Prenatal screening for foetal abnormalities such as Down's syndrome differs from other forms of population screening in that the usual aim of achieving health gains through treatment or prevention does not seem to apply. This type of screening leads to no other options but the choice between continuing or terminating the pregnancy and can only be morally justified if its aim is to provide meaningful options for reproductive choice to pregnant women and their partners. However, this aim should not be (...) understood as maximizing reproductive choice per se. Only if understood as allowing prospective parents to avoid suffering related to living with serious disorders and handicaps can prenatal screening be a publicly or collectively funded programme. The alternative of moving prenatal testing outside the healthcare system into the private sector is problematic, as it makes these tests accessible only to those who can afford to pay for it. New developments in prenatal screening will have to be assessed in terms of whether and to what extent they either contribute to or undermine the stated aim of providing meaningful options for reproductive choice. In the light of this criterion, this article discusses the introduction of the new non-invasive prenatal test , the tendency to widen the scope of follow-up testing, as well as the possible future scenarios of genome-wide screening and ‘prenatal personalised medicine’. The article ends with recommendations for further debate, research and analysis. (shrink)

Prenatal screening for foetal abnormalities such as Down's syndrome differs from other forms of population screening in that the usual aim of achieving health gains through treatment or prevention does not seem to apply. This type of screening leads to no other options but the choice between continuing or terminating the pregnancy and can only be morally justified if its aim is to provide meaningful options for reproductive choice to pregnant women and their partners. However, this aim should not be (...) understood as maximizing reproductive choice per se. Only if understood as allowing prospective parents to avoid suffering related to living with (a child with) serious disorders and handicaps can prenatal screening be a publicly or collectively funded programme. The alternative of moving prenatal testing outside the healthcare system into the private sector is problematic, as it makes these tests accessible only to those who can afford to pay for it. New developments in prenatal screening will have to be assessed in terms of whether and to what extent they either contribute to or undermine the stated aim of providing meaningful options for reproductive choice. In the light of this criterion, this article discusses the introduction of the new non‐invasive prenatal test (NIPT), the tendency to widen the scope of follow‐up testing, as well as the possible future scenarios of genome‐wide screening and ‘prenatal personalised medicine’. The article ends with recommendations for further debate, research and analysis. (shrink)

Prenatal screening pathways, as nowadays offered in most Western countries consist of similar tests. First, a risk-assessment test for major aneuploides is offered to pregnant women. In case of an increased risk, invasive diagnostic tests, entailing a miscarriage risk, are offered. For decades, only conventional karyotyping was used for final diagnosis. Moreover, several foetal ultrasound scans are offered to detect major congenital anomalies, but the same scans also provide relevant information for optimal support of the pregnancy and the delivery. Recent (...) developments in prenatal screening include the application of microarrays that allow for identifying a much broader range of abnomalities than karyotyping, and non-invasive prenatal testing that enables reducing the number of invasive tests for aneuploidies considerably. In the future, broad NIPT may become possible and affordable. This article will briefly address the ethical issues raised by these technological developments. First, a safe NIPT may lead to routinisation and as such challenge the central issue of informed consent and the aim of prenatal screening: to offer opportunity for autonomous reproductive choice. Widening the scope of prenatal screening also raises the question to what extent ‘reproductive autonomy’ is meant to expand. Finally, if the same test is used for two different aims, namely detection of foetal anomalies and pregnancy-related problems, non-directive counselling can no longer be taken as a standard. Our broad outline of the ethical issues is meant as an introduction into the more detailed ethical discussions about prenatal screening in the other articles of this special issue. (shrink)

Prenatal screening pathways, as nowadays offered in most Western countries consist of similar tests. First, a risk‐assessment test for major aneuploides is offered to pregnant women. In case of an increased risk, invasive diagnostic tests, entailing a miscarriage risk, are offered. For decades, only conventional karyotyping was used for final diagnosis. Moreover, several foetal ultrasound scans are offered to detect major congenital anomalies, but the same scans also provide relevant information for optimal support of the pregnancy and the delivery.Recent developments (...) in prenatal screening include the application of microarrays that allow for identifying a much broader range of abnomalities than karyotyping, and non‐invasive prenatal testing (NIPT) that enables reducing the number of invasive tests for aneuploidies considerably. In the future, broad NIPT may become possible and affordable.This article will briefly address the ethical issues raised by these technological developments. First, a safe NIPT may lead to routinisation and as such challenge the central issue of informed consent and the aim of prenatal screening: to offer opportunity for autonomous reproductive choice. Widening the scope of prenatal screening also raises the question to what extent ‘reproductive autonomy’ is meant to expand. Finally, if the same test is used for two different aims, namely detection of foetal anomalies and pregnancy‐related problems, non‐directive counselling can no longer be taken as a standard. Our broad outline of the ethical issues is meant as an introduction into the more detailed ethical discussions about prenatal screening in the other articles of this special issue. (shrink)

