Certification for biofuels has been developed to ensure that biofuel production methods adhere to social and environmental sustainability standards. As such, requiring biofuel production to be certified has become part of EU policy through the 2009 renewable energy directive, that aims to promote energy security, reduce emissions and promote rural development. According to the EU RED, in 2020 10 % of our transport energy should come from renewable sources, most of which are expected to be biofuels. In this paper I (...) examine what biofuel certificates are, what they can achieve and what their limitations are. Methodologically, I will evaluate them using the standards of instrumental, practical and communicative rationality. With regard to instrumental rationality, I conclude that the EU RED makes an important but unjustified assumption in demanding certified biofuels for its target: that if biofuel production is sustainable, then biofuel use is too. I also argue that, where the EU assumes that biofuel certification is a sufficient means to achieve the EU RED’s goals, it is at best an insufficient means and at worst not a means at all towards achieving these goals. With regard to practical rationality, I argue that more attention needs to be paid to trade-offs between different goals in the EU RED, particularly with regard to providing investor security and not capping transport energy consumption. With regard to communicative rationality, I argue that the policy-making process of the EU RED has been seriously flawed, and that certification development processes also can improve significantly. (shrink)

Stakeholder involvement in design is desirable from both a practical and an ethical point of view. It is difficult to do well, however, and some problems recur again and again, both of a practical nature, e.g. stakeholders acting strategically rather than openly, and of an ethical nature, e.g. power imbalances unduly affecting the outcome of the process. Hidden Design has been proposed as a method to deal with the practical problems of stakeholder involvement. It aims to do so by taking (...) the observation of stakeholder actions, rather than the outcomes of a deliberative process, as its input. Furthermore, it hides from stakeholders the fact that a design process is taking place so that they will not behave differently than they otherwise would. Both aspects of Hidden Design have raised ethical worries. In this paper I make an ethical analysis of what it means for a design process to leave participants uninformed or deceived rather than acquiring their informed consent beforehand, and to use observation of actions rather than deliberation as input for design, using Hidden Design as a case study. This analysis is based on two sets of normative guidelines: the ethical guidelines for psychological research involving deception or uninformed participants from two professional psychological organisations, and Habermasian norms for a fair and just process. It supports the conclusion that stakeholder involvement in design organised in this way can be ethically acceptable, though under a number of conditions and constraints. (shrink)

The problem of the time of a killing is often cited as providing grounds for rejecting the action identification thesis favoured by Anscombe and Davidson. In this paper I make three claims. First, I claim that this problem is a threat to the action identification thesis because of two assumptions the thesis makes: since the thesis takes actions to be a kind of doings, it has to assume that agents’ doings last as long as their actions and vice versa. Second, (...) I claim that not making both of these assumptions necessarily leads to another problem, the problem of the acting dead. This means that any theory of action has to choose its poison and face either one of these unresolved problems. Third, I claim that the solution to the problem of the time of a killing can be found by heeding linguistic arguments that ‘kill’ cannot mean ‘cause to die,’ as is commonly assumed, but instead has to have a more complex meaning. I discuss an alternative, more complex proposal and show how it allows us to keep the action identification thesis, fits colloquial usage of ‘kill’ and deals with the problem of the time of a killing. (shrink)

Artefacts can influence our actions in several ways. They can be instruments, enabling and facilitating actions, where their presence affects the number and quality of the options for action available to us. They can also influence our actions in a morally more salient way, where their presence changes the likelihood that we will actually perform certain actions. Both kinds of influences are closely related, yet accounts of how they work have been developed largely independently, within different conceptual frameworks and for (...) different purposes. In this paper I account for both kinds of influences within a single framework. Specifically, I develop a descriptive account of how the presence of artefacts affects what we actually do, which is based on a framework commonly used for normative investigations into how the presence of artefacts affects what we can do. This account describes the influence of artefacts on what we actually do in terms of the way facts about those artefacts alter our reasons for action. In developing this account, I will build on Dancy’s (2000a) account of practical reasoning. I will compare my account with two alternatives, those of Latour and Verbeek, and show how my account suggests a specification of their respective key concepts of prescription and invitation. Furthermore, I argue that my account helps us in analysing why the presence of artefacts sometimes fails to influence our actions, contrary to designer expectations or intentions. (shrink)

