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 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 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)

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)

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)

This volume includes the critical edition of five apologias (1522-1529) in which Erasmus defended his New Testament translation and commentary (1516)against Diego López de Zúñiga and Sancho Carranza. The edition is partly based on manuscript sources never used before.

Autonomous vehicles (AVs) hold considerable promise for maintaining aging adults’ mobility as they develop impairments in driving skill. Nonetheless, attitudes can be a significant barrier to adoption as has been shown for other technologies. We investigated how different introductions to AV, video with a driver in the front seat, the rear seat, and a written description, affected attitudes, as well as how individual difference variables such as age, gender, prior knowledge, and personality traits predict attitudes within a middle-aged (Median age (...) = 34, IQR = 20, n = 441) Amazon Mechanical Turk sample. The 16-item attitude survey uncovered three factors: Concern with AV, Eagerness to Adopt AV technology, and Willingness to Relinquish Driving Control. ANOVAs showed that only age (younger less concerned) and gender, (females more concerned) were significant factors in Concern with AV. Only gender affected Willingness to Relinquish Driving Control, with males more willing. Multiple regressions that included previous knowledge level and personality traits showed a different pattern. Female gender and greater conscientiousness were associated with greater Concern about AV. Prior knowledge of AV was associated with less concern. Emotional stability and openness to experience were positive predictors of Eagerness to Adopt AV, whereas conscientiousness was a negative predictor. Prior knowledge and openness to experience, positively, and extraversion, negatively, were associated wi... (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)

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 legitimacy of the dominant intensive meat production system with respect to the issue of animal welfare is increasingly being questioned by stakeholders across the meat supply chain. The current meat supply is highly undifferentiated, catering only for the extremes of morality concerns (i.e., conventional vs. organic meat products). However, a latent need for compromise products has been identified. That is, consumer differences exist regarding the trade-offs they make between different aspects associated with meat consumption. The heterogeneity in consumer demand (...) could function as a starting point for market segmentation, targeting and positioning regarding animal welfare concepts that are differentiated in terms of animal welfare and price levels. Despite this, stakeholders in the meat supply chain seem to be trapped in the dominant business model focused on low cost prices. This paper aims to identify conflicting interests that stakeholders in the meat supply chain experience in order to increase understanding of why heterogeneous consumer preferences are not met by a more differentiated supply of meat products produced at different levels of animal welfare standards. In addition, characteristics of the supply chain that contribute to the existence of high exit barriers and difficulty to shift to more animal-friendly production systems are identified. Following the analysis of conflicting interests among stakeholders and factors that contribute to difficulty to transform the existing dominant regime, different routes are discussed that may help and motivate stakeholders to overcome these barriers and stimulate the creation of new markets. (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)

Education has significant and far-reaching effects not only on individuals, but also on the societies in which they live and to which they contribute. The education level of a population affects how a country supports itself and others and the degree to which it can participate in the global field. While everyone from politicians to policymakers to celebrities has stressed the importance of education, there has not been-until now-a vigorous yet comprehensible examination of data to support what has long been (...) common knowledge: education matters. In Education Matters: Global Gains from the 19th to the 21st Century, renowned economists Robert Barro and Jong-Wha Lee present a revolutionary new data set on education in 146 countries since 1870 and projected through 2040. With case studies from the United States, China, and Korea, Barro and Lee evaluate schooling both quantitatively and qualitatively, and assess the role of education in economic and political development. In this comprehensive study, the authors establish the critical role that education plays - particularly for women and girls - in economic growth, fertility, and democracy. The book also addresses sensitive and controversial topics, such as international disparities in education, and the role of education in modernization and development. Both challenging and enlightening, Education Matters has exciting implications for the future of education and promises to be a ground-breaking work in the fields of economics and educational attainment. Engaging and informative, Education Matters is a compelling read for students, scholars, and anyone with a passion for education. (shrink)

Automated technologies and robots make decisions that cannot always be fully controlled or predicted. In addition to that, they cannot respond to punishment and blame in the ways humans do. Therefore, when automated cars harm or kill people, for example, this gives rise to concerns about responsibility-gaps and retribution-gaps. According to Sven Nyholm, however, automated cars do not pose a challenge on human responsibility, as long as humans can control them and update them. He argues that the agency exercised in (...) automated cars should be understood in terms of human–robot collaborations. This brief note focuses on the problem that arises when there are multiple people involved, but there is no obvious shared collaboration among them. Building on John Danaher’s discussion of command responsibility, it is argued that, although Nyholm might be right that autonomous cars cannot be regarded as acting on their own, independently of any human beings, worries about responsibility-gaps and retribution-gaps are still justified, because it often remains unclear how to allocate or distribute responsibility satisfactorily among the key humans involved after they have been successfully identified. (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)

Throughout more than two millennia philosophers adhered massively to ideal standards of scientific rationality going back ultimately to Aristotle’s Analytica posteriora . These standards got progressively shaped by and adapted to new scientific needs and tendencies. Nevertheless, a core of conditions capturing the fundamentals of what a proper science should look like remained remarkably constant all along. Call this cluster of conditions the Classical Model of Science . In this paper we will do two things. First of all, we will (...) propose a general and systematized account of the Classical Model of Science. Secondly, we will offer an analysis of the philosophical significance of this model at different historical junctures by giving an overview of the connections it has had with a number of important topics. The latter include the analytic-synthetic distinction, the axiomatic method, the hierarchical order of sciences and the status of logic as a science. Our claim is that particularly fruitful insights are gained by seeing themes such as these against the background of the Classical Model of Science. In an appendix we deal with the historiographical background of this model by considering the systematizations of Aristotle’s theory of science offered by Heinrich Scholz, and in his footsteps by Evert W. Beth. (shrink)

The original, Dutch version of this book served in 1979 as a doctoral disserta tion in philosophy at the Free University in Amsterdam. In this preface to the - slightly revised - English translation, I wish once again to express my gratitude to my supervisors, Prof. J. van der Hoeven of the Free University and Prof. G. Nuchelmans of the University of Leiden, for their excellent and stimulating support. Professor van der Hoeven was associated with this project from the outset. (...) It was a privilege to benefit from his incisive commentaries, especially in those instances where the objective was to break through to more fundamental insights. I shall not lightly forget his friendly and heartening encouragement. I am equally grateful for my discussions with Professor Nuchelmans. I almost always tried to follow his advice, since it was based upon awesome expertness and erudition. I am happy to have found in the person of Herbert Donald Morton, Th.M., M.A., an able and enthusiastic translator. Drs. Gerben Groenewoud made the translations of a number of the Latin citations. I acknowledge permission from Routledge and Kegan Paul and the University of Toronto Press to quote from The Collected Works of John Stuart Mill. And I thank the Netherlands Organization for the Advancement of Pure Research (Z.W.O.) for fmancing this translation. (shrink)