As artefacts, the worlds of digital games are designed and developed to fulfil certain expressive, functional, and experiential objectives. During play, players infer these purposes and aspirations from various aspects of their engagement with the gameworld. Influenced by their sociocultural backgrounds, sensitivities, gameplay preferences, and familiarity with game conventions, players construct a subjective interpretation of the intentions with which they believe the digital game in question was created. By analogy with the narratological notion of the implied author, we call the (...) figure to which players ascribe these intentions ‘the implied designer’. In this article, we introduce the notion of the implied designer and present an initial account of how appreciators ascribe meaning to interactive, fictional gameworlds and act within them based on what they perceive to be the designer’s intentions. (shrink)

What do players of videogames mean when they say they want to shoot zombies? Surely they know that the zombies are not real, and that they cannot really shoot them, but only control a fictional character who does so. Some philosophers of fiction argue that we need the concept of imaginative desires to explain situations in which people feel desires towards fictional characters or desires that motivate pretend actions. Others claim that we can explain these situations without complicating human psychology (...) with a novel mental state. Within their debates, however, these scholars exclusively focus on non-interactive fictions and children’s games of make-believe. In this paper, I argue that our experience of immersive, interactive fictions like videogames gives us cause to reappraise the concept of imaginative desires. Moreover, I describe how i-desires are a useful conceptual tool within videogame development and can shed new light on apparently immoral in-game actions. (shrink)

ABSTRACTVideogames often confront players with frustratingly difficult challenges, fearsome enemies, and tragic stories. As such, they can evoke feelings of failure, sadness, anger, and fear. Although these feelings are usually regarded as undesirable, many players seem to enjoy videogames which cause them. In this paper, I argue that player misery often originates from a fictional or lusory attitude which brackets game events from real-life, making the player’s emotions solely relevant within the game context. As they are part of the game (...) themselves, these negative emotions can be enjoyed and easily relativized, since players can acknowledge that their cause is ‘only a game’. However, there are feelings of misery associated with the playing of videogames which are not caused by either the game’s fiction or challenge. In the last part of this paper, I describe a qualitatively different kind of player misery: one that is caused by elements that are not perceived as part of the game by the player, and is no... (shrink)

In this book, Grant Tavinor, well known for his influential work on the aesthetics of videogames, offers the first focused study of the aesthetics of virtual reality media. When reading the first pages, one cannot help but notice Tavinor’s enthusiasm about virtual reality (VR) in the vivid descriptions of his explorations of virtual haunted houses, distant planets, and ancient Rome. These descriptions also reveal Tavinor’s refreshing aim to focus on present uses of VR media, instead of the so-called “perfect virtual (...) realities” (virtual realities that are indistinguishable from the actual world) that are often the focus of philosophical discussions. When talking about VR, philosophers indeed often target hypothetical situations in which people are brains in vats, hooked up to experience machines, or living in a world that is, unbeknownst to them, merely a simulated one. Tavinor, however, intends to avoid metaphysical or ontological questions about hypothetical virtual realities, instead focusing on our aesthetic experiences of concrete VR media. With this, he generally refers to “immersive, interactive, and computable VR technologies” (p. 15), such as the HTC Vive, the PlayStation VR, and the Oculus, which depict virtual environments through head mounted displays. Tavinor’s aim is to show how these systems are media that allow for “a technologically fancy kind of picturing” (p. 12), and to contextualize them in the history of representational media alongside of painting, photography, and film. (shrink)

Emotions Caused by Untrue Propositions: A Broader View of the Paradox of Fiction Ever since Colin Radford wrote his article ‘How Can We Be Moved by the Fate of Anna Karenina?’ in 1975, philosophers have tried to solve the so-called paradox of fiction, or the question how we can be moved by objects of which we know they don’t really exist. What is striking about discussions on the paradox of fiction is that they often present fictional works as collections of (...) untrue statements and focus on the content of these works, without regard for their form or mode of presentation. In this paper, I argue for a re-examination of the paradox of fiction, in which the work of fiction is treated as a complex of form and content. In this regard, I propose to expand Peter Lamarque’s thought theory, which he explicitly formulated to solve the paradox of fiction, with his later developed concept of opacity, which states that the content of the imaginings we form when reading fiction are fundamentally connected to the specific descriptions within the fictional work. (shrink)

Drawing from narratology and design studies, this article makes use of the notions of the ‘implied designer’ and ‘ludic unreliability’ to understand deceptive game design as a specific sub-set of transgressive game design. More specifically, in this text we present deceptive game design as the deliberate attempt to misguide players’ inferences about the designers’ intentions. Furthermore, we argue that deceptive design should not merely be taken as a set of design choices aimed at misleading players in their efforts to understand (...) the game, but also as decisions devised to give rise to experiential and emotional effects that are in the interest of players. Finally, we propose to introduce a distinction between two varieties of deceptive design approaches based on whether they operate in an overt or a covert fashion in relation to player experience. Our analysis casts light on expressive possibilities that are not customarily part of the dominant paradigm of user-centered design, and can inform game designers in their pursuit of wider and more nuanced creative aspirations. (shrink)

Here, we focus on the underexplored fictional relevance of videogame glitches. For this purpose, we will make use philosophical theories on fiction, as well as standard suggestions about how best to deal with unintended errors within fiction. Focusing on glitches like that of Red Dead Redemption’s "manimals", we argue that glitches, more than any kinds of mistakes in traditional, non-interactive fictions, can actually have a significant influence on the fictional worlds of the work in which they appear. In particular, we (...) will show that some glitches generate new fictional content without this content being intended by a videogame’s creators, and will offer practical ways for dealing with the inconsistencies that inevitably accompany such glitch-generated fictions. (shrink)