The human enhancement debate typically centres on moral issues regarding changes in human nature, not on the means for these changes. We argue that one cannot grasp what is morally salient about human enhancement without understanding how technologies affect human action and practical reasoning. We present a minimalist conception of human agents as bounded practical reasoners. Then, we categorise different effects of technologies on our possibilities for action and our evaluation of these possibilities. For each, we discuss whether enhancement technologies (...) have morally salient effects; which technologies show these effects; and whether these differ significantly from those of other, non-enhancement technologies. We conclude that enhancement technologies are morally salient in several respects, that not all enhancement technologies share all those morally salient respects, and that continuities with traditional technologies may be found in all morally salient respects. (shrink)

The advent of personal genomics companies offering direct translation of scientific data into personal health information, calls into question traditional policies to refuse disclosure of such scientific data to research participants. This seems especially true for population biobanks, as they collect not only genotype information but also associated phenotype information, and thus may be in a unique position to translate their scientific findings into personal health information for their participants. Disclosure of such information seems mandated by the expectations raised by (...) biobanks and their participants' rights to know health information, to know clinical research results, to life and health and particularly their right to benefit. Refusals to disclose such information can be grounded in the lack of analytical validity and/or clinical utility of most findings, the need to avoid the therapeutic misconception, the complexity and costs involved in translation and disclosure and the disproportionate burden resulting from the obligation to respect participants' right not to know before any disclosure can be made. Currently, any demands by participants in population biobanks for full disclosure of all pertinent personal health information potentially resulting from the biobank's scientific findings are unlikely to be granted by a Dutch court under Dutch and international law. As the law stands now, a population biobank is neither a doctor nor a personal genomics company. However, in view of the rapid scientific, medical, technological, commercial and social developments, population biobanks must prepare to take more care of their participants' legitimate interest in receiving as much validated personal health information as reasonably possible, in a timely fashion, by developing appropriate translation and disclosure mechanisms. This paper examines whether population biobank participants have the right, under Dutch civil law and international law, to full disclosure, i.e. to all information generated by the biobank that is pertinent to their present and future health. It pioneers the format of a hypothetical court case to elucidate the legal and policy arguments" for and against full disclosure. (shrink)

The aim of this study was to examine to what extent patients remained silent to the health care system after they experienced abusive or wrongful incidents in health care. Female patients visiting a women’s clinic in Sweden (n = 530) answered the Transgressions of Ethical Principles in Health Care Questionnaire (TEP), which was constructed to measure patients’ abusive experiences in the form of staff’s transgressions of ethical principles in health care. Of all the patients, 63.6% had, at some point, experienced (...) staff’s transgressions of ethical principles, and many perceived these events as abusive and wrongful. Of these patients, 70.3% had remained silent to the health care system about at least one transgression. This silence is a loss of essential feedback for the health care system and should not automatically be interpreted as though patients are satisfied. (shrink)

Robert F. is an eighty-five-year-old who suffered a heart attack at home in a rural location some thirty minutes from any major hospital. By the time the paramedics arrived, he was unconscious and nonresponsive. After spontaneous return of circulation, they began their standard procedure of therapeutic hypothermia. Robert's core temperature was lowered using ice packs, and cold intravenous fluids were initiated. Soon afterward, Robert started to shiver when his body temperature reached 35.6° Celsius. He was then given a bolus of (...) vecuronium as a neuromuscular blockade, sedated, and intubated. He was also given a low-dose vasopressin for blood-pressure control. Shortly after Robert arrived in the emergency room, his daughter, his medical decision-maker, produced an advance directive documenting that her father has a do-not-resuscitate order, and she demanded that the breathing tube and any other life-sustaining treatments be withdrawn immediately. The medical staff is very reluctant to comply with this demand for immediate action. Until the neuromuscular blockade wears off, removing the ventilator will prevent Robert from breathing. Furthermore, it may take some time to reverse the therapeutic hypothermia procedure to the point that the patient is at normal temperature. In addition, therapeutic hypothermia itself often causes arrest, so the patient may need to be resuscitated again. Should the staff wait until the patient is warm or honor the decision of his daughter, who holds his medical power of attorney? (shrink)

There has been longstanding interest in the consistency of decisions made by research ethics committees in the UK, but most of the evidence has come from single studies submitted to multiple committees. A systematic comparison was carried out of the decisions made on 18 purposively selected applications, each of which was reviewed independently by three different RECs in a single strategic health authority. Decisions on 11 applications were consistent, but disparities were found among RECs on decisions on seven applications. An (...) analysis of the agreement between decisions of RECs yielded an overall measure of agreement of κ = 0.286 , indicating a level of agreement that, although probably better than chance, may be described as “slight”. The small sample size limits the robustness of these findings. Further research on reasons for inconsistencies in decision making between RECs, and on the importance of such inconsistencies for a range of arguments, is needed. (shrink)

The intuitionistic consequence operation restricted to the language with (equivalence) and (negation) as the only connectives is axiomatized by means of a finite set of sequential rules of inference.

