Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction and the assignment of responsibilities . This theoretical (...) framework prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as ‘intentionally taking the life of another person by a physician, upon that person’s request’ can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)

Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction and the assignment of responsibilities. This theoretical framework (...) prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as ‘intentionally taking the life of another person by a physician, upon that person’s request’ can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)

Physics is the most fundamental of the sciences and its main purpose is to explain how the world works on the smallest as well as the largest scales. This book outlines the most important discoveries and technical development in the field of physics during the past two decades. The reader will learn the basics of the major theories that form the backbone of the current understanding of the universe through descriptions of the latest findings in particle physics, quantum optics, structure (...) of matter or astrophysics. The book also explains how devices such as lasers or particle accelerators work. (shrink)

This essay traces the history of premenstrual syndrome in French, British, and American medical literature from 1950 to 2004. Aetiological theories, treatments and diagnostic criteria have varied over time and place, reflecting local conditions and changing notions of objectivity and evidence. During the 1970s researchers in each nation utilised different research strategies to overcome variation and contradictory results characteristic of PMS research. Since the 1980s, attempts have been made to standardise research internationally through prospective daily rating questionnaires that diagnose and (...) measure PMS. Amidst controversy, a psychiatric reformulation of the syndrome was included in the Diagnostic and Statistical Manual of Mental Disorders . While the diagnostic criteria for this psychiatric category, now called premenstrual dysphoric disorder , are widely accepted for research purposes, efforts to transfer them to medical practice have been less successful. PMDD remains a contested disease construct. (shrink)

Medical and public health research includes surveys, interviews, and biospecimens — techniques that do not present substantial risks to subjects. Consequently, this research is exempt from regulation under the Federal Common Rule. Nevertheless, at many institutions, exempt research is frequently subject to the same regulatory process that is required for non-exempt research, requiring the consumption of time and resources for review by Institutional Review Board members or staff. The federal government has indicated an intention to reform and centralize this system, (...) but has not yet specified the form that it will use instead. By examining the policies of the top 50 research institutions, this article assesses institutional practices surrounding exempt research, quantifies the extent of exempt-research review requirements, documents a problem of “over-compliance,” and makes recommendations for reform. (shrink)

This article summarizes the multitude of empirical studies that test ethical decision making in business and suggests additional research necessary to further theory in this area. The studies are categorized and related to current theoretical ethical decision making models. The studies are related to awareness, individual and organizational factors, intent, and the role of moral intensity in ethical decision making. Summary tables provide a quick reference for the sample, findings, and publication outlet. This review provides insights for understanding organizational ethical (...) decision constructs, where ethical decision making theory currently stands, and provides insights for future empirical work on organizational ethical decision making. (shrink)

In the debate surrounding the introduction of non-invasive prenatal testing in prenatal screening programmes, the concept of routinisation is often used to refer to concerns and potential negative consequences of the test. A literature analysis shows that routinisation has many different meanings, which can be distinguished in three major versions of the concept. Each of these versions comprises several inter-related fears and concerns regarding prenatal screening and particularly regarding NIPT in three areas: informed choice, freedom to choose and consequences for (...) people with a disability. Three of the strongest arguments raised under the flag of routinisation are assessed for their validity: the threat that NIPT poses to informed choice, the potential increase in uptake of first-trimester prenatal screening and its consequences for social pressure to participate in screening or terminate affected pregnancies, and the negative consequences for disabled people. These routinisation arguments lack empirical or normative ground. However, the results of this analysis do not imply that no attention should be paid to possible problems surrounding the introduction of NIPT. At least two problems remain and should be addressed: there should be an ongoing debate about the requirements of informed choice, particularly related to an expanded scope of prenatal screening. Also, reproductive autonomy can only be achieved when expecting parents’ options are variegated, real and valuable, so that they can continue to choose whether or not to screen or to terminate a pregnancy. (shrink)

Informed consent is a key condition for prenatal screening programmes to reach their aim of promoting reproductive autonomy. Reaching this aim is currently being challenged with the introduction of non-invasive prenatal testing (NIPT) in first-trimester prenatal screening programmes: amongst others its procedural ease—it only requires a blood draw and reaches high levels of reliability—might hinder women’s understanding that they should make a personal, informed decision about screening. We offer arguments for a renewed recognition and use of informed consent compared to (...) informed choice, and for a focus on value-consistent choices and personalized informational preferences. We argue for a three-step counselling model in which three decision moments are distinguished and differently addressed: (1) professionals explore women’s values concerning whether and why they wish to know whether their baby has a genetic disorder; (2) women receive layered medical-technical information and are asked to make a decision about screening; (3) during post-test counselling, women are supported in decision-making about the continuation or termination of their pregnancy. This model might also be applicable in other fields of genetic (pre-test) counselling, where techniques for expanding genome analysis and burdensome test-outcomes challenge counselling of patients. (shrink)