The advent of new genetic and genomic technologies may cause friction with the principle of respect for autonomy and demands a rethinking of traditional interpretations of the concept of informed consent. Technologies such as whole‐genome sequencing and micro‐array based analysis enable genome‐wide testing for many heterogeneous abnormalities and predispositions simultaneously. This may challenge the feasibility of providing adequate pre‐test information and achieving autonomous decision‐making. At a symposium held at the 11th World Congress of Bioethics in June 2012 (Rotterdam), organized by (...) the International Association of Bioethics, these challenges were presented for three different areas in which these so‐called ‘new genetics’ technologies are increasingly being applied: newborn screening, prenatal screening strategies and commercial personal genome testing. In this article, we build upon the existing ethical framework for a responsible set‐up of testing and screening offers and reinterpret some of its criteria in the light of the new genetics. As we will argue, the scope of a responsible testing or screening offer should align with the purpose(s) of testing and with the principle of respect for autonomy for all stakeholders involved, including (future) children. Informed consent is a prerequisite but requires a new approach. We present preliminary and general directions for an individualized or differentiated set‐up of the testing offer and for the informed consent process. With this article we wish to contribute to the formation of new ideas on how to tackle the issues of autonomy and informed consent for (public) healthcare and direct‐to‐consumer applications of the new genetics. (shrink)

The advent of new genetic and genomic technologies may cause friction with the principle of respect for autonomy and demands a rethinking of traditional interpretations of the concept of informed consent. Technologies such as whole-genome sequencing and micro-array based analysis enable genome-wide testing for many heterogeneous abnormalities and predispositions simultaneously. This may challenge the feasibility of providing adequate pre-test information and achieving autonomous decision-making. At a symposium held at the 11th World Congress of Bioethics in June 2012 (Rotterdam), organized by (...) the International Association of Bioethics, these challenges were presented for three different areas in which these so-called ‘new genetics’ technologies are increasingly being applied: newborn screening, prenatal screening strategies and commercial personal genome testing. In this article, we build upon the existing ethical framework for a responsible set-up of testing and screening offers and reinterpret some of its criteria in the light of the new genetics. As we will argue, the scope of a responsible testing or screening offer should align with the purpose(s) of testing and with the principle of respect for autonomy for all stakeholders involved, including (future) children. Informed consent is a prerequisite but requires a new approach. We present preliminary and general directions for an individualized or differentiated set-up of the testing offer and for the informed consent process. With this article we wish to contribute to the formation of new ideas on how to tackle the issues of autonomy and informed consent for (public) healthcare and direct-to-consumer applications of the new genetics. (shrink)

The whats and whys of religious belief -- A history of thanatocentric theories of religion -- Measuring faith and fear -- Are people afraid of death? -- The religious correlates of death anxiety -- Death anxiety and religion: causes and consequences -- The future of immortality, literal, and symbolic.

“Fair and equitable benefit-sharing” is one of the objectives of the UN Convention on Biological Diversity and the FAO International Treaty on Plant Genetic Resources for Food and Agriculture. In essence, benefit-sharing holds that countries, farmers, and indigenous communities that grant access to their plant genetic resources and/or traditional knowledge should share in the benefits that users derive from these resources. But what exactly is understood by “fair” and “equitable” in this context? Neither term is defined in the international treaties. (...) A complicating factor, furthermore, is that different motivations and perspectives exist with respect to the notion of benefit-sharing itself. This paper looks at six different approaches to benefit-sharing that can be extracted from the current debates on “Access and Benefit-Sharing.” These approaches form the basis of a philosophical reflection in which the different connotations of “fair and equitable” are considered, by analyzing the main principles of justice involved. Finally, the various principles are brought together in order to draw some conclusions as to how a fair and equitable benefit-sharing mechanism might best be realized. This results in several recommendations for policymakers. (shrink)

Medical missionaries made a breakthrough in Korean history in healing and caring for many Hansen and tuberculosis patients. There was a missionary who had no less good influence than medical missionaries at this time. The person is missionary Sarah Barry, who inspired and developed one of the most influential student movements in South Korea. The aim of the present study is to examine life of Sarah Barry and her ministry, focusing upon her positive influences on Korean intellectuals. The relevance of (...) the study is conditioned by the fact that there is no professional academic research on her ministry except for one short paper, which discusses the importance of her role in formulating campus evangelism. In order to achieve the aim of the study, the method of analysis and synthesis of biographical and historical data was used. As a result of the study, Sarah Barry’s biography was researched and systematized. It gave ground to a conclusion that her role in South Korea’s gradual resurgence after the Civil War was seminal. (shrink)