We would like to thank Dolega and Dewhurst for a thought-provoking and informed deconstruction of our article, which we take as applause from valued members of our audience. In brief, we fully concur with the theatre-free formulation offered by Dolega and Dewhurst and take the opportunity to explain why we used the Cartesian theatre metaphor. We do this by drawing an analogy between consciousness and evolution. This analogy is used to emphasize the circular causality inherent in the free energy principle. (...) We conclude with a comment on the special forms of active inference that may be associated with selfawareness and how they may be especially informed by dream states. (shrink)

The question of how an individual firm's social and environmental performance impacts its firm risk has not been examined in any empirical UK research. Does a company that strives to attain good environmental performance decrease its market risk or is environmental performance just a disadvantageous cost that increases such risk levels for these firms? Answers to this question have important implications for the management of companies and the investment decisions of individuals and institutions. The purpose of this paper is to (...) examine the relationship between corporate environmental performance and firm risk in the British context. Using the largest dataset assembled so far, with community and environmental responsibility (CER) rankings for all rated UK companies between 1994 and 2006, we show that a company's environmental performance is inversely related to its systematic financial risk. However, an increase of 1.0 in the CER score is associated with only a 0.028 reduction in its β. (shrink)

The question of how an individual firm's social and environmental performance impacts its firm risk has not been examined in any empirical UK research. Does a company that strives to attain good environmental performance decrease its market risk or is environmental performance just a disadvantageous cost that increases such risk levels for these firms? Answers to this question have important implications for the management of companies and the investment decisions of individuals and institutions. The purpose of this paper is to (...) examine the relationship between corporate environmental performance and firm risk in the British context. Using the largest dataset assembled so far, with community and environmental responsibility (CER) rankings for all rated UK companies between 1994 and 2006, we show that a company's environmental performance is inversely related to its systematic financial risk. However, an increase of 1.0 in the CER score is associated with only a 0.028 reduction in its β. (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)

To investigate the possible dichotomy between the neurophysiological bases of perceptual transitions versus sustaining a particular percept over time, an fMRI study was conducted with subjects viewing fragmented pictures. Unlike most other perceptually unstable stimuli, fragmented pictures give rise to only one perceptual transition and a continuous period of sustained perception. Earlier research is inconclusive on the subject of which anatomical regions should be attributed to what temporal aspect of perception, and the aim of the present study was to shed (...) more light on the subject. In this study occipitotemporal and fronto-parietal regions were found to be activated for both aspects. However, regions in the medial-temporal lobe were activated specifically for transitions, whereas medial and dorsolateral prefrontal regions were activated specifically for sustained perception. These results provide further support for the theory that the initial creation of perceptual awareness and upholding perceptual awareness over time are separate processes involving different brain regions. (shrink)

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

In this paper we distinguish two competing conceptions of dignity, one recognizably Hobbesian and one recognizably Kantian. We provide a formal model of how decision-makers committed to these conceptions of dignity might reason when engaged in an economic transaction that is not inherently insulting, but in which it is possible for the dignity of the agent to be called into question. This is a modified version of the ultimatum game. We then use this model to illustrate ways in which the (...) Kantian evaluative standpoint enjoys a kind of internal stability that the Hobbesian framework lacks. Our interpersonal argument shows that, under certain conditions, Hobbesians prefer to cultivate Kantian commitments in others and promote the presence of Kantians in the population. Our intrapersonal argument shows that agents who are conflicted between Kantian and Hobbesian commitments have powerful reasons not to resolve this commitment in favour of Hobbesian values. Our emulation argument illustrates that in repeated versions of the ultimatum game, the Hobbesian chooses to behave like a Kantian, including publicly repudiating her Hobbesian commitments. Here again, however, the Hobbesian is able to achieve a desired benefit only on the condition that there are genuine Kantians in the population. Finally, our social planning argument explores the reasons why a community of Hobbesians would opt to enshrine a Kantian conception of dignity into law. The paper concludes with some remarks about the policy implications of this work. The value or worth of a man is, as for all other things, his price, that is to say, so much as would be given for the use of his power; and therefore is not absolute, but a thing dependent on the need and judgement of another... The public worth of a man, which is the value set on him by the Common-wealth, is that which men commonly call DIGNITY. Hobbes, _Leviathan X_, 16. (shrink)

