Euthanasia and physician-assisted suicide (PAS) by request and/or based on an advance directive are legal in The Netherlands under strict conditions, thus providing options for patients with Huntington's disease (HD) and other neurodegenerative diseases to stay in control and choose their end of life. HD is an inherited progressive disease characterised by chorea and hypokinesia, psychiatric symptoms and dementia. From a qualitative study based on interviews with 15 physicians experienced in treating HD, several ethical issues emerged. Consideration of these aspects (...) leads to a discussion about the professional role of a physician in relation to the personal autonomy of a patient. Such a discussion can raise awareness that talking about end-of-life wishes with an HD patient is part of the legal, professional and moral responsibility of the physician, and that a letter of intent on behalf of the physician can improve active participation in the process. Discussion of these issues can help to advance the debate on euthanasia and PAS in HD and other neurodegenerative diseases. (shrink)

The medical record, as a managerial, historic, and legal document, serves many purposes. Although its form may be well established and many of the cases documented in it routine in medical experience, what is written in the medical record nevertheless records decisions and actions of individuals. Viewed as an interpretive text, it can itself become the object of interpretation. This essay applies literary theory and methodology to the structure, content, and writing style(s) of an actual medical record for the purpose (...) of exploring the relationship between the forms and language of medical discourse and the daily decisions surrounding medical treatment. The medical record is shown to document not only the absence of a consistent treatment plan for the patient studied but also a breakdown in communication between different health professionals caring for that patient. The paper raises questions about the kind of education being given to house staff in this instance. The essay concludes with a consideration of how such situations might be more generally avoided. (shrink)

ABSTRACTThe recognition of emotional facial expressions is often subject to contextual influence, particularly when the face and the context convey similar emotions. We investigated whether spontaneous, incidental affective theory of mind inferences made while reading vignettes describing social situations would produce context effects on the identification of same-valenced emotions as well as differently-valenced emotions conveyed by subsequently presented faces. Crucially, we found an effect of context on reaction times in both experiments while, in line with previous work, we found evidence (...) for a context effect on accuracy only in Experiment 1. This demonstrates that affective theory of mind inferences made at the pragmatic level of a text can automatically, contextually influence the perceptual processing of emotional facial expressions in a separate task even when those emotions are of a distinctive valence. Thus, our novel findings suggest that language acts as a contex... (shrink)

This article discusses the nature of euthanasia, and the way in which redevelopment of the concept of euthanasia in some influential recent philosophical writing has led to morally less discriminating killing/letting die/not saving being misdescribed as euthanasia. Peter Singer's defence of non-voluntary ‘euthanasia’of defective infants in his influential book Practical Ethics is critically evaluated. We argue that Singer's pseudo-euthanasia arguments in Practical Ethics are unsatisfactory as approaches to determining the legitimacy of killing, and that these arguments present a total utilitarian (...) improvement policy—not a case for non-voluntary euthanasia. (shrink)

The standard medical case report often reduces patients and caregivers to complexes of medical facts and clinical decisions. Restructuring the genre itself to acknowledge the human dimensions of both patients and physicians allows questions of human values to regain their stature as integral components of the discourse.

The objective of this study is to evaluate if use of a patient decision aid, when choosing between a repeat cesarean or a trial of labor after a cesarean, reduces medical liability exposure. The authors conclude that use of a PDA conferred liability protection when potential jurors were presented with a hypothetical malpractice claim against an obstetrician following a TOLAC.

Institutional review boards are almost universally considered to be overworked and understaffed. They also require substantial commitments of time and resources from their members. Although some surveys report average IRB memberships of 15 people or more, federal regulations require only five. We present data on IRB meetings at eight of the top 25 academic medical centers in the United States funded by the National Institutes of Health. These data indicate substantial contributions from primary reviewers and chairs during protocol discussions but (...) little from other members, which implies that it may be possible for smaller IRBs to accomplish the same tasks with no reduction in the quality of review. (shrink)