With his doctrine of the “complete irresponsibility of man,” Nietzsche in different ways complicates the opposition between responsibility and irresponsibility. This article traces the different and conflicting senses of irresponsibility throughout Nietzsche’s development. First, the doctrine is shown to build on Nietzsche’s early study of Heraclitus (section I), whom Nietzsche admired for expounding and embodying a radical “innocence” that was both responsible and irresponsible in different senses. When presented as “philosophical conviction” in Human, All too Human, Nietzsche paradoxically speculates about (...) the doctrine’s incorporation out of a sense of responsibility for the future of mankind (section II). Section III shows how Nietzsche’s later writings evince an increasing awareness of this paradox by explicitly positing complete irresponsibility as his own redemptive doctrine in Twilight of the Idols. After 1881, he has come to affirm a new notion of responsibility and criticizes a weak sense of irresponsibility as the abdication of one’s task. I end by discussing the relation of these different senses of irresponsibility, and argue that the fact that Nietzsche’s texts often deliberately complicate rather than clarify such distinctions is an important reflection of how he textually takes responsibility for “complete irresponsibility” (section IV). (shrink)

This study argues that contemporary theology needs a reconceptualised form of metaphysical theology to readdress this question of universality. In order to develop such a new metaphysical theology, de Jong turns to the work of Karl Rahner and Edward Schillebeeckx. Presenting a new perspective on their theological methods, he demonstrates that these theologians employ a dialectical interplay of hermeneutical and metaphysical arguments yielding a modest theological metaphysics. Crucially, these thinkers recognise that acknowledging hermeneutical conditions does not need to end (...) in particularism. Instead, Rahner and Schillebeeckx argue that the infinite variety of particular human experiences can act as potential encounters with the universally self-revealing God. Retrieving these modest forms of theological metaphysics reminds contemporary theology that it is possible to think about universality from within particularity. Balancing the intelligible and mysterious nature of God, Rahner and Schillebeeckx show how a modest theological metaphysics contains its own self-critical hermeneutical disciplining. This renewed understanding about the earlier use of metaphysics opens up new avenues of thought for fundamental theologians that do not want to shy away from the difficult question of the universality of God. (shrink)

The Movement of Showing investigates the idea, shared by Derrida, Hegel and Heidegger, that the value of their thought is not found in its results or conclusions, but in its "movement." All three describe the heart of their work in terms of a pathway, development, or movement rather than in terms of its propositions or conclusions. This seems to deprive their thought of a solid ground, and indeed deconstruction in particular is often criticized in this way. Johan de Jong (...) argues that this is a structural vulnerability that is both its weakness and the source of its value, tracing Derrida's indirect method from his early to later works, and considering his engagements with Hegel and Heidegger. His analysis locates an affinity among Hegel, Heidegger and Derrida in a shared distrust of externality and, against the grain of some Levinasian commentaries, argues that Derrida's indirectness results in an ethics of complicity. The Movement of Showing answers a central question that many polemics about continental philosophy and postmodernism revolve around concerning how, methodologically, one can philosophize responsibly. It shows the difference between critique and polemics, and why simply taking up a position for or against is insufficient in order to think responsibly. (shrink)

This paper analyses the relationship between Hobbes's theory of language and his theory of science and method. It is shown that Hobbes, at least in his Computatio sive Logica (1655), deviates in some measure from the traditional (Aristotelian) model of language. In this model speech is considered to be a fairly unproblematic expression of thought, which itself is independent of language. Basing himself on a nominalist account of universals, Hobbes states that the demonstration or assertion of universal propositions presupposes speech (...) (more especially, the use of names as marks). This insight turns out to be essential for Hobbes's (rationalist) view of scientific method. (shrink)

This article explores witchcraft-related violence against elderly women in the AmaZizi chiefdom of kwaZangashe in Eastern Cape, South Africa. The potential causes that have promoted such violence form the central subject of the study. The study includes a research design that combines questionnaires, focus groups and follow-on interviews. The findings have revealed a prevalence of witchcraft beliefs in the region and have pointed to elderly women as the likely victims of witchcraft violence. This has resulted in AmaZizi’s elderly women being (...) socially isolated, verbally abused and at risk of physical violence and even murder. This study concludes with several interventions organised to combat future witchcraft-related violence and to support the elderly women in the chiefdom.Contribution: By giving voice to the lives and stories of a community of people rendered invisible in the wider public sphere, this article introduces accounts on witchcraft and healthcare that might otherwise have gone unarticulated. (shrink)

Inleiding in de moderne logica - met name de syllogistiek - bedoeld voor zelfstudie en inleidende academische cursussen.