Informed consent is a key condition for prenatal screening programmes to reach their aim of promoting reproductive autonomy. Reaching this aim is currently being challenged with the introduction of non‐invasive prenatal testing (NIPT) in first‐trimester prenatal screening programmes: amongst others its procedural ease—it only requires a blood draw and reaches high levels of reliability—might hinder women’s understanding that they should make a personal, informed decision about screening. We offer arguments for a renewed recognition and use of informed consent compared to (...) informed choice, and for a focus on value‐consistent choices and personalized informational preferences. We argue for a three‐step counselling model in which three decision moments are distinguished and differently addressed: (1) professionals explore women’s values concerning whether and why they wish to know whether their baby has a genetic disorder; (2) women receive layered medical‐technical information and are asked to make a decision about screening; (3) during post‐test counselling, women are supported in decision‐making about the continuation or termination of their pregnancy. This model might also be applicable in other fields of genetic (pre‐test) counselling, where techniques for expanding genome analysis and burdensome test‐outcomes challenge counselling of patients. (shrink)

We study a generalization of the standard syntax and game-theoretic semantics of logic, which is based on a duality between two players, to a multiplayer setting. We define propositional and modal languages of multiplayer formulas, and provide them with a semantics involving a multiplayer game. Our focus is on the notion of equivalence between two formulas, which is defined by saying that two formulas are equivalent if under each valuation, the set of players with a winning strategy is the same (...) in the two respective associated games. We provide a derivation system which enumerates the pairs of equivalent formulas, both in the propositional case and in the modal case. Our approach is algebraic: We introduce multiplayer algebras as the analogue of Boolean algebras, and show, as the corresponding analog to Stone’s theorem, that these abstract multiplayer algebras can be represented as concrete ones which capture the game-theoretic semantics. For the modal case we prove a similar result. We also address the computational complexity of the problem whether two given multiplayer formulas are equivalent. In the propositional case, we show that this problem is co-NP-complete, whereas in the modal case, it is PSPACE-hard. (shrink)

The nature of mental representations of linguistic expressions in relation to the time course from intention to articulation is a major issue. We discuss Branigan & Pickering's proposal to use structural priming to tap into this process. We show that their interpretation of their findings cannot be maintained. We reinterpret these results and suggest a revision of their conclusions.

This article is a case study of a woman-owned and-operated sexual products business, conceived in the midst of a fragmenting women's movement in 1977. The article tracks the evolution of pro-sex feminist ideology within this business during the past 22 years. Whereas most feminist organizations research focuses on nonprofit organizations and their relationship to the state, this study focuses on a political organization that depends on profits for survival. The voices in this study reveal the complexities of running an “alternative” (...) business during the 1980s and 1990s and of balancing political ideals with profit needs. Ironically, as Toy Box and its consumer base grow, more and more men and women are exposed to pro-sex feminism and buying into its philosophy. This contradiction is fundamental to the story of Toy Box's history and evolution. (shrink)

The introduction of non-invasive prenatal testing in healthcare systems around the world offers an opportunity to reconsider funding policies for prenatal screening. In some countries with universal access healthcare systems, pregnant women and their partners are asked to pay for NIPT. In this paper, we discuss two important rationales for charging women for NIPT: to prevent increased uptake of NIPT and to promote informed choice. First, given the aim of prenatal screening, high or low uptake rates are not intrinsically desirable (...) or undesirable. Using funding policies to negatively affect uptake, however, is at odds with the aim of screening. Furthermore, copayment disproportionally affects those of lower socioeconomic status, which conflicts with justice requirements and impedes equal access to prenatal screening. Second, we argue that although payment models may influence pregnant women’s choice behaviours and perceptions of the relevance of NIPT, the copayment requirement does not necessarily lead to better-informed choices. On the contrary, external influences on women’s personal choices for or against prenatal screening should ideally be avoided. To improve informed decision-making, healthcare systems should instead invest in adequate non-directive, value-focused pretest counselling. This paper concludes that requiring copayments for NIPT in universal access healthcare systems fails to promote reproductive autonomy and is unfair. (shrink)

Aan de orde komen opvattingen over (de rol van) vrouwen in het werk van westerse filosofen, te weten Plato, Aristoteles, St. Thomas Aquinas, Christine de Pisan, Bacon, Descartes, Rousseau, Kant, Wollstonecraft, Schopenhauer, Nietzsche, Irigaray.

Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction (Abbott) and the assignment of responsibilities (Gusfield). This (...) theoretical framework prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as 'intentionally taking the life of another person by a physician, upon that person's request' can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)

This article provides a brief overview of several formal frameworks concerning the relation between knowledge on the one hand, and obligation on the other. We discuss the paradox of the knower, knowledge based obligation, knowingly doing, deontic dynamic epistemology, descriptive obligations, and responsibilities as dynamic epistemology.