Research has shown that it requires less time to process information that is part of an objective causal relation describing states of affairs in the world (She was out of breath because she was running), than information that is part of a subjective relation (She must have been in a hurry because she was running) expressing a claim or conclusion and a supporting argument. Representing subjectivity seems to require extra cognitive operations. In Mental Spaces Theory (MST; Fauconnier, Gilles. 1994. Mental (...) spaces: Aspects of meaning construction in natural language. Cambridge: MIT Press) the difference between these two relation types can be described in terms of an extra mental space in the discourse representation of subjective relations: representing the Subject of Consciousness (SoC). In processing terms, this might imply that the processing difference is not present if this SoC has already been established in the discourse. We tested this prediction in two eye tracking experiments. The results of Experiment 1 showed that signaling the subjectivity of the relation by introducing a subject of consciousness beforehand did not diminish the processing asymmetry compared to a neutral context. However, the relative complexity of subjective relations was diminished in the context of Free Indirect Speech (No! He was absolutely sure. There was no doubt about it. She was running so she was in hurry; Experiment 2). In terms of MST and the representation of subjectivity in general, this implies that not only creating a representation of a thinking subject, but also assigning a claim to this thinking subject requires extra processing effort. (shrink)

As sharing and secondary research use of biospecimens increases, IRBs and researchers face the challenge of protecting and respecting donors without comprehensive regulations addressing the human subject protection issues posed by biobanking. Variation in IRB biobanking policies about these issues has not been well documented.

New agrifood technologies are often difficult to grasp for the public, which may lead to resistance or even rejection. Insight into which technology features determine public acceptability of the technology could offer guidelines for responsible technology development. This paper systematically assesses the relative importance of specific technology features for consumer response in the agrifood domain in two consecutive studies. Prominent technology features were selected from expert judgment and literature. The effects of these features on consumer evaluation were tested in a (...) consumer study. Fictitious technologies were used to avoid any uncontrollable contextual influences that existing new technologies may evoke. Results show that technologies that were seen as more natural and newer were perceived less risky, more beneficial, and were evaluated more positively. Technologies applied to food were judged to be more beneficial, but also more risky than those applied to non-food. Technologies used in the production process were perceived to be less risky and evaluated more positively than those used in the product. Technologies owned by the market leader were perceived to be more beneficial, and evaluated more positively than those that were freely available. In a next study, effects of the technology features on consumer response were tested for existing new agrifood technologies. This study replicated the results for perceived naturalness, perceived newness, and place in the production process where the technology is applied. However, in contrast to the first study, we did not find an effect of application area and technology ownership. (shrink)

When experiencing personal distress, people usually expect their romantic partner to be supportive. However, when put in a situation to provide support, people may at times be struggling with issues of their own. This interdependent nature of dyadic coping interactions as well as potential spillover effects is mirrored in the state-of-the-art research method to behaviorally assess couple’s dyadic coping processes. This paradigm typically includes two videotaped 8-min dyadic coping conversations in which partners swap roles as sharer and support provider. Little (...) is known about how such dyadic coping interactions may feed back into one another, impacting the motivation and ability to be a responsive support provider. In three behavioral studies, we examined how sharers’ experiences may spill over to affect their own support provision in a subsequent dyadic coping interaction. We hypothesized that the extent to which sharers perceive their partner as responsive to their self-disclosure increases the quality of their own subsequent support provision, whereas sharers’ lingering negative affect reduces the quality of their own subsequent support provision. In line with our first hypothesis, perceived partner responsiveness predicted the provision of higher-quality support, though primarily as perceived by the partner. Sharers who perceived their partner to have been more responsive were somewhat more likely to subsequently engage in positive dyadic coping and were rated as more responsive by their partners. Negative dyadic coping behavior was unaffected. Evidence for our second hypothesis was mixed. While lingering negative affect did not affect positive dyadic coping behavior or perceived support, it did increase the chances of negative dyadic coping behavior. However, given the very low occurrences of negative affect and negative dyadic coping, these findings should be interpreted with caution. Taken together, these findings suggest that support interactions may feed back into one another, highlighting the complex and interdependent nature of dyadic coping. The strongest and most consistent findings concerned the spillover effect of perceived partner responsiveness on subsequent perceived support quality, speaking to the key role of believing that one’s partner is responsive to one’s needs in promoting healthy relationship functioning. (shrink)

