus. Discussion Testing the features against Hurst's definition demonstrates that they all concern the same issue: pregnant women are only vulnerable because a higher exposure to risk due to lack of scientific knowledge comprises an increased wrong. Research Ethics Committees have a responsibility to protect the vulnerable, but a higher exposure to risk due to lack of scientific knowledge is a much broader issue and also needs to be addressed by other stakeholders. Conclusions The only reason why pregnant women are potentially vulnerable is to the extent that they are increasingly exposed to higher risks due to a lack of scientific knowledge. Accordingly, the discussion can advance to the development of practical strategies to promote fair inclusion of pregnant women in clinical research. (shrink)

Introduction: In The Netherlands, physicians have to be convinced that the patient suffers unbearably and hopelessly before granting a request for euthanasia. The extent to which general practitioners (GPs), consulted physicians and members of the euthanasia review committees judge this criterion similarly was evaluated. Methods: 300 GPs, 150 consultants and 27 members of review committees were sent a questionnaire with patient descriptions. Besides a “standard case” of a patient with physical suffering and limited life expectancy, the descriptions included cases in (...) which the request was mainly rooted in psychosocial or existential suffering, such as fear of future suffering or dependency. For each case, respondents were asked whether they recognised the case from their own practice and whether they considered the suffering to be unbearable. Results: The cases were recognisable for almost all respondents. For the “standard case” nearly all respondents were convinced that the patient suffered unbearably. For the other cases, GPs thought the suffering was unbearable less often (2–49%) than consultants (25–79%) and members of the euthanasia review committees (24–88%). In each group, the suffering of patients with early dementia and patients who were “tired of living” was least often considered to be unbearable. Conclusions: When non-physical aspects of suffering are central in a euthanasia request, there is variance between and within GPs, consultants and members of the euthanasia committees in their judgement of the patient’s suffering. Possible explanations could be differences in their roles in the decision-making process, differences in experience with evaluating a euthanasia request, or differences in views regarding the permissibility of euthanasia. (shrink)

During the past decennium, one of the main issues discussed in research ethics has been focused on the care that should be provided to the control group in a clinical trial. This discussion is also called the standard of care debate . Current international research ethics guidelines contain a wide variety of standards for the standard of care—including the provision of the highest attainable, the best available, the best current, a proven , and an established effective treatment. In this article, (...) we systematically review the currently used standards and argue that none of the current standards is adequate to serve as a universal standard for the standard of care. Alex London has made a substantial proposal for a universal standard, but universally adopting his standard is problematic. In this article, we propose a revised version of London's standard. (shrink)

In academic research, many attempts have been undertaken to legitimize corporate community involvement by showing a business case for it. However, much less attention has been devoted to building understanding about the actual dynamics and challenges of managing CCI in the business context. As an alternative to existing predominantly static and top-down approaches, this paper introduces a social movement framework for analyzing CCI management. Based on the analysis of qualitative case study data, we argue that the active role of employees (...) pressuring for CCI policies and practices, as well as the organization audience responses to their efforts, are at the core of the challenges involved in managing CCI. These challenges also pose limits to how far CCI can be extended to a “business as usual” activity. (shrink)

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.

It is often argued that clinical research should not violate the Kantian principle that people must not be used merely as a means for the purposes of others. At first sight, the practice of clinical research itself, however, seems to violate precisely this principle: clinical research is often beneficial to future people rather than to participants; even if participants benefit, all things considered, they are exposed to discomforts which are absent both in regular care for their diseases and in other (...) areas of daily life. Therefore, in this paper we will consider whether people are used merely as a means by being enrolled in clinical research. On the basis of recent studies of Kantian scholars we will argue that clinical research is compatible with the Kantian principle if the conditions of possible consent and end-sharing have been met. Participants are not used merely as a means if they have sufficient reasons to consent to being enrolled in clinical research and can share the ends of the researchers who use them. Moreover, we will claim that even if people are used merely as a means by participating in clinical research, it may not always be morally wrong to use them in this way. (shrink)