This article focuses on the influence of male role models on the lives of adolescents in the U.S. National Longitudinal Lesbian Family Study. Half of the adolescents had male role models; those with and those without male role models had similar scores on the feminine and masculine scales of the Bem Sex Role Inventory, as well as on the trait subscales of the State-Trait Personality Inventory and the Child Behavior Checklist. A positive association was found between feminine gender role traits (...) and curiosity, and a negative correlation between this trait and internalizing problem behavior; these associations were independent of the gender of the adolescents and the presence of male role models. In sum, the absence of male role models did not adversely affect the psychological adjustment of adolescents reared by lesbian mothers. (shrink)

Der Beitrag perspektiviert das Verhältnis von Werk und Wissenschaften auf zwei­ fache Weise: zum einen nimmt er das künstlerische Werk als ›Gegenstand‹ der Wissenschaften in den Blick. Ausgehend von Werkausgaben wird gezeigt, dass und inwiefern die Literaturwissenschaft im Rahmen der Editionspraxis maßgeblich an der Konstitution ihrer primären Forschungsgegenstände beteiligt ist. Zum anderen werden Werke als ›Medien‹ der Wissenschaften untersucht. Dabei wird nach den Implikationen des Werkstatus von Forschungsarbeiten für die wissenschaftliche Praxis gefragt. Neben der Kategorie des wissenschaftlichen Œuvres werden dazu (...) spezifische Werktypen (Standardwerke, Dissertations­ und Habilitationsschriften) untersucht und auch die medialen Rahmenbedingungen von wissenschaftlichen Werken reflektiert. Aus dieser Doppelperspektive erweist sich die Kategorie des Werks als aufschlussreicher Bezugspunkt für die Untersuchung von disziplinspezifischen und disziplinübergreifenden Wissenschaftspraktiken. (shrink)

Asking pregnant women to pay for non-invasive prenatal testing out of pocket leads to unequal access across socioeconomic strata. To avoid these social justice issues, first-trimester prenatal screening should be publicly funded in countries such as the Netherlands, with universal coverage healthcare systems that offer all other antenatal care services and screening programmes free of charge. In this reply, we offer three additional reasons for public funding of NIPT. First, NIPT may not primarily have medical utility for women and children, (...) but rather offers relevant information and reproductive options, and thus serves important autonomy interests of women. Second, public funding of NIPT can be justified because it results in a reduction of collectively borne costs associated with care and support for children with chromosomal abnormalities. It is important to note that this is not an argument for individual women to take part in screening or to terminate an affected pregnancy. However, it is a legitimate argument in policy making regarding funding arrangements for screening programmes. Finally, public funding would help to amend current misunderstandings among pregnant women, and thus to support informed consent for first-trimester prenatal screening. (shrink)

We present nine facets for the analysis of the past and future evolution of AI. Each facet has also a set of edges that can summarise different trends and contours in AI. With them, we first conduct a quantitative analysis using the information from two decades of AAAI/IJCAI conferences and around 50 years of documents from AI topics, an official database from the AAAI, illustrated by several plots. We then perform a qualitative analysis using the facets and edges, locating AI (...) systems in the intelligence landscape and the discipline as a whole. This analytical framework provides a more structured and systematic way of looking at the shape and boundaries of AI. (shrink)

Despite changes in their representation and visibility, there are still serious concerns about the inclusion and day-to-day workplace challenges various groups face (e.g., women, ethnic and cultural minorities, LGBTQ+, people as they age, and those dealing with physical or mental disabilities). Men are also underrepresented in specific work fields, in particular those in HEED (Health care, Elementary Education and the Domestic sphere). Previous literature has shown that group stereotypes play an important role in maintaining these inequalities. We outline how insights (...) from research on stigma, social-identity, and self-regulation together increase our understanding of how targets are affected by and regulate negative stereotypes in the workplace. This approach starts from the basis that members of negatively-stereotyped groups are not just passive recipients of negative attitudes, stereotypes, and behaviors, but are active individuals pursuing multiple goals, such as goals for belonging and achievement. We argue that it is only by understanding stigma from the target’s perspective (e.g., how targets are affected and respond) that we can successfully address workplace inequality. Key in this understanding is that stereotypes, prejudice and discrimination have taken on much more subtle forms, with consequences for the way members of stigmatized-groups cope. These insights lead us to propose an approach to understanding barriers to workplace equality that highlights four key aspects: a) the different (often subtle) potential triggers of identity-threat in the workplace for members of stigmatized-groups, b) the ways in which members of stigmatized-groups cope with these threats, c) the role of supportive factors that mitigate potential threats and affect self-regulation, and d) potential hidden costs for the self or others of what appears at first to be effective self-regulation. The focus on threats, coping, support, and potential hidden costs helps us understand why current diversity efforts are not always successful in increasing and maintaining members of stigmatized-groups in organizations, and provides insight into how we can aid efforts to effectively lower barriers to workplace equality. (shrink)