This article presents standards for setting up and educating institutional ethics committees (IECs). These standards are based on experiences in the Netherlands, where IECs have been established in a large number of health care institutions. Though the IEC has become a generally accepted institution within Dutch health care, there are concerns over its effectiveness regarding the improving of the moral quality of clinical decision making. Health care practitioners and members of IECs too, experience a gap between the IEC and the (...) reality of the clinical environment. At this moment, there is interest in developing programmes which educate practitioners in moral issues and how to deal with them, using the method of a structured debate on the ward. The IEC will not be made obsolete by this development, but can play a guiding role in the implementation of such programmes. Current concerns are the lack of patient representation in the Dutch IEC, and the loss of contact with the local community of health care practitioners because of the merger of hospitals into bodies similar to UK National Health Service (NHS) trusts. (shrink)

This article reports the findings of a study into the role of Dutch nurses in the alleviation of pain and symptoms with a life-shortening intention, conducted as part of a study into the role of nurses in medical end-of-life decisions. A questionnaire survey was carried out using a population of 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The response rate was 82.0%; 78.1% (1179) were suitable for analysis. The results show that in about half (...) of the cases (55.8%) nurses were involved in the decision making by the physician and that nurses were frequently (81.5%) involved in administering the medication. The authors' conclusion is that alleviation of pain and symptoms with a life-shortening intention represents a `grey' area, in which physicians and nurses act on the basis of personal ethical norms rather than legal rules, professional guidelines or shared moral values. (shrink)

This document presents the Bonn PRINTEGER Consensus Statement: Working with Research Integrity—Guidance for research performing organisations. The aim of the statement is to complement existing instruments by focusing specifically on institutional responsibilities for strengthening integrity. It takes into account the daily challenges and organisational contexts of most researchers. The statement intends to make research integrity challenges recognisable from the work-floor perspective, providing concrete advice on organisational measures to strengthen integrity. The statement, which was concluded February 7th 2018, provides guidance on (...) the following key issues: § 1.Providing information about research integrity § 2.Providing education, training and mentoring § 3.Strengthening a research integrity culture § 4.Facilitating open dialogue § 5.Wise incentive management § 6.Implementing quality assurance procedures § 7.Improving the work environment and work satisfaction § 8.Increasing transparency of misconduct cases § 9.Opening up research § 10.Implementing safe and effective whistle-blowing channels § 11.Protecting the alleged perpetrators § 12.Establishing a research integrity committee and appointing an ombudsperson § 13.Making explicit the applicable standards for research integrity. (shrink)

This article reports the findings of a study into the role of Dutch nurses in the alleviation of pain and symptoms with a life-shortening intention, conducted as part of a study into the role of nurses in medical end-of-life decisions. A questionnaire survey was carried out using a population of 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The response rate was 82.0%; 78.1% were suitable for analysis. The results show that in about half of (...) the cases nurses were involved in the decision making by the physician and that nurses were frequently involved in administering the medication. The authors' conclusion is that alleviation of pain and symptoms with a life-shortening intention represents a `grey' area, in which physicians and nurses act on the basis of personal ethical norms rather than legal rules, professional guidelines or shared moral values. (shrink)

Results of two survey studies are presented. It is shown that attitudes of the public about "technology in general" are not stable and can easily be affected by how the subject is introduced. Eight areas of technology are compared on the basis of empirical relations in attitudinal judgments, in attribute ratings, in self- assigned importance weights of attributes, and in importance of reference groups and persons. On the basis of similarities in these four kinds of judgments, three clusters of technology (...) areas were identified: a cluster of modern reproductive technologies, an information cluster containing automation, computer, and communication technologies, and a cluster containing nuclear energy and military technology. The attitude toward "technology in general" can not be considered as an aggregation of attitudes toward these areas of technology: The relations between general attitude and specific attitudes are only moderate to negligible. (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)

