Although law is established on a strong presumption that persons younger than a certain age are not competent to consent, statutory age limits for asking children’s consent to clinical research differ widely internationally. From a clinical perspective, competence is assumed to involve many factors including the developmental stage, the influence of parents and peers, and life experience. We examined potential determining factors for children’s competence to consent to clinical research and to what extent they explain the variation in competence judgments.

‘GRONDSLAGEN christelijke ethiek’ van de theoloog-ethicus J. Douma geeft een goede gelegenheid de ‘Reformatorische Wijsbegeerte’, speciaal die van H. Dooyeweerd, en haar toepassing op een vakwetenschap, te vergelijken met traditioneel-theologische c.q. klassiek-gereformeerde opvattingen over de grondslagen van de ethiek. Die vergelijking ligt voor de hand omdat het hoofdonderwerp van dit tamelijk omvangrijke boek van 413 pagina’s een filosofisch onderwerp is, geen theologie, zelfs geen theologische ethiek, maar een vakfilosofisch onderwerp. We zullen dus niet discussiëren met de schrijver over allerlei onderwerpen (...) die men gewoonlijk als ethische problemen beschouwt, want daarover zal een geplande reeks van vijf andere boeken gaan. Bovengenoemd boek echter gaat niet over een of ander ethisch vraagstuk, maar over wat de titel alleen al door de gebruikte hoofdletters, met veel nadruk stelt: grondslagen van de eigenlijke ethiek. (shrink)

In het eerste deel van deze studie zagen we dat de levensbeschouwelijke idee van een normatieve kosmische wereldorde oorspronkelijk een mythische geloofsidee was, die in vrijwel alle grote godsdiensten voorkwam. In de joodse en christelijke tradities werd deze idee in niet-wetenschappelijke zin geloofsmatig, vanuit het Oude Testament verstaan. Temeer omdat de Schrift op dit punt bepaald niet haaks stond op de algemeen gangbare, religieus-heidense publieke opinie, noch in de tijd van Homerus en Hesiodus, noch in de begintijd van het christendom.89 (...) Vervolgens werden de beide genoemde geloofstradities levensbeschouwelijk, theologisch en wijsgerig verwerkt met hantering van uit het heidendom, voornamelijk uit de Stoa, overgenomen gedachten en denkpatronen. (shrink)

Behalve onze volledige erkenning dat in het Stoïcisme een duidelijke herinnering ligt aan Gods overmachtige openbaring van zijn scheppingsorde, is ook met waardering te melden dat de Stoa een sterk besef heeft gehad van een onder de oppervlakte van het actieve leven gelegen diepere dimensie van de zogenaamde zedelijke deugden. Zelf spreek ik liever van ‘disposities’, de eerste onderlaag in de structuur van de concrete menselijke activiteiten.De genoemde stoïsche gedachte is van belang in het licht van de latere ontwikkelingen van (...) de praxeologie, met name in de zogenaamde goederenethiek, plichtenethiek of verantwoordingsethiek. ‘Gezindheidsethiek’ in diverse wijsgerige stromingen kon daarbij aanknopen. Dit was inderdaad een bij de Stoa positief te waarderen voortzetting van een reeds bestaande Sokratische, Platonische en Aristotelische traditie. Het is een goede weerstand tegenover elke tot de oppervlakte van het handelen beperkte visie, die dit oppervlakte-niveau, deze boven- of buitenkant, abstraheert, verzelfstandigt en overschat. Een denken in deze trant van wetticisme en activisme, van formalisme, legalisme en verjuridisering van de moraal, is met de reformatorische wijsbegeerte te weerstaan vanuit haar analyse van de dieptedimensies in de actstructuur: acten, disposities, ethos en centraal-religieuze worteldimensie in het menselijk hart. (shrink)

For decades, the discussion on children’s competence to consent to medical issues has concentrated around normative concerns, with little progress in clinical practices. Decision-making competence is an important condition in the informed consent model. In pediatrics, clinicians need to strike a proper balance in order to both protect children’s interests when they are not fully able to do so themselves and to respect their autonomy when they are. Children’s competence to consent, however, is currently not assessed in a standardized way. (...) Moreover, the correlation between competence to give informed consent and age in children has never been systematically investigated, nor do we know which factors exactly contribute to children’s competence. (shrink)

During the past 25 years, the words “theory of action” and “agency theory” have become key-terms in a new branch of philosophy. The themes appear to gain a centrality and influence such that one is led to think that they should cover most of philosophy, including the foundation for all of the human sciences. The number of treatises on human action and on philosophical and special-scientific theories of action is staggering. For the most part inspired by analytic philosophy, the new (...) approach threatens to take over that school’s central place on the stage of international philosophical concern. Having ousted theory of science from that position with an avalanche of analytic studies, analytic philosophy, in turn, is now being overrun by philosophy of action as supposedly suitable basis for the sciences. (shrink)