BackgroundPatient-centeredness, respect for patient autonomy, and shared decision-making have now made it to center stage in discussions on quality of care. Knowing what actually counts in care and how it should be accomplished from the patients’ and nurses’ perspective seems crucial.AimTo explore how patients and their nurses perceive the importance and enactment of values in their healthcare.Research designAn observational, cross-sectional study using a self-developed questionnaire, consisting of 15 items related to seven values (e.g. uniqueness, autonomy, professionalism, compassion, responsiveness, partnership, and (...) empowerment) as described in the taxonomy of Bastemeijer et al.Participants and research contextThe survey was completed by 384 patients and 81 nurses. Participants were recruited on eight internal medicine wards of a 1000-bed university hospital in Belgium.Ethical considerationsThis study was approved by the ethical committee of the Ghent University Hospital (B670201836799).Findings(1) Patients and nurses prioritize values of care differently; (2) nurses report not being able to enact the values they prioritize in actual practice as much as one would like to; and (3) there is a gap in experienced delivery of a comprehensible explanation of all treatment options, a conversation based on equality, making shared decisions, and being non-judgmental between nurses and patients.DiscussionOur findings challenge nurses’ overemphasis on professional compassion and uniqueness while arguing for increased attention on authentic shared decision-making and empowerment. The first step to a patient-centered culture truly involving patients in their healthcare is communication and information provision, rather than focusing on tangible and normative constructs.ConclusionOur findings revealed differences in prioritization and actual enactment of values in care between patients and nurses. This was especially so for values related to communication, provision of complete unbiased information, and shared decision-making. Nurses should prioritize providing comprehensible information and using conversations based on equality to make decision together with patients. (shrink)