Children who experience well-being are engaging more confidently and positively with their caregiver and peers, which helps them to profit more from available learning opportunities and support current and later life outcomes. The goodness-of-fit theory suggests that children’s well-being might be a result of the interplay between their temperament and the environment. However, there is a lack of studies that examined the association between children’s temperament and well-being in early childhood education and care, and whether this association is affected by (...) ECEC process quality. Using a multilevel random coefficient approach, this study examines the association between toddlers’ temperament and well-being in Norwegian ECEC and investigates whether process quality moderates this association. Results reveal an association between temperament and well-being. Staff-child conflict moderates the association between shyness and well-being, and between activity and well-being. Moreover, high emotional behavioral support moderates the association between activity and well-being. Extra attention should be paid by the staff to these children’s needs. (shrink)

Critically significant parental effects in behavioral genetics may be partly understood as a consequence of maternal brain structure and function of caregiving systems recently studied in humans as well as rodents. Key parental brain areas regulate emotions, motivation/reward, and decision making, as well as more complex social-cognitive circuits. Additional key environmental factors must include socioeconomic status and paternal brain physiology. These have implications for developmental and evolutionary biology as well as public policy.

The least infringement principle has been widely endorsed by public health scholars. According to this principle, public health policies may infringe upon “general moral considerations” in order to achieve a public health goal, but if two policies provide the same public health benefit, then policymakers should choose the one that infringes least upon “general moral considerations.” General moral considerations can encompass a wide variety of goals, including fair distribution of burdens and benefits, protection of privacy and confidentiality, and respect for (...) autonomy.In this article, we argue that the Center for Disease Control and Prevention's 2006 HIV screening recommendations may violate the least infringement principle. This is a concern because, although not legally binding, the Recommendations appear to have already influenced state laws and will likely continue to do so as legislative proposals continue to be passed. At a minimum, therefore, the Recommendations have important implications for HIV screening within the United States. (shrink)

This handbook presents a comprehensive introduction to the core areas of philosophy of education combined with an up-to-date selection of the central themes. It includes 95 newly commissioned articles that focus on and advance key arguments; each essay incorporates essential background material serving to clarify the history and logic of the relevant topic, examining the status quo of the discipline with respect to the topic, and discussing the possible futures of the field. The book provides a state-of-the-art overview of philosophy (...) of education, covering a range of topics: Voices from the present and the past deals with 36 major figures that philosophers of education rely on; Schools of thought addresses 14 stances including Eastern, Indigenous, and African philosophies of education as well as religiously inspired philosophies of education such as Jewish and Islamic; Revisiting enduring educational debates scrutinizes 25 issues heavily debated in the past and the present, for example care and justice, democracy, and the curriculum; New areas and developments addresses 17 emerging issues that have garnered considerable attention like neuroscience, videogames, and radicalization. The collection is relevant for lecturers teaching undergraduate and graduate courses in philosophy of education as well as for colleagues in teacher training. Moreover, it helps junior researchers in philosophy of education to situate the problems they are addressing within the wider field of philosophy of education and offers a valuable update for experienced scholars dealing with issues in the sub-discipline. Combined with different conceptions of the purpose of philosophy, it discusses various aspects, using diverse perspectives to do so. Contributing Editors: Section 1: Voices from the Present and the Past: Nuraan Davids Section 2: Schools of Thought: Christiane Thompson and Joris Vlieghe Section 3: Revisiting Enduring Debates: Ann Chinnery, Naomi Hodgson, and Viktor Johansson Section 4: New Areas and Developments: Kai Horsthemke, Dirk Willem Postma, and Claudia Ruitenberg. (shrink)

This book updates and adds to the classic Social Movements of the Sixties and Seventies, showing how social movement theory has grown and changed.