The relationship between ideals I of Turing degrees and groups of I-recursive automorphisms of the ordering on rationals is studied. We discuss the differences between such groups and the group of all automorphisms, prove that the isomorphism type of such a group completely defines the ideal I, and outline a general correspondence between principal ideals of Turing degrees and the first-order properties of such groups.

The considerable attention to financial interests in clinical research has focused mostly on academic medical centers, even though the majority of clinical research is conducted in community practice settings. To fill this gap, this article maps the practices and policies in 73 community hospitals and several hundred specialized facilities around the country for reviewing clinical investigators’ financial relationships with research sponsors. Community hospitals face a substantially different mix of issues than academic medical centers do because their physician researchers are usually (...) not employees, and more of their studies are later-phase, multicenter trials. Accordingly, community physicians stand to benefit personally from per capita payments, but they tend to have less direct influence over research findings when compared with their academic peers. These and other contrasts require separate guidance for community-based organizations that takes into account their particular needs, circumstances, and institutional capacities. (shrink)

Originally published in 1926, this book attempts to state 'what has been believed with regard to God's incapacity for suffering'. Mozley charts the development of the doctrine from the Apostolic Fathers through the Reformation to the modern influence of metaphysical philosophy and concludes with six questions intended to prompt further theological discussion on this point. This book will be of value to anyone with an interest in the history of Christian theology.

A longitudinal, epidemiological study was carried out in a rural area of Kenya with a population of about 28,000 between 1974 and 1980. Population registration during this time showed that population growth was very high between 1974 and 1978 (4·4% per year) and much lower in 1979 and 1980 (1·1%). Natural increase was nearly as high as in Kenya as a whole (3·7%) in this period. Fertility was somewhat lower than in all Kenya (the crude birth rate was 46 per (...) 1000) while mortality was substantially lower (7 per 1000). Evidence is presented supporting the argument that these low mortality rates are genuine. Levels of temporary and permanent migration are high and probably characteristic for many parts of Kenya. The change in population growth in 1979 and 1980 is probably due to changes in economic conditions leading in particular to less in-migration and to more out-migration. (shrink)

Harris’ reply to our defence of the National Institute for Clinical Excellence’s (NICE) current cost-effectiveness procedures contains two further errors. First, he wrongly draws a conclusion from the fact that NICE does not and cannot evaluate all possible uses of healthcare resources at any one time and generally cannot know which National Health Service (NHS) activities would be displaced or which groups of patients would have to forgo health benefits: the inference is that no estimate is or can be made (...) by NICE of the benefits to be forgone. This is a non-sequitur. Second, he asserts that it is a flaw at the heart of the use of quality-adjusted life years (QALYs) as an outcome measure that comparisons between people need to be made. Such comparisons do indeed have to be made, but this is not a consequence of the choice of any particular outcome measure, be it the QALY or anything else. (shrink)

A study was undertaken of the views of users of two genitourinary medicine (GUM) clinics in England on unlinked anonymous testing (UAT) for HIV. The UAT programme measures the prevalence of HIV in the population, including undiagnosed prevalence, by testing residual blood (from samples taken for clinical purposes) which is anonymised and irreversibly unlinked from the source. 424 clinic users completed an anonymous questionnaire about their knowledge of, and attitudes towards, UAT. Only 1/7 (14%) were aware that blood left over (...) from clinical testing may be tested anonymously for HIV. A large majority (89%) said they would agree to their blood being tested, although 74% wanted the opportunity to consent. These findings indicate broad support for UAT of blood in a group of patients whose samples are included in the HIV surveillance programme. The findings suggest the need for greater attention to be given to the provision of information and, if replicated in a larger survey, may justify a reappraisal of UK policy on UAT. (shrink)

Recently, new developments took place in the Dutch debate on the legislation of euthanasia. After a brief account of that debate, the article discusses a new government proposal for legislation in this field, which was submitted to the Dutch parliament in November 1991. This proposal relates not only to euthanasia but also to some other medical decisions concerning the end of life. The author concludes that, for several reasons, it is unsatisfactory.