Table of contentsI1 Proceedings of the 4th World Conference on Research IntegrityConcurrent Sessions:1. Countries' systems and policies to foster research integrityCS01.1 Second time around: Implementing and embedding a review of responsible conduct of research policy and practice in an Australian research-intensive universitySusan Patricia O'BrienCS01.2 Measures to promote research integrity in a university: the case of an Asian universityDanny Chan, Frederick Leung2. Examples of research integrity education programmes in different countriesCS02.1 Development of a state-run “cyber education program of research ethics” in (...) KoreaEun Jung Ko, Jin Sun Kwak, TaeHwan Gwon, Ji Min Lee, Min-Ho LeeCS02.3 Responsible conduct of research teachers’ training courses in Germany: keeping on drilling through hard boards for more RCR teachersHelga Nolte, Michael Gommel, Gerlinde Sponholz3. The research environment and policies to encourage research integrityCS03.1 Challenges and best practices in research integrity: bridging the gap between policy and practiceYordanka Krastev, Yamini Sandiran, Julia Connell, Nicky SolomonCS03.2 The Slovenian initiative for better research: from national activities to global reflectionsUrsa Opara Krasovec, Renata SribarCS03.3 Organizational climate assessments to support research integrity: background of the Survey of Organizational Research Climate and the experience with its use at Michigan State UniversityBrian C. Martinson, Carol R. Thrush, C.K. Gunsalus4. Expressions of concern and retractionsCS04.1 Proposed guidelines for retraction notices and their disseminationIvan Oransky, Adam MarcusCS04.2 Watching retractions: analysis of process and practice, with data from the Wiley retraction archivesChris Graf, Verity Warne, Edward Wates, Sue JoshuaCS04.3 An exploratory content analysis of Expressions of ConcernMiguel RoigCS04.4 An ethics researcher in the retraction processMichael Mumford5. Funders' role in fostering research integrityCS05.1 The Fonds de Recherche du Québec’s institutional rules on the responsible conduct of research: introspection in the funding agency activitiesMylène Deschênes, Catherine Olivier, Raphaëlle Dupras-LeducCS05.2 U.S. Public Health Service funds in an international setting: research integrity and complianceZoë Hammatt, Raju Tamot, Robin Parker, Cynthia Ricard, Loc Nguyen-Khoa, Sandra TitusCS05.3 Analyzing decision making of funders of public research as a case of information asymmetryKarsten Klint JensenCS05.4 Research integrity management: Empirical investigation of academia versus industrySimon Godecharle, Ben Nemery, Kris Dierickx5A: Education: For whom, how, and what?CS05A.1 Research integrity or responsible conduct of research? What do we aim for?Mickey Gjerris, Maud Marion Laird Eriksen, Jeppe Berggren HoejCS05A.2 Teaching and learning about RCR at the same time: a report on Epigeum’s RCR poll questions and other assessment activitiesNicholas H. SteneckCS05A.4 Minding the gap in research ethics education: strategies to assess and improve research competencies in community health workers/promoteresCamille Nebeker, Michael Kalichman, Elizabeth Mejia Booen, Blanca Azucena Pacheco, Rebeca Espinosa Giacinto, Sheila Castaneda6. Country examples of research reward systems and integrityCS06.1 Improving systems to promote responsible research in the Chinese Academy of SciencesDing Li, Qiong Chen, Guoli Zhu, Zhonghe SunCS06.4 Exploring the perception of research integrity amongst public health researchers in IndiaParthasarathi Ganguly, Barna Ganguly7. Education and guidance on research integrity: country differencesCS07.1 From integrity to unity: how research integrity guidance differs across universities in Europe.Noémie Aubert Bonn, Kris Dierickx, Simon GodecharleCS07.2 Can education and training develop research integrity? The spirit of the UNESCO 1974 recommendation and its updatingDaniele Bourcier, Jacques Bordé, Michèle LeducCS07.3 The education and implementation mechanisms of research ethics in Taiwan's higher education: an experience in Chinese web-based curriculum development for responsible conduct of researchChien Chou, Sophia Jui-An PanCS07.4 Educating principal investigators in Swiss research institutions: present and future perspectivesLouis Xaver Tiefenauer8. Measuring and rewarding research productivityCS08.1 Altimpact: how research integrity underpins research impactDaniel Barr, Paul TaylorCS08.2 Publication incentives: just reward or misdirection of funds?Lyn Margaret HornCS08.3 Why Socrates never charged a fee: factors contributing to challenges for research integrity and publication ethicsDeborah Poff9. Plagiarism and falsification: Behaviour and detectionCS09.1 Personality traits predict attitude towards plagiarism of self and others in biomedicine: plagiarism, yes we can?Martina Mavrinac, Gordana Brumini, Mladen PetrovečkiCS09.2 Investigating the concept of and attitudes toward plagiarism for science teachers in Brazil: any challenges for research integrity and policy?Christiane Coelho Santos, Sonia VasconcelosCS09.3 What have we learnt?: The CrossCheck Service from CrossRefRachael LammeyCS09.4 High p-values as a sign of data fabrication/falsificationChris Hartgerink, Marcel van Assen, Jelte Wicherts10. Codes for research integrity and collaborationsCS10.1 Research integrity in cross-border cooperation: a Nordic exampleHanne Silje HaugeCS10.3 Research integrity, research misconduct, and the National Science Foundation's requirement for the responsible conduct of researchAaron MankaCS10.4 A code of conduct for international scientific cooperation: human rights and research integrity in scientific collaborations with international academic and industry partnersRaffael Iturrizaga11. Countries' efforts to establish mentoring and networksCS11.1 ENRIO : a network facilitating common approaches on research integrity in EuropeNicole FoegerCS11.2 Helping junior investigators develop in a resource-limited country: a mentoring program in PeruA. Roxana Lescano, Claudio Lanata, Gissella Vasquez, Leguia Mariana, Marita Silva, Mathew Kasper, Claudia Montero, Daniel Bausch, Andres G LescanoCS11.3 Netherlands Research Integrity Network: the first six monthsFenneke Blom, Lex BouterCS11.4 A South African framework for research ethics and integrity for researchers, postgraduate students, research managers and administratorsLaetus OK Lategan12. Training and education in research integrity at an early career stageCS12.1 Research integrity in curricula for medical studentsGustavo Fitas ManaiaCS12.2 Team-based learning for training in the responsible conduct of research supports ethical decision-makingWayne T. McCormack, William L. Allen, Shane Connelly, Joshua Crites, Jeffrey Engler, Victoria Freedman, Cynthia W. Garvan, Paul Haidet, Joel Hockensmith, William McElroy, Erik Sander, Rebecca Volpe, Michael F. VerderameCS12.4 Research integrity and career prospects of junior researchersSnezana Krstic13. Systems and research environments in institutionsCS13.1 Implementing systems in research institutions to improve quality and reduce riskLouise HandyCS13.2 Creating an institutional environment that supports research integrityDebra Schaller-DemersCS13.3 Ethics and Integrity Development Grants: a mechanism to foster cultures of ethics and integrityPaul Taylor, Daniel BarrCS13.4 A culture of integrity at KU LeuvenInge Lerouge, Gerard Cielen, Liliane Schoofs14. Peer review and its role in research integrityCS14.1 Peer review research across disciplines: transdomain action in the European Cooperation in Science and Technology “New Frontiers of Peer Review ”Ana Marusic, Flaminio SquazzoniCS14.2 Using blinding to reduce bias in peer reviewDavid VauxCS14.3 How to intensify the role of reviewers to promote research integrityKhalid Al-Wazzan, Ibrahim AlorainyCS14.4 Credit where credit’s due: professionalizing and rewarding the role of peer reviewerChris Graf, Verity Warne15. Research ethics and oversight for research integrity: Does it work?CS15.1 The psychology of decision-making in research ethics governance structures: a theory of bounded rationalityNolan O'Brien, Suzanne Guerin, Philip DoddCS15.2 Investigator irregularities: iniquity, ignorance or incompetence?Frank Wells, Catherine BlewettCS15.3 Academic plagiarismFredric M. Litto16. Research integrity in EuropeCS16.1 Whose responsibility is it anyway?: A comparative analysis of core concepts and practice at European research-intensive universities to identify and develop good practices in research integrityItziar De Lecuona, Erika Löfstrom, Katrien MaesCS16.2 Research integrity guidance in European research universitiesKris Dierickx, Noémie Bonn, Simon GodecharleCS16.3 Research Integrity: processes and initiatives in Science Europe member organisationsTony Peatfield, Olivier Boehme, Science Europe Working Group on Research IntegrityCS16.4 Promoting research integrity in Italy: the experience of the Research Ethics and Bioethics Advisory Committee of the Consiglio Nazionale delle Ricerche Cinzia Caporale, Daniele Fanelli17. Training programs for research integrity at different levels of experience and seniorityCS17.1 Meaningful ways to incorporate research integrity and the responsible conduct of research into undergraduate, graduate, postdoctoral and faculty training programsJohn Carfora, Eric Strauss, William LynnCS17.2 "Recognize, respond, champion": Developing a one-day interactive workshop to increase confidence in research integrity issuesDieter De Bruyn, Bracke Nele, Katrien De Gelder, Stefanie Van der BurghtCS17.4 “Train the trainer” on cultural challenges imposed by international research integrity conversations: lessons from a projectJosé Roberto Lapa e Silva, Sonia M. R. Vasconcelos18. Research and societal responsibilityCS18.1 Promoting the societal responsibility of research as an integral part of research integrityHelene IngierdCS18.2 Social responsibility as an ethical imperative for scientists: research, education and service to societyMark FrankelCS18.3 The intertwined nature of social responsibility and hope in scienceDaniel Vasgird, Stephanie BirdCS18.4 Common barriers that impede our ability to create a culture of trustworthiness in the research communityMark Yarborough19. Publication ethicsCS19.1 The authors' forum: A proposed tool to improve practices of journal editors and promote a responsible research environmentIbrahim Alorainy, Khalid Al-WazzanCS19.2 Quantifying research integrity and its impact with text analyticsHarold GarnerCS19.3 A closer look at authorship and publication ethics of multi- and interdisciplinary teamsLisa Campo-Engelstein, Zubin Master, Elise Smith, David Resnik, Bryn Williams-JonesCS19.4 Invisibility of duplicate publications in biomedicineMario Malicki, Ana Utrobicic, Ana Marusic20. The causes of bad and wasteful research: What can we do?CS20.1 From countries to individuals: unravelling the causes of bias and misconduct with multilevel meta-meta-analysisDaniele Fanelli, John PA IoannidisCS20.2 Reducing research waste by integrating systems of oversight and regulationGerben ter Riet, Tom Walley, Lex Marius BouterCS20.3 What are the determinants of selective reporting?: The example of palliative care for non-cancer conditionsJenny van der Steen, Lex BouterCS20.4 Perceptions of plagiarism, self-plagiarism and redundancy in research: preliminary results from a national survey of Brazilian PhDsSonia Vasconcelos, Martha Sorenson, Francisco Prosdocimi, Hatisaburo Masuda, Edson Watanabe, José Carlos Pinto, Marisa Palácios, José Lapa e Silva, Jacqueline Leta, Adalberto Vieyra, André Pinto, Mauricio Sant’Ana, Rosemary Shinkai21. Are there country-specific elements of misconduct?CS21.1 The battle with plagiarism in Russian science: latest developmentsBoris YudinCS21.2 Researchers between ethics and misconduct: A French survey on social representations of misconduct and ethical standards within the scientific communityEtienne Vergès, Anne-Sophie Brun-Wauthier, Géraldine VialCS21.3 Experience from different ways of dealing with research misconduct and promoting research integrity in some Nordic countriesTorkild VintherCS21.4 Are there specifics in German research misconduct and the ways to cope with it?Volker Bähr, Charité22. Research integrity teaching programmes and their challengesCS22.1 Faculty mentors and research integrityMichael Kalichman, Dena PlemmonsCS22.2 Training the next generation of scientists to use principles