BackgroundFor many decades, the debate on children’s competence to give informed consent in medical settings concentrated on ethical and legal aspects, with little empirical underpinnings. Recently, data from empirical research became available to advance the discussion. It was shown that children’s competence to consent to clinical research could be accurately assessed by the modified MacArthur Competence Assessment Tool for Clinical Research. Age limits for children to be deemed competent to decide on research participation have been studied: generally children of 11.2 (...) years and above were decision-making competent, while children of 9.6 years and younger were not. Age was pointed out to be the key determining factor in children’s competence. In this article we reflect on policy implications of these findings, considering legal, ethical, developmental and clinical perspectives.DiscussionAlthough assessment of children’s competence has a normative character, ethics, law and clinical practice can benefit from research data. The findings may help to do justice to the capacities children possess and challenges they may face when deciding about treatment and research options. We discuss advantages and drawbacks of standardized competence assessment in children on a case-by-case basis compared to application of a fixed age limit, and conclude that a selective implementation of case-by-case competence assessment in specific populations is preferable. We recommend the implementation of age limits based on empirical evidence. Furthermore, we elaborate on a suitable model for informed consent involving children and parents that would do justice to developmental aspects of children and the specific characteristics of the parent-child dyad.SummaryPrevious research outcomes showed that children’s medical decision-making capacities could be operationalized into a standardized assessment instrument. Recommendations for policies include a dual consent procedure, including both child as well as parents, for children from the age of 12 until they reach majority. For children between 10 and 12 years of age, and in case of children older than 12 years in special research populations of mentally compromised patients, we suggest a case-by-case assessment of children’s competence to consent. Since such a dual consent procedure is fundamentally different from a procedure of parental permission and child assent, and would imply a considerable shift regarding some current legislations, practical implications are elaborated. (shrink)

The article attempts to put the undervalued cultural phenomenon of offering comfort by means of persuasive speech acts (‘arguments’) on the research agenda of the human¬ities. The article proceeds in four steps. First, it defines ‘argumentative consolation’. Second, it argues that there has been a broad overlap of ancient philosophical and Christian modes of argumentative consolation. Third, it would be misguided to attribute today’s uneasiness with argumentative consolation to a process of ‘secularization’; the uneasiness stems from a radicalized intensification of (...) life that is played out against the possibility of consolation in the face of death. Fourth, the ensuing emphasis on the notions of desires, plans and projects to measure the completeness of a life is self-defeating. The article argues the continued relevance of pre-modern argumentative consolation that identified virtue as the key factor in the completeness of a biography. (shrink)

The Problem of Perception offers two arguments against direct realism--one concerning illusion, and one concerning hallucination--that no current theory of ...

A. H. Louie's More Than Life Itself is an exploratory journey in relational biology, a study of life in terms of the organization of entailment relations in living systems. This book represents a synergy of the mathematical theories of categories, lattices, and modelling, and the result is a synthetic biology that provides a characterization of life. Biology extends physics. Life is not a specialization of mechanism, but an expansive generalization of it. Organisms and machines share some common features, but organisms (...) are not machines. Life is defined by a relational closure that places it beyond the reach of physicochemical and mechanistic dogma, outside the reductionistic universe, and into the realm of impredicativity. Function dictates structure. Complexity brings forth living beings. (shrink)

This companion is a cutting-edge primer to critical forms of the posthumanities and the feminist posthumanities, aimed at students and researchers who want to catch up with the recent theoretical developments in various fields in the humanities, such as new media studies, gender studies, cultural studies, science and technology studies, human animal studies, postcolonial critique, philosophy and environmental humanities. It contains a collection of nineteen new and original short chapters introducing influential concepts, ideas and approaches that have shaped and developed (...) new materialism, inhuman theory, critical posthumanism, feminist materialism, and posthuman philosophy. A resource for students and teachers, this comprehensive volume brings together established international scholars and emerging theorists, for timely and astute definitions of a moving target – posthuman humanities and feminist posthumanities. (shrink)

Inspired by Castañeda (1966, 1968), Perry (1979) and Lewis (1979) showed that a specific variety of singular thoughts, thoughts about oneself “as oneself” – de se thoughts, as Lewis called them – raise special issues, and they advanced rival accounts. Their suggestive examples raise the problem of de se thought – to wit, how to characterize it so as to give an accurate account of the data, tracing its relations to singular thoughts in general. After rehearsing the main tenets of (...) two contrasting accounts – a Lewisian one and a Perrian one – in the first section of this paper, in the second I will present a proposal of my own, which is a specific elaboration of the Perrian account. In the first section I will indicate some weaknesses of Perry’s presentation of his view; the proposal I will articulate in the second overcomes them. I will conclude with a brief discussion of reasons for preferring one or another account, in particular regarding the issue of the communication of de se thoughts. (shrink)

The book questions two key dichotomies: that of the apparent and real, and that of the internal and external. This leads to revised notions of the structure of experience and the object of knowledge. Our world is experienced as possibilities of action, and to know is to know what to do. A further consequence is that the mind is best considered as a property of organisms' interactions with their environment. The unit of analysis is the loop of action and perception, (...) and the central concept is the notion of habit of action, which provides the embodied basis of cognition as the anticipation of action. This holds for non-linguistic tacit meanings as well as for linguistic meanings. Habit of action is a teleological notion and thus opens a possibility for defining intentionality and normativity in terms of the soft naturalism adopted in the book. The mind is embodied, and this embodiment determines our physical perspective on the world. Our sensory organs and other instruments give us instrumental access to the world, and this access is epistemic in character. The distinction between the physical and conceptual viewpoint allows us to define truth as the correspondence with operational fit. This embodied epistemic truth is however not a sign of antirealism, as the instrumentally accessed theoretical objects are precisely those objects that experimental science deals with.. (shrink)

Following the trend of sharing, and associating being on-line with being 'on-life', many people are now demanding the ownership and control of their data across all processing phases, including the erasure of their presence on the web. In Europe, recent proposals for regulation include an explicit 'Right to be Forgotten'; this right stated in the European Commission Proposal for Regulation COM 2011/12 does not emerge without controversy. It is being criticised on several grounds, including clashing with other rights, such as (...) freedom of expression, as well as setting the terrain for censorship. Besides the purely legal aspects of the proposed provisions, the chapters of this volume discuss how those legal provisions correspond in practice to worldviews and how individual and collective memory must be governed. They look into the deeper consequences of such provisions to construction of identity, culture and community formation, and how such a right affects how, what and why individuals, groups and societies remember and forget. (shrink)