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

From 1980 until 1985, the Dutch Faculties of Philosophy went through a period of transition. First, in 1982 the national government introduced a new system of financing research at the universities. This was essentially based on the natural sciences and did not match philosophers' work organization. In 1983 a drastic reduction in the budget for philosophy was proposed within the framework of a policy of introducing savings by distributing tasks among the universities. Recently, a visiting committee reported on the weak (...) and strong areas of Dutch philosophy and proposed a policy to strengthen Dutch philosophy. This study explores the effects of the institutional reorganizations on the study of philosophy at the faculties, using scientometric methods. In addition to presenting empirical results, some methodological questions concerning the application of scientometric methods to a field of the humanities will be discussed. The number of publications went up as funding was cut back and different subfields made different kinds of changes in orientation. The results show the relevance of publication-based data in research evaluation. (shrink)

Research on social influences often distinguishes between social and quality incentives to ascribe meaning to the value that popularity conveys. This study examines the neural correlates of those incentives through which popularity influences preferences. This research reports an functional magnetic resonance imaging experiment and a behavioral task in which respondents evaluated popular products with three focus perspectives; unspecified focus, focus on social aspects, and focus on quality. The results show that value derived with a social focus reflects inferences of approval (...) and reward value, and positively affects preferences. Value derived with a quality focus reflects inferences of quality and negatively affects preferences. This study provides evidence of two distinct inferential routes on both a neurological level, represented by different regions in the brain, and a behavioral level. These results provide the first evidence that a single popularity cue can in different ways influence the value derived from product popularity. (shrink)

Since the emergence of the innovative field of artificial intelligence in the 1960s, the late Hubert Dreyfus insisted on the ontological distinction between man and machine, human and artificial intelligence. In the different editions of his classic and influential book What computers can’t do, he posits that an algorithmic machine can never fully simulate the complex functioning of the human mind—not now, nor in the future. Dreyfus’ categorical distinctions between man and machine are still relevant today, but their relation has (...) become more complex in our increasingly data-driven society. We, humans, are continuously immersed within a technological universe, while at the same time ubiquitous computing, in the words of computer scientist Mark Weiser, “forces computers to live out here in the world with people” The cell phone reader. Peter Lang Publishing, New York, 2006, p 20). Dreyfus’ ideas are therefore challenged by thinkers such as Weiser, Kevin Kelly, Bruno Latour, Philip Agre, and Peter Paul Verbeek, who all argue that humans are much more intrinsically linked to machines than the original dichotomy suggests—they have evolved in concert. Through a discussion of the classical concepts of individuum and ‘authenticity’ within Western civilization, this paper argues that within the ever-expanding data-sphere of the twenty-first century, a new concept of man as ‘aggregate of data’ has emerged, which further erodes and undermines the categorical distinction between man and machine. This raises political and ethical questions beyond the confines of technology and artificial intelligence. Moreover, this seemingly never-ending debate on what computers should do provokes the philosophical necessity to once again define the concept of what it is to be ‘human.’. (shrink)

Individuals with heavy paid and unpaid work burdens may experience time deprivations that restrict their well-being and put them at risk of becoming or remaining income poor. Because unpaid work outside of the market is not captured in most large survey-based datasets, time poverty is rarely recognized in policy and practice. Yet income poverty and time poverty are mutually reinforcing; they can sap energy and impede effective decision-making, thus perpetuating the state of poverty. This essay offers a five-step approach to (...) conceptualizing and measuring time poverty and it compares time poverty rates by gender across a range of developing countries. Results show that women have higher time poverty rates than men in most cases, with the main exception being countries with low rates of female labor force participation. Policies that strengthen physical and social infrastructure, thereby decreasing the time needed for unpaid household work, have demonstrable effects on reducing time poverty. (shrink)

I en række afhandlinger beskrives den hollandske ISAF styrkes indsats i Afghanisatn fra 2001-2010. I en fireårig periode fra 2006-2010 var det hollandske kontingent indsat i den afghanske provins Uruzgan og opnåede bemærkelsesværdige resultater. Sikkerhedssituationen blev forbedret, den økonomiske udvikling blev stabiliseret ligesom den offentlige administration, uddannelsen af børn og sundhedsplejen m.v. blev forbedret. Efter 2010 er provinsen overtaget af amerikanske og australske tropper.