of research quality assurance to improve data integrity and reliabilityRebecca Lynn Davies, Katrina LaubeCS22.3 Fostering research integrity in a culturally-diverse environmentCynthia Scheopner, John GallandCS22.4 Towards a standard retraction formHervé Maisonneuve, Evelyne Decullier23. Commercial research and integrityCS23.1 The will to commercialize: matters of concern in the cultural economy of return-on-investment researchBrian NobleCS23.2 Quality in drug discovery data reporting: a mission impossible?Anja Gilis, David J. Gallacher, Tom Lavrijssen, Malwitz David, Malini Dasgupta, Hans MolsCS23.3 Instituting a research integrity policy in the context of semi-private-sector funding: an example in the field of occupational health and safetyPaul-Emile Boileau24. The interface of publication ethics and institutional policiesCS24.1 The open access ethical paradox in an open government effortTony SavardCS24.2 How journals and institutions can work together to promote responsible conductEric MahCS24.3 Improving cooperation between journals and research institutions in research integrity casesElizabeth Wager, Sabine Kleinert25. Reproducibility of research and retractionsCS25.1 Promoting transparency in publications to reduce irreproducibilityVeronique Kiermer, Andrew Hufton, Melanie ClyneCS25.2 Retraction notices issued for publications by Latin American authors: what lessons can we learn?Sonia Vasconcelos, Renan Moritz Almeida, Aldo Fontes-Pereira, Fernanda Catelani, Karina RochaCS25.3 A preliminary report of the findings from the Reproducibility Project: Cancer biologyElizabeth Iorns, William Gunn26. Research integrity and specific country initiativesCS26.1 Promoting research integrity at CNRS, FranceMichèle Leduc, Lucienne LetellierCS26.2 In pursuit of compliance: is the tail wagging the dog?Cornelia MalherbeCS26.3 Newly established research integrity policies and practices: oversight systems of Japanese research universitiesTakehito Kamata27. Responsible conduct of research and country guidelinesCS27.1 Incentives or guidelines? Promoting responsible research communication through economic incentives or ethical guidelines?Vidar EnebakkCS27.3 Responsible conduct of research: a view from CanadaLynn PenrodCS27.4 The Danish Code of Conduct for Research Integrity: a national initiative to promote research integrity in DenmarkThomas Nørgaard, Charlotte Elverdam28. Behaviour, trust and honestyCS28.1 The reasons behind non-ethical behaviour in academiaYves FassinCS28.2 The psychological profile of the dishonest scholarCynthia FekkenCS28.3 Considering the implications of Dan Ariely’s keynote speech at the 3rd World Conference on Research Integrity in MontréalJamal Adam, Melissa S. AndersonCS28.4 Two large surveys on psychologists’ views on peer review and replicationJelte WichertsBrett Buttliere29. Reporting and publication bias and how to overcome itCS29.1 Data sharing: Experience at two open-access general medical journalsTrish GrovesCS29.2 Overcoming publication bias and selective reporting: completing the published recordDaniel ShanahanCS29.3 The EQUATOR Network: promoting responsible reporting of health research studiesIveta Simera, Shona Kirtley, Eleana Villanueva, Caroline Struthers, Angela MacCarthy, Douglas Altman30. The research environment and its implications for integrityCS30.1 Ranking of scientists: the Russian experienceElena GrebenshchikovaCS30.4 From cradle to grave: research integrity, research misconduct and cultural shiftsBronwyn Greene, Ted RohrPARTNER SYMPOSIAPartner Symposium AOrganized by EQUATOR Network, Enhancing the Quality and Transparency of Health ResearchP1 Can we trust the medical research literature?: Poor reporting and its consequencesIveta SimeraP2 What can BioMed Central do to improve published research?Daniel Shanahan, Stephanie HarrimanP3 What can a "traditional" journal do to improve published research?Trish GrovesP4 Promoting good reporting practice for reliable and usable research papers: EQUATOR Network, reporting guidelines and other initiativesCaroline StruthersPartner Symposium COrganized by ENRIO, the European Network of Research Integrity OfficersP5 Transparency and independence in research integrity investigations in EuropeKrista Varantola, Helga Nolte, Ursa Opara, Torkild Vinther, Elizabeth Wager, Thomas NørgaardPartner Symposium DOrganized by IEEE, the Institute of Electrical and Electronics EngineersRe-educating our author community: IEEE's approach to bibliometric manipulation, plagiarism, and other inappropriate practicesP6 Dealing with plagiarism in the connected world: An Institute of Electrical and Electronics Engineers perspectiveJon RokneP7 Should evaluation of raises, promotion, and research proposals be tied to bibliometric indictors? What the Institute of Electrical and Electronics Engineers is doing to answer this questionGianluca SettiP8 Recommended practices to ensure conference content qualityGordon MacPhersonPartner Symposium EOrganized by the Committee on Freedom and Responsibility in the Conduct of Science of ICSU, the International Council for ScienceResearch assessment and quality in science: perspectives from international science and policy organisationsP9 Challenges for science and the problems of assessing researchEllen HazelkornP10 Research assessment and science policy developmentCarthage SmithP11 Research integrity in South Africa: the value of procedures and processes to global positioningRobert H. McLaughlinP12 Rewards, careers and integrity: perspectives of young scientists from around the worldTatiana Duque MartinsPartner Symposium FOrganized by the Online Resource Center for Ethics Education in Engineering and Science / Center for Engineering, Ethics, and Society of the National Academy of EngineeringP13 Research misconduct: conceptions and policy solutionsTetsuya Tanimoto, Nicholas Steneck, Daniele Fanelli, Ragnvald Kalleberg, Tajammul HusseinPartner Symposium HOrganized by ORI, the Office of Research Integrity; Universitas 21; and the Asia Pacific Research Integrity NetworkP14 International integrity networks: working together to ensure research integrityPing Sun, Ovid Tzeng, Krista Varantola, Susan ZimmermanPartner Symposium IOrganized by COPE, the Committee on Publication EthicsPublication without borders: Ethical challenges in a globalized worldP15 Authorship: credit and responsibility, including issues in large and interdisciplinary studiesRosemary ShinkaiPartner Symposium JOrganized by CITI, the Cooperative Institutional Training InitiativeExperiences on research integrity educational programs in Colombia, Costa Rica and PeruP16 Experiences in PeruRoxana LescanoP17 Experiences in Costa RicaElizabeth HeitmanP18 Experiences in ColumbiaMaria Andrea Rocio del Pilar Contreras NietoPoster Session B: Education, training, promotion and policyPT.01 The missing role of journal editors in promoting responsible researchIbrahim Alorainy, Khalid Al-WazzanPT.02 Honorary authorship in Taiwan: why and who should be in charge?Chien Chou, Sophia Jui-An PanPT.03 Authorship and citation manipulation in academic researchEric Fong, Al WilhitePT.04 Open peer review of research submission at medical journals: experience at BMJ Open and The BMJTrish GrovesPT.05 Exercising authorship: claiming rewards, practicing integrityDésirée Motta-RothPT.07 Medical scientists' views on publication culture: a focus group studyJoeri Tijdink, Yvo SmuldersPoster Session B: Education, training, promotion and policyPT.09 Ethical challenges in post-graduate supervisionLaetus OK LateganPT.10 The effects of viable ethics instruction on international studentsMichael Mumford, Logan Steele, Logan Watts, James Johnson, Shane Connelly, Lee WilliamsPT.11 Does language reflect the quality of research?Gerben ter Riet, Sufia Amini, Lotty Hooft, Halil KilicogluPT.12 Integrity complaints as a strategic tool in policy decision conflictsJanneke van Seters, Herman Eijsackers, Fons Voragen, Akke van der Zijpp and Frans BromPoster Session C: Ethics and integrity intersectionsPT.14 Regulations of informed consent: university-supported research processes and pitfalls in implementationBadaruddin Abbasi, Naif Nasser AlmasoudPT.15 A review of equipoise as a requirement in clinical trialsAdri LabuschagnePT.16 The Research Ethics Library: online resource for research ethics educationJohanne Severinsen, Espen EnghPT.17 Research integrity: the view from King Abdulaziz City for Science and TechnologyDaham Ismail AlaniPT. 18 Meeting global challenges in high-impact publications and research integrity: the case of the Malaysian Palm Oil BoardHJ. Kamaruzaman JusoffPT.19 University faculty perceptions of research practices and misconductAnita Gordon, Helen C. HartonPoster Session D: International perspectivesPT.21 The Commission for Scientific Integrity as a response to research fraudDieter De Bruyn, Stefanie Van der BurghtPT. 22 Are notions of the responsible conduct of research associated with compliance with requirements for research on humans in different disciplinary traditions in Brazil?Karina de Albuquerque Rocha, Sonia Maria Ramos de VasconcelosPT.23 Creating an environment that promotes research integrity: an institutional model of Malawi Liverpool Welcome TrustLimbanazo MatandikaPT.24 How do science policies in Brazil influence user-engaged ecological research?Aline Carolina de Oliveira Machado Prata, Mark William NeffPoster Session E: Perspectives on misconductPT.26 What “causes” scientific misconduct?: Testing major hypotheses by comparing corrected and retracted papersDaniele Fanelli, Rodrigo Costas, Vincent LarivièrePT.27 Perception of academic plagiarism among dentistry studentsDouglas Leonardo Gomes Filho, Diego Oliveira GuedesPT. 28 a few bad apples?: Prevalence, patterns and attitudes towards scientific misconduct among doctoral students at a German university hospitalVolker Bähr, Niklas Keller, Markus Feufel, Nikolas OffenhauserPT. 29 Analysis of retraction notices published by BioMed CentralMaria K. Kowalczuk, Elizabeth C. MoylanPT.31 "He did it" doesn't work: data security, incidents and partnersKatie SpeanburgPoster Session F: Views from the disciplinesPT.32 Robust procedures: a key to generating quality results in drug discoveryMalini Dasgupta, Mariusz Lubomirski, Tom Lavrijssen, David Malwitz, David Gallacher, Anja GillisPT.33 Health promotion: criteria for the design and the integrity of a research projectMaria Betânia de Freitas Marques, Laressa Lima Amâncio, Raphaela Dias Fernandes, Oliveira Patrocínio, and Cláudia Maria Correia Borges RechPT.34 Integrity of academic work from the perspective of students graduating in pharmacy: a brief research studyMaria Betânia de Freitas Marques, Cláudia Maria Correia Borges Rech, Adriana Nascimento SousaPT.35 Research integrity promotion in the Epidemiology and Health Services, the journal of the Brazilian Unified Health SystemLeila Posenato GarciaPT.36 When are clinical trials registered? An analysis of prospective versus retrospective registration of clinical trials published in the BioMed Central series, UKStephanie Harriman, Jigisha PatelPT.37 Maximizing welfare while promoting innovation in drug developmentFarida LadaOther posters that will be displayed but not presented orally:PT.38 Geoethics and the debate on research integrity in geosciencesGiuseppe Di Capua, Silvia PeppoloniPT.39 Introducing the Professionalism and Integrity in Research Program James M. DuBois, John Chibnall, Jillon Van der WallPT.40 Validation of the professional decision-making in research measureJames M. DuBois, John Chibnall, Jillon Van der Wall, Raymond TaitPT.41 General guidelines for research ethicsJacob HolenPT. 42 A national forum for research ethicsAdele Flakke Johannessen, Torunn EllefsenPT.43 Evaluation of integrity in coursework: an approach from the perspective of the higher education professorClaudia Rech, Adriana Sousa, Maria Betânia de Freitas MarquesPT.44 Principles of geoethics and research integrity applied to the European Multidisciplinary Seafloor and Water Column Observatory, a large-scale European environmental research infrastructureSilvia Peppoloni, Giuseppe Di Capua, Laura BeranzoliF1 Focus track on improving research systems: the role of fundersPaulo S.L. Beirão, Susan ZimmermanF2 Focus track on improving research systems: the role of countriesSabine Kleinert, Ana MarusicF3 Focus track on improving research systems: the role of institutionsMelissa S. Anderson, Lex Bouter. (shrink)