Among the many forms of research misconduct, publishing fraudulent data is considered to be serious where the confidence and validity of the research is detrimentally undermined. In this study, the trend of 303 retracted publications from 44 authors (with more than three retracted publications each) was analysed. The results showed that only 6.60% of the retracted publications were single-authored and the discovery of fraudulent publications had reduced from 52.24 months (those published before the year 2000) to 33.23 months (those published (...) on the year 2000 and onwards). It appears that with the widely accessible public databases like PubMed, fraudulent publications can be detected more easily. The different approaches adopted by authors who had previous publications retracted are also discussed herein. (shrink)

This study focuses on CEO hubris and its detrimental effect on corporate financial performance along with an examination of critical corporate governance contingencies that may moderate the negative effect. From 654 observations of 164 Korean firms over the years 2001–2008, we found that CEO power exacerbated the negative effect of CEO hubris on corporate financial performance, whereas board vigilance mitigated it. This study provides empirical evidence that entrenchment problems arising from CEO hubris would be exacerbated as CEOs become more powerful, (...) but weakened as board of directors become more vigilant. Theoretical contributions and practical implications will be discussed. (shrink)

Paternalism has attracted new defenders in recent years. Such defenders typically either downplay the normative significance of autonomy or deny that we are sufficiently rational for paternalistic interventions to be objectionable.1 Both of these argumentative strategies constitute challenges to John Stuart Mill’s influential anti-paternalistic ‘harm principle’, which states that coercive interference with the liberty of competent adults is justifiable only if such interference prevents harm to non-consenting third parties (Mill, p. 23).2 In this journal, Wilkinson has provided a novel, provocative (...) defence of paternalism in the medical context—one that (provisionally) accepts rather than challenges Mill’s harm principle.3 Wilkinson’s argument is complex. But he begins with Parfit’s influential account of personal identity.4 According to Parfit, Alice at T1 can be the same person as Alice at T2, but the extent to which Alice at T1 and Alice at T2 are similar depends on the extent to which there are ‘chains’ of strong psychological connections between Alice at T1 and Alice at T2. Strong psychological connections, in turn, are mental states such as intentions or beliefs, or psychological traits. For example, if Alice at T2 remembers very little about herself the day before, and the day before that, all the way to Alice at T1, Alice at T2 has completely different psychological traits than Alice at T1—for example, Alice at T1 was courageous, whereas Alice at T2 is cowardly—then Alice at T1 and Alice at T2 are distinct persons. If the harm principle is correct and Alice is autonomous, it is permissible to interfere with Alice’s liberty only if it prevents harm to some non-consenting third party. But if we accept Parfit’s view on personal identity, then a novel defence of paternalistic intervention emerges: Alice at T2 may well be a distinct person from Alice at T1. So, …. (shrink)

The growing emphasis on the importance of publishing scientific findings in the academic world has led to increasing prevalence of potentially significant publications in which scientific and ethical rigour may be questioned. This has not only hindered research progress, but also eroded public trust in all scientific advances. In view of the increasing concern and the complexity of research misconduct, the Committee on Publication Ethics (COPE) was established in 1997 to manage cases with ethical implications. In order to review the (...) outcomes of cases investigated by COPE, a total of 408 cases that had been managed by COPE were successfully extracted and analysed with respect to 7 distinct criteria. The results obtained indicate that the number of ethical implications per case has not changed significantly (p > 0.01) since the year COPE was instigated. Interestingly, the number of ethical cases, and to some extent, research misconduct, is not diminishing. Therefore, journal editors and publishers need to work closely together with COPE to inculcate adoption of appropriate research ethics and values in younger researchers while discouraging others from lowering standards. It is hoped that with a more concerted effort from the academic community and better public awareness, there will be fewer incidences of ethically and scientifically challenged publications. The ultimate aim being to enhance the quality of published works with concomittant public trust in the results. (shrink)

For academic research outcomes, there is an increasing emphasis on the bibliometric scorings like the journal impact factor and citations when the assessment of the scientific merits of research or researchers is required. Currently, no known study has been conducted to explore the bibliographical trends of the subject category of multidisciplinary sciences as indexed by the annual Journal Citation Reports of the Thomson Scientific. The effect of journal self-citations and intra-citing within a discipline to the bibliometric data computation can be (...) confounding. In this study, six journals were selected from the multidisciplinary sciences subject category where the trend of self-citations and intra-citing were analysed. These journals were chosen as they published more than 450 citable articles in the year 2007 and had available bibliometric data for a 10-year period. The results showed that self-citations rose as much as +23.98% while intra-citing declined up to −5.80% over the observed period. The retrospective impacts and influences of these observations were also discussed in this study. (shrink)

There is an increasing trend towards assessing the scientific performance of researchers and institutions of higher learning in the form of journal publications and the associated citations. Currently, the journal impact factor (JIF) value is the most widely used measure for any academic contents. However, there are growing concerns for the unethical practices adopted by journal editors to manipulate the JIF computations. Recently, a Swiss journal, Folia Phoniatrica et Logopaedica which has a JIF value of 0.655 in the year 2006 (...) registers a remarkable JIF increment (of 119%) to 1.439 in the year 2007. It is believed that the journal can achieve such a prominent JIF improvement by publishing a single editorial article that self-cited 66 of its own articles published either in the year 2005 or 2006. The journal has been revoked of any JIF value in the following year of 2008. Thus, it is interesting to review the possible alternative bibliographical trend for the journal should the self-cite event has been avoided, the circumstances leading to the decision by the editor to publish such an article and the possible ethical implications or lessons that can be derived from this incident. (shrink)

Medical devices have been long used for odiagnostic, therapeutic or rehabilitation purposes. Currently, they can range from a low-cost portable device that is often used for personal health monitoring to high-end sophisticated equipment that can only be operated by trained professionals. Depending on the functional purposes, there are different certification or compliance markings on the device when it is sold. One common certification marking is the Conformité Européenne affixation but this has a range of certification mark numbering for a variety (...) of functional purposes. While the regulators and medical device manufacturers understand the associated significance and clinical implications, these may not be apparent to the professionals and the general public. With portable healthcare devices and mobile applications gaining popularity, better awareness of certification marking will be needed. Particularly, there are differences in the allowed functional purposes and the associated cost derivations of devices with a seemingly similar nature. A preferred approach such as an easy-to-understand notation next to any certification marking on a device can aid in differentiation without the need to digest mountainous regulatory details. (shrink)

In the mid-1980s, Dario Donatelli participated in a laboratory study of the effects of around 800 h of practice on digit-span and increased his digit-span from 8 to 104 digits. This study assessed changes in the structure of his memory skill after around 30 years of essentially no practice on the digit-span task. On the first day of testing, his estimated span was only 10 digits, but over the following 3 days of testing it increased to 19 digits. Further analyses (...) of his recall performance and verbal reports identified which mechanisms of the original memory skill he could retrieve or reacquire over the 3 days of practice. We discuss theoretical implications for the retention of skilled memory performance, the effects of age-related changes in memory on it, and for the future study of the effects of disuse on exceptional performance and complex skill. (shrink)

This study investigates the relationship among ethical philosophy, thinking style, and managerial ethical decision-making. Based on the premise that business ethics is a function of culture and time, we attempt to explore two important questions as to whether the national differences in managerial ethical philosophies remain over time and whether the relationship between thinking style and ethical decision-making is consistent across different national contexts. We conducted a survey on Korean managers’ ethical decision-making and thinking style and made a cross-cultural, cross-temporal (...) comparison with the results presented by previous studies that surveyed Korean and US managers with the same questionnaire at different points in time. Our analysis revealed that Korean managers have become more reliant on rule utilitarianism for ethical decision-making over the last two decades, which is dominantly used by US managers, corroborating our convergence hypothesis built on social contracts theory. However, as opposed to previous research, we found that managers with a balanced linear and nonlinear thinking style do not necessarily make more ethical decisions compared to those with a predominantly linear or nonlinear thinking style. This study contributes to international business ethics literature by presenting a theoretical framework that may explain the convergence of ethical philosophies employed by managers in different national contexts over time, and that the relationship between thinking style and managerial ethical decision-making may not be universal, but contingent on contextual factors. (shrink)

It is generally accepted that liberal states should fund public schools for compulsory education. But whether states should also finance denominational schools is controversial. Does such funding not compromise the principle of liberal neutrality? In this article we evaluate two opposing views on this question. Both views give different interpretations of liberal neutrality and both have contrasting views on the relation between education and conceptions of the good. Arguing that neither view is convincing, we defend an alternative view, which holds (...) that the liberal state under certain conditions should fund denominational schools. (shrink)