Despite the burgeoning literature on professionalism in other health professions, psychology lags behind in the level of attention given to this core competency. In this article, we review definitions from other health professions and how they address professionalism. Next, we review how this competency evolved within health service psychology (HSP), and we propose a definition. We offer an approach for assessing professionalism within HSP. Consideration is given to strategies and methods for providing effective education and training in this multifaceted competency. (...) Finally, recommendations are made for creating a culture of professionalism within HSP and honoring psychology’s social contract with multiple publics. (shrink)

Toward A Sociological Imagination builds on the ideas C. Wright Mills expressed in The Sociological Imagination for an approach to the scientific method broad enough to open up to the full range of knowledge within the sociology discipline. In this book, nine sociologists and one philosopher provide detailed tests of the utility of the approach within diverse substantive sociological areas.

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.

Although certain aspects of C.S. Lewis's work have been studied in great detail, others have been comparatively neglected. This collection of essays looks at Lewis's life and work, and those of his friends and associates, from many different angles, but all connected through a common theme of identity. Questions of identity are essential to the understanding of any writer. The ways authors perceive themselves and who they are, the communities they belong to by birth or choice, inevitably influence their work. (...) The way they present other people, real or fictional, are also rooted in their own conception of identity. In this volume, scholars from several countries examine gender and family roles; national, regional, racial and professional identities; membership of a particular church; ideological attachments and personal descriptions, either with regard to Lewis and those who knew him and influenced him, or in a study of their writings. Authors studied here include J.R.R. Tolkien, Dorothy L. Sayers, Charles Williams, George MacDonald and T.S. Eliot. (shrink)

This co-edited volume compares Chinese and Western experiences of engineering, technology, and development. In doing so, it builds a bridge between the East and West and advances a dialogue in the philosophy of engineering. Divided into three parts, the book starts with studies on epistemological and ontological issues, with a special focus on engineering design, creativity, management, feasibility, and sustainability. Part II considers relationships between the history and philosophy of engineering, and includes a general argument for the necessity of dialogue (...) between history and philosophy. It continues with a general introduction to traditional Chinese attitudes toward engineering and technology, and philosophical case studies of the Chinese steel industry, railroads, and cybernetics in the Soviet Union. Part III focuses on engineering, ethics, and society, with chapters on engineering education and practice in China and the West. The book’s analyses of the interactions of science, engineering, ethics, politics, and policy in different societal contexts are of special interest. The volume as a whole marks a new stage in the emergence of the philosophy of engineering as a new regionalization of philosophy. This carefully edited interdisciplinary volume grew out of an international conference on the philosophy of engineering hosted by the University of the Chinese Academy of Sciences in Beijing. It includes 30 contributions by leading philosophers, social scientists, and engineers from Australia, China, Europe, and the United States. (shrink)

Sedlakova and Trachsel (2023) argue that on the one hand, conversational artificial intelligence (CAI) does not fulfill the necessary conditions for full attribution of agency, such as having consc...

Mental health chatbots (MHCBs) designed to support individuals in coping with mental health issues are rapidly advancing. Currently, these MHCBs are predominantly used in commercial rather than clinical contexts, but this might change soon. The question is whether this use is ethically desirable. This paper addresses a critical yet understudied concern: assuming that MHCBs cannot have genuine emotions, how this assumption may affect psychotherapy, and consequently the quality of treatment outcomes. We argue that if MHCBs lack emotions, they cannot have (...) genuine (affective) empathy or utilise countertransference. Consequently, this gives reason to worry that MHCBs are (a) more liable to harm and (b) less likely to benefit patients than human therapists. We discuss some responses to this worry and conclude that further empirical research is necessary to determine whether these worries are valid. We conclude that, even if these worries are valid, it does not mean that we should never use MHCBs. By discussing the broader ethical debate on the clinical use of chatbots, we point towards how further research can help us establish ethical boundaries for how we should use mental health chatbots. (shrink)

Aim To ascertain the quantity and nature of gifts and items provided by the pharmaceutical industry in Australia to medical specialists and to consider whether these are appropriate in terms of justifiable ethical standards, empirical research and views expressed in the literature.