Value Sensitive Design (VSD) is an established method for integrating values into technical design. It has been applied to different technologies and, more recently, to artificial intelligence (AI). We argue that AI poses a number of challenges specific to VSD that require a somewhat modified VSD approach. Machine learning (ML), in particular, poses two challenges. First, humans may not understand how an AI system learns certain things. This requires paying attention to values such as transparency, explicability, and accountability. Second, ML (...) may lead to AI systems adapting in ways that ‘disembody’ the values embedded in them. To address this, we propose a threefold modified VSD approach: 1) integrating a known set of VSD principles (AI4SG) as design norms from which more specific design requirements can be derived; 2) distinguishing between values that are promoted and respected by the design to ensure outcomes that not only do no harm but also contribute to good; and 3) extending the VSD process to encompass the whole life cycle of an AI technology in order to monitor unintended value consequences and redesign as needed. We illustrate our VSD for AI approach with an example use case of a SARS-CoV-2 contact tracing app. (shrink)

In "Off Track" art and philosophy are the inspiration to look differently at daily life and organizations. The book is a plea to approach the complexity of the current world with new metaphors. The author calls this "hinking around". She sees that in "square worlds" there is a need for tools to approach entrenched patterns and systems differently and to get thought processes moving. Sarai van de Boel challenges the reader to look at one's own systems from the inside with (...) a philosophical approach. In eight chapters there are eight "tracks" to follow, but it is also possible to go off the rails. More than fifty works of art by well-known and lesser-known artists and designers play a role in these traces. The author questions the essence of their works and asks philosophical questions about phenomena they evoke. With Marlene Dumas, Marinus Boezem, L.A. Raeven, Ed Atkins, Wong Ping, Kazumasa Nagai, Remy Jungerman, Otto Piene, Eiko Ishioka, Campana brothers, Ann Demeulemeester and Kara Walker. The book ends with the Art & Philosophy Strategy, a theoretical framework for the use of art and philosophy. (shrink)