Background: Although genetic research into Alzheimer disease (AD) is increasing, the ethical aspects of this kind of research and the differences between ethical issues related to genetic and non-genetic research into AD have not yet received much attention. Objectives: (1) To identify and compare the five ethical issues considered most important by surveyed expert panellists in non-genetic and genetic AD research and (2) to compare our empirical findings with ethical issues in genetic research in general as described in the literature. (...) Method: A modified Delphi study in two rounds Results: Genetic and non-genetic research into AD generated an approximately equal number of topics with a considerable overlap. Different priorities in the ethics of both types of research were found. Genetic research raised new topics such as “confidentiality of genetic information” and “implications of research for relatives” which changes the impact and application of existing ethical topics such as “informed consent” and is judged to have more impact on both individuals and society. A difference with the results of more theoretical approaches on ethical aspects related to AD research was also found. Conclusions: Different priorities are given to ethical issues in genetic and non-genetic research. These arise partly because genetic research causes unique and new questions, mostly related to the position of family members and the status of and access to genetic information. Differences found between the results of our empirical study and the more theoretical literature, suggest an additional value for empirical research in medical ethics. (shrink)

This essay attempts to develop a psychologically informed semantics of perception reports, whose predictions match with the linguistic data. As suggested by the quotation from Miller and Johnson-Laird, we take a hallmark of perception to be its fallible nature; the resulting semantics thus necessarily differs from situation semantics. On the psychological side, our main inspiration is Marr's (1982) theory of vision, which can easily accomodate fallible perception. In Marr's theory, vision is a multi-layered process. The different layers have filters of (...) different gradation, which makes vision at each of them approximate. On the logical side, our task is therefore twofold - to formalise the layers and the ways in which they may refine each other, and. (shrink)

Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the (...) contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people’s perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization. (shrink)

The dominant view of the ventral and dorsal visual systems is that they subserve perception and action. De Wit, Van der Kamp, and Masters suggested that a more fundamental distinction might exist between the nature of information exploited by the systems. The present study distinguished between these accounts by asking participants to perform delayed matching , pointing and perceptual judgment responses to masked Müller–Lyer stimuli of varying length. Matching and pointing responses of participants who could not perceptually judge stimulus length (...) at brief durations remained sensitive to veridical stimulus length , but not the illusion , which was effective at long durations. Distinct thresholds for egocentric and allocentric information pick up were thus evident irrespective of whether perception or action responses were required. It was concluded that the dorsal and ventral systems may be delineated fundamentally by fast egocentric- and slower allocentric information pick up, respectively. (shrink)

Background: Debates over legalisation of physician-assisted suicide or euthanasia often warn of a “slippery slope”, predicting abuse of people in vulnerable groups. To assess this concern, the authors examined data from Oregon and the Netherlands, the two principal jurisdictions in which physician-assisted dying is legal and data have been collected over a substantial period.Methods: The data from Oregon comprised all annual and cumulative Department of Human Services reports 1998–2006 and three independent studies; the data from the Netherlands comprised all four (...) government-commissioned nationwide studies of end-of-life decision making and specialised studies. Evidence of any disproportionate impact on 10 groups of potentially vulnerable patients was sought.Results: Rates of assisted dying in Oregon and in the Netherlands showed no evidence of heightened risk for the elderly, women, the uninsured , people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations. The only group with a heightened risk was people with AIDS. While extralegal cases were not the focus of this study, none have been uncovered in Oregon; among extralegal cases in the Netherlands, there was no evidence of higher rates in vulnerable groups.Conclusions: Where assisted dying is already legal, there is no current evidence for the claim that legalised PAS or euthanasia will have disproportionate impact on patients in vulnerable groups. Those who received physician-assisted dying in the jurisdictions studied appeared to enjoy comparative social, economic, educational, professional and other privileges. (shrink)