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)

The relation between “presence” and “representation” is an age-old topic in the arts, but it is further complicated in our time of advanced media conditions. Pierre Huyghe is one artist who has consistently addressed questions of presence and representation throughout his artistic oeuvre, including the role of the witness within it. Considering the sophistication of Huyghe’s work with regard to the riddle of presence in the realm of contemporary means of representation, the artist’s work is taken as a case study (...) for a broad range of artists exploring related topics within the arts and the media. This paper argues that art that interrogates the question of presence within the context of contemporary media culture—from Marina Abramović to Stelarc, Jeffrey Shaw to Julia Scher—asks for being interpreted through presence theories developed within the field of media studies in addition to methods of art theory and criticism. Accordingly, Huyghe’s work is productively related to one such theory, namely the YUTPA model by Caroline Nevejan, which theorizes the interrelated concepts of natural, mediated, and witnessed presence. (shrink)

We analyze the cognitive strategies underlying performance in the Number task, a Math game that requires both arithmetic fluency and mathematical creativity. In this game all elements in a set of numbers have to be used precisely once to create a target number with basic arithmetic operations. We argue that some instances of this game are NP complete, by showing its relation to the well-known Partition problem. We propose heuristics based on the distinction in forward and backward reasoning. The Number (...) Game is part of Math Garden, a popular online educational platform for practicing and monitoring math skills using innovations in computerized adaptive testing. These educational games generate enormous amounts of rich data on children's cognitive development. We found converging evidence for the use of forward proximity heuristics in the data of Math Garden, consisting of more than 20 million answers to 1,700 items. Item difficulties and the structure of correct answers were analyzed. (shrink)

There is ambiguity with regard to what counts as an acceptable level of risk in clinical research in pregnant women and there is no input from stakeholders relative to such research risks. The aim of our paper was to explore what stakeholders who are actively involved in the conduct of clinical research in pregnant women deem an acceptable level of risk for pregnant women in clinical research. Accordingly, we used the APOSTEL VI study, a low-risk obstetrical randomised controlled trial, as (...) a case-study. We conducted a prospective qualitative study using 35 in-depth semi-structured interviews and one focus group. We interviewed healthcare professionals, Research Ethics Committee members and regulators who are actively involved in the conduct of clinical research in pregnant women, in addition to pregnant women recruited for the APOSTEL VI case-study in the Netherlands. Three themes characterise the way stakeholders view risks in clinical research in pregnant women in general. Additionally, one theme characterises the way healthcare professionals and pregnant women view risks with respect to the case-study specifically. First, ideas on what constitutes an acceptable level of risk in general ranged from a preference for zero risk for the foetus up to minimal risk. Second, the desirability of clinical research in pregnant women in general was questioned altogether. Third, stakeholders proposed to establish an upper limit of risk in potentially beneficial clinical research in pregnant women in order to protect the foetus and the pregnant woman from harm. Fourth and finally, the case-study illustrates that healthcare professionals’ individual perception of risk may influence recruitment. Healthcare professionals, RECs, regulators and pregnant women are all risk adverse in practice, possibly explaining the continuing underrepresentation of pregnant women in clinical research. Determining the acceptable levels of risk on a universal level alone is insufficient, because the individual perception of risk also influences behaviour towards pregnant women in clinical research. Therefore, bioethicists and researchers might be interested in changing the perception of risk, which could be achieved by education and awareness about the actual benefits and harms of inclusion and exclusion of pregnant women. (shrink)

This volume presents a comprehensive analysis of the linkages between inequality, development, and growth from a feminist economics perspective. More specifically, it examines connections between intergroup inequality and macroeconomic outcomes, considering various channels through which gender, growth, and development interact. Using a range of analytical methods, country studies, and levels of aggregation, the contributors argue that inequalities based on gender, race, ethnicity, and class undermine the ability of people to provision and live fully to their capabilities. Authors examine the effect (...) of macroeconomic policies and economic growth on inequalities in material resources and well-being, as well as the effects of inequality on economic growth. The volume offers specific explanations for how the macroeconomy can hinder the achievement of gender equality and in turn how gender relations in areas like education and wage gaps can have macro-level impacts. Finally, the volume offers a rich array of policy options for promoting gender equality as both an intrinsic goal and a step toward improving well-being and broadly-shared development. This book was published as a special issue of _Feminist Economics_. (shrink)

Sober and Brandon et al. disagree about the role of screening-off in the appraisal of theories of natural selection. Some problems disregarded by them are unearthed in this discussion note.