— We prescnt here a comparative study on the decay of chlorophyll a fluorescence yield in thylakoid membranes and photosystem 11 ‐enriched samples, measured with multifrequency cross‐correlation phase fluorometry. These measurements confirm the general conclusions of Van Mieghem ef al., obtained with a flash method, on the effects of reduction of the primary quinone acceptor on ChI a fluorescence yield of PSI. Different states of the reaction centers of PSII were produced by: pretreatment with sodium dithionite and mcthyl viologen followed (...) by laser illumination: the doubly reduced QA centers: with laser illumination or pretreatment with diuron: QA‐ centers; and the addition of micromolar concentration of dichlorobenzoquinonc : oxidized QA centers. The data were analyzed with Lorentzian distribution as well as with multiexponential fluorescence decay functions. The analysis with Lorcntzian distribution function showed that upon formation of QA. the major lifetime distribution peak shifted to longer lifetimes: from 0.25 ns to 1.66 ns and from 0.24 ns to 1.31 ns. However, when QAHZ was formed, the lifetime distribution peaks shifted back to shorter lifetimes both in thylakoids and PSIl membranes. Multiexponential analysis showed three lifetime components: fast, middle and slow. When QA was formed in PS11 centers, the amplitude of the fast Component decreased, but both thc amplitude and the lifetime of the middle component increased severalfold. However, when QA was doubly reduccd, the amplitude of the fast component increased and the amplitude of the middle component decreased: in addition, the lifetime of the slow component increased. All of the above results are consistent with the conclusions that PS11 charge separation is decreased when QA is formed and increased when doubly reduced QA is formed. Copyright © 1993, Wiley Blackwell. All rights reserved. (shrink)

Deals with such questions as: What is engineering? In what respect does engineering differ from science? What ethical problems does engineering raise? By what ethical principles are engineers guided? How do engineers themselves conceive of their profession? What do they see as the main philosophical challenges confronting them in the 21st century?

Research questions and backgroundThis study explores a highly controversial issue of medical care in Germany: the decision to withhold or withdraw mechanical ventilation in critically ill patients. It analyzes difficulties in making these decisions and the physicians’ uncertainty in understanding the German terminology of Sterbehilfe, which is used in the context of treatment limitation. Used in everyday language, the word Sterbehilfe carries connotations such as helping the patient in the dying process or helping the patient to enter the dying process. (...) Yet, in the legal and ethical discourse Sterbehilfe indicates several concepts: (1) treatment limitation, i.e., withholding or withdrawing life-sustaining treatment (passive Sterbehilfe), (2) the use of medication for symptom control while taking into account the risk of hastening the patient’s death (indirekte Sterbehilfe), and (3) measures to deliberately terminate the patient’s life (aktive Sterbehilfe). The terminology of Sterbehilfe has been criticized for being too complex and misleading, particularly for practical purposes. Materials and methods An exploratory study based on qualitative interviews was conducted with 28 physicians from nine medical intensive care units in tertiary care hospitals in the German federal state of Baden-Wuerttemberg. The method of data collection was a problem-centered, semi-structured interview using two authentic clinical case examples. In order to shed light on the relation between the physicians’ concepts and the ethical and legal frames of reference, we analyzed their way of using the terms passive and aktive Sterbehilfe. Results Generally, the physicians were more hesitant in making decisions to withdraw rather than withhold mechanical ventilation. Almost half of them assumed a categorical prohibition to withdraw any mechanical ventilation and more than one third felt that treatment ought not to be withdrawn at all. Physicians showed specific uncertainty about classifying the withdrawal of mechanical ventilation as passive Sterbehilfe, and had difficulties understanding that terminating ventilation is not basically illegal, but the permissibility of withdrawal depends on the situation. Conclusions The physicians’ knowledge and skills in interpreting clinical ethical dilemmas require specific improvement on the one hand; on the other hand, the terms passive and aktive Sterbehilfe are less clear than desirable and not as easy to use in clinical practice. Fear of making unjustified or illegal decisions may motivate physicians to continue (even futile) treatment. Physicians strongly opt for more open discussion about end-of-life care to allow for discontinuation of futile treatment and to reduce conflict. (shrink)

Classical neo-Darwinian explanations do not fully account for changes in biological forms, and new theories have emerged, primarily in maths and physics, that offer new approaches to the problem of the origin of life and phenomena of order in evolution. This volume focuses on the role of closure at various hierarchical levels as the catalyst between self-organization and selection. Participants addressed special areas of the closure problem such as autopoiesis and autocatalysis and function and selection, and semiosis. Presentations on physical (...) and mathematical modelling are included. The book seeks to clarify the role closure plays in explaining the emergence, development and evolution of structurally stable systems at the thermodynamic, chemical and biochemical, biological, psychological and cultural levels. (shrink)

