Direct-to-consumer advertising (DTCA) of prescription drugs has been a heavily contested issue over the past decade, touching on several issues of responsibility facing the pharmaceutical industry. Much research has been conducted on DTCA, but hardly any studies have discussed this topic from a corporate social responsibility (CSR) perspective. In this article, we use several elements of CSR, emphasising consumer autonomy and safety, to analyse differences in DTCA practices within two different policy contexts, the United States of America and the European (...) Union (EU). Doing so results in an alternative analysis of the struggle between proponents and opponents of DTCA from a CSR perspective, adding an alternative view on this debate. (shrink)

This paper was presented at the First Conference of the ISSEI ‘Turning Points in History’, 26–30 September 1988. It belongs to Theme 1, ‘Comparative History of European Revolutions’.

In the introduction to hisAllgemeine Psychopathologie, published in 1913, Karl Jaspers stated that psychology has little value for the psychopathologist because it focuses on all kinds of interesting matters, but not on normal psychic life. In this article we argue that today, in the year 2013, little has changed in this respect. During the past century, normal psychic life (non-pathological psychic life) has rarely been a topic of research. Clinical psychology has focused primarily on studying three other topics: the mind-body (...) problem (does the mind actually exist, or are we exclusively the result of brain function?), the methodological debate (should psychology use quantitative or qualitative research results as a basis for its expertise?) and the psychotherapy debate (Is psychotherapy effective? If so, which form is the most effective?). Due to this focus, our knowledge in the above-mentioned areas has increased significantly, but the issue raised by Karl Jaspers about normal psychic life has still not been addressed. In this article, we propose that normal psychic life should indeed become the new focus of clinical psychology. We illustrate the importance of this new focus with three examples from clinical psychology: the Global Assessment of Functioning scale, empathy and the emergence of positive psychology during the past decade. We then explore the efficacy of phenomenology for studying this normal psychic life, thereby discovering a useful epistemological basis in Husserl’s systematic phenomenology. Various phenomenological research methods are evaluated in the light of this systematic phenomenology. (shrink)

Theory of mind refers to the human capacity for reasoning about others’ mental states based on observations of their actions and unfolding events. This type of reasoning is notorious in the cognitive science literature for its presumed computational intractability. A possible reason could be that it may involve higher-order thinking. To investigate this we formalize theory of mind reasoning as updating of beliefs about beliefs using dynamic epistemic logic, as this formalism allows to parameterize ‘order of thinking.’ We prove that (...) theory of mind reasoning, so formalized, indeed is intractable. Using parameterized complexity we prove, however, that the ‘order parameter’ is not a source of intractability. We furthermore consider a set of alternative parameters and investigate which of them are sources of intractability. We discuss the implications of these results for the understanding of theory of mind. (shrink)

Dialogic Teaching is effective in fostering student learning; yet, it is hard to implement. Little research focused on secondary teachers’ learning of DT and on the link between teachers’ understanding and practices, although these two are usually strongly intertwined. Using a wide range of evidence, this case study systematically investigated and compared two secondary teachers’ understanding and practice of DT during their participation in a continuing professional development programme