There is a growing recognition that philosophy isn’t unique to the West, that it didn’t begin only with the classical Greeks, and that Greek philosophy was influenced by Near Eastern traditions. Yet even today there is a widespread assumption that what came before the Greeks was "before philosophy." In Philosophy before the Greeks, Marc Van De Mieroop, an acclaimed historian of the ancient Near East, presents a groundbreaking argument that, for three millennia before the Greeks, one Near Eastern people had (...) a rich and sophisticated tradition of philosophy fully worthy of the name. In the first century BC, the Greek historian Diodorus of Sicily praised the Babylonians for their devotion to philosophy. Showing the justice of Diodorus’s comment, this is the first book to argue that there were Babylonian philosophers and that they studied knowledge systematically using a coherent system of logic rooted in the practices of cuneiform script. Van De Mieroop uncovers Babylonian approaches to knowledge in three areas: the study of language, which in its analysis of the written word formed the basis of all logic; the art of divination, which interpreted communications between gods and humans; and the rules of law, which confirmed that royal justice was founded on truth. The result is an innovative intellectual history of the ancient Near Eastern world during the many centuries in which Babylonian philosophers inspired scholars throughout the region—until the first millennium BC, when the breakdown of this cosmopolitan system enabled others, including the Greeks, to develop alternative methods of philosophical reasoning. (shrink)

On 11 September 2019, the verdict was read in the first prosecution of a doctor for euthanasia since the Termination of Life on Request and Assisted Suicide Act of 2002 was installed in the Netherlands. The case concerned euthanasia on the basis of an advance euthanasia directive for a patient with severe dementia. In this paper we describe the review process for euthanasia cases in the Netherlands. Then we describe the case in detail, the judgement of the Regional Review Committees (...) for Termination of Life on Request and Euthanasia and the judgement of the medical disciplinary court. Both the review committees and the disciplinary court came to the conclusion there were concerns with this case, which mainly hinged on the wording of the AED. They also addressed the lack of communication with the patient, the absence of oral confirmation of the wish to die and the fact that the euthanasia was performed without the patient being aware of this. However, the doctor was acquitted by the criminal court as the court found she had in fact met all due care criteria laid down in the act. We then describe what this judgement means for euthanasia in the Netherlands. It clarifies the power and reach of AEDs, it allows taking conversations with physicians and the testimony of the family into account when interpreting the AED. However, as a practical consequence the prosecution of this physician has led to fear among doctors about prosecution after euthanasia. (shrink)

Peterson's objection to my proposal to treat new technologies as social experiments seems straightforward. Doing so would replace the old question ‘Is technology X ethically acceptable?’ (Let us ca...

Logic has a function in the social act of persuading. It defines the rules of relevance, coherence, and consistency which persuading should exemplify. These rules are not themselves objects of persuasion, but a priori reference-points persuading must take for granted. In the theories of logic currently in vogue, logical rules are found, not made. As we find them, we are ‘logical spectators’. Using them, we are ‘logical agents’.

_English_ ASD VII, 5 contains the second part of Erasmus’ _Paraphrasis_ on the apostolic letters. It is the first scientific edition of these Paraphrases. _German_ ASD VII, 5 enthält der zweite Teil von Erasmus' Paraphrasis zur apostolische Briefe des Neuen Testaments. Diese ist die erste wissenschaftliche Edition dieser Parafrasen.

The ninth and last volume of the _Adagia_ (Proverbs) of the Amsterdam edition of the Latin texts of Erasmus gives an introduction in German and a critical edition of the Latin text of the _Collectanea_, an early version of the _Adagia_ that completely differs from the latter collection.

_Ordo II_ comprises the work that made Erasmus famous, namely the _Adagia_ (Proverbs) some of which were extended into essays. This first volume of the _Adages_ in the Amsterdam edition of the Latin texts of Erasmus gives a general introduction to the _Adages_ in German, as well as a critical edition of the Latin text of the first half of the first thousand _Adages_.

The second volume of the _Adagia_ (Proverbs) of the Amsterdam edition of the Latin texts of Erasmus gives an introduction in German and a critical edition of the Latin text of the second half of the first thousand _Adages_.

_Ordo II_ comprises the work that made Erasmus famous, namely the _Adagia_ (Proverbs) some of which were extended into essays. This first volume of the _Adages_ in the Amsterdam edition of the Latin texts of Erasmus gives a general introduction to the _Adages_ in German, as well as a critical edition of the Latin text of the first half of the first thousand _Adages_.

The second volume of the _Adagia_ (Proverbs) of the Amsterdam edition of the Latin texts of Erasmus gives an introduction in German and a critical edition of the Latin text of the second half of the first thousand _Adages_.

Part Five of the Amsterdam edition of the Latin text of Erasmus’ _Annotations to the New Testament_ presents his notes on Paul’s letters to the Galatians, Ephesians, Philippians, Colossians, and to the Thessalonians 1 & 2.

Part Four of the Amsterdam edition of the Latin text of Erasmus’ _Annotations to the New Testament_ presents his notes on St. Paul’s letters to the Corinthians.

This paper analyses the use of strategies and instruments for organising ethics by small and large business in the Netherlands. We find that large firms mostly prefer an integrity strategy to foster ethical behaviour in the organisation, whereas small enterprises prefer a dialogue strategy. Both large and small firms make least use of a compliance strategy that focuses on controlling and sanctioning the ethical behaviour of workers. The size of the business is found to have a positive impact on the (...) use of several instruments, like code of conduct, ISO certification, social reporting, social handbook and confidential person. Also being a subsidiary of a larger firm has a significant positive influence on the use of instruments. The most popular instrument used by small firms is to let one member of the board be answerable for ethical questions, which fits the informal culture of most small firms. With respect to sectorial differences, we find that firms in the metal manufacturing and construction sectors are more actively using formal instruments than firms in the financial service sector and retail sector. The distinction between family and non-family firms hardly affects the use of instruments. (shrink)

We propose a new approach for tracing value change. Value change may lead to a mismatch between current value priorities in society and the values for which technologies were designed in the past, such as energy technologies based on fossil fuels, which were developed when sustainability was not considered a very important value. Better anticipating value change is essential to avoid a lack of social acceptance and moral acceptability of technologies. While value change can be studied historically and qualitatively, we (...) propose a more quantitative approach that uses large text corpora. It uses probabilistic topic models, which allow us to trace values that are latent. We demonstrate the approach for five types of value change in technology. Our approach is useful for testing hypotheses about value change, such as verifying whether value change has occurred and identifying patterns of value change. The approach can be used to trace value change for various technologies and text corpora, including scientific articles, newspaper articles, and policy documents. (shrink)

We extend BDDs for plain propositional logic to the fragment of first order logic, consisting of quantifier free logic with zero, successor and equality. We allow equations with zero and successor in the nodes of a BDD, and call such objects -BDDs. We extend the notion of Ordered BDDs in the presence of zero, successor and equality. -BDDs can be transformed to equivalent Ordered -BDDs by applying a number of rewrite rules until a normal form is reached. All paths in (...) these ordered -BDDs represent satisfiable conjunctions. The major advantage of transforming a formula to an equivalent Ordered -BDD is that on the latter it can be observed in constant time whether the formula is a tautology, a contradiction, or just satisfiable. (shrink)

In this paper we report on our experiences with using network analysis to discern and analyse ethical issues in research into, and the development of, a new wastewater treatment technology. Using network analysis, we preliminarily interpreted some of our observations in a Group Decision Room session where we invited important stakeholders to think about the risks of this new technology. We show how a network approach is useful for understanding the observations, and suggests some relevant ethical issues. We argue that (...) a network approach is also useful for ethical analysis of issues in other fields of research and development. The abandoning of the overarching rationality assumption, which is central to network approaches, does not have to lead to ethical relativism. (shrink)

Standardisation is increasingly seen as a means to insert ethics in innovation processes. We examine the institutionalisation of responsible innovation in de jure standardisation as this is an important but unexplored research area. In de jure standardisation, stakeholders collaborate in committees to develop standards. We adopt the anticipation, inclusion, reflexivity, and responsiveness responsible innovation framework as our theoretical lens. Our study suggests that responsible standardisation processes should embody forms of these four dimensions. We investigate the institutionalisation of these dimensions and (...) identify 96 factors that can motivate, hinder, or facilitate responsible standardisation. Factors were found through in-depth interviews with managers of a standard developing organisation. These are subsequently validated/rejected using surveys completed by committee representatives. The results suggest that the social desirability of standards is not self-evident. This study could pave the way for future research on responsible standardisation processes, complementing research on legitimacy, responsible innovation, and standardisation. (shrink)

In this article, we develop an approach for the moral assessment of research and development networks on the basis of the reflective equilibrium approach proposed by Rawls and Daniels. The reflective equilibrium approach aims at coherence between moral judgments, principles, and background theories. We use this approach because it takes seriously the moral judgments of the actors involved in R & D, whereas it also leaves room for critical reflection about these judgments. It is shown that two norms, namely reflective (...) learning and openness and inclusiveness, which are used in the literature on policy and technological networks, contribute to achieving a justified overlapping consensus. We apply the approach to a case study about the development of an innovative sewage treatment technology and show how in this case the two norms are or could be instrumental in achieving a justified overlapping consensus on relevant moral issues. (shrink)

In some situations in which undesirable collective effects occur, it is very hard, if not impossible, to hold any individual reasonably responsible. Such a situation may be referred to as the problem of many hands. In this paper we investigate how the problem of many hands can best be understood and why, and when, it exactly constitutes a problem. After analyzing climate change as an example, we propose to define the problem of many hands as the occurrence of a gap (...) in the distribution of responsibility that may be considered morally problematic. Whether a gap is morally problematic, we suggest, depends on the reasons why responsibility is distributed. This, in turn, depends, at least in part, on the sense of responsibility employed, a main distinction being that between backward-looking and forward-looking responsibility. (shrink)

Purpose The purpose of this paper is to demonstrate privacy concerns arising from the rapidly increasing advancements and use of artificial intelligence technology and the challenges of existing privacy regimes to ensure the on-going protection of an individual’s sensitive private information. The authors illustrate this through a case study of energy smart meters and suggest a novel combination of four solutions to strengthen privacy protection. Design/methodology/approach The authors illustrate how, through smart meter obtained energy data, home energy providers can use (...) AI to reveal private consumer information such as households’ electrical appliances, their time and frequency of usage, including number and model of appliance. The authors show how this data can further be combined with other data to infer sensitive personal information such as lifestyle and household income due to advances in AI technologies. Findings The authors highlight data protection and privacy concerns which are not immediately obvious to consumers due to the capabilities of advanced AI technology and its ability to extract sensitive personal information when applied to large overlapping granular data sets. Social implications The authors question the adequacy of existing privacy legislation to protect sensitive inferred consumer data from AI-driven technology. To address this, the authors suggest alternative solutions. Originality/value The original value of this paper is that it illustrates new privacy issues brought about by advances in AI, failings in current privacy legislation and implementation and opens the dialog between stakeholders to protect vulnerable consumers. (shrink)

We propose a pragmatist account of value change that helps to understand how and why values sometimes change due to technological developments. Inspired by John Dewey’s writings on value, we propose to understand values as evaluative devices that carry over from earlier experiences and that are to some extent shared in society. We discuss the various functions that values fulfil in moral inquiry and propose a conceptual framework that helps to understand value change as the interaction between three manifestations of (...) value distinguished by Dewey, i.e., “immediate value,” “values as the result of inquiry” and “generalized values.” We show how this framework helps to distinguish three types of value change: value dynamism, value adaptation, and value emergence, and we illustrate these with examples from the domain of technology. We argue that our account helps to better understand how technology may induce value change, namely through the creation of what Dewey calls indeterminate situations, and we show how our account can integrate several insights on moral change offered by other authors. (shrink)

Gebhardt in his brief report1 pleads for patient organisations to establish databanks on medical complications. Given the references and the lack of argumentation, there is substantial danger of misinterpretation of the current situation, which in turn may frustrate the process of increased transparency. We would therefore like to respond to this by giving background information and reasons for some of the choices that were made with respect to the registry of complications mentioned by Gebhardt.First, a distinction needs to be made (...) between an error and an adverse outcome, which are often confused. From Gebhardt’s reference to the journalist’s article which discusses the same registry of adverse outcomes, but with the title referring to errors, both Gebhardt and the journalist think errors and adverse outcomes are the same thing. However, an error refers to the process in which something has gone wrong, a substandard performance, regardless of the outcome. It has been explained by others that such a judgement may have a degree of subjectivity.2 An adverse outcome refers to the outcome which is unwanted but does not necessarily imply that an error has been made. This is why the term “adverse outcomes” is used rather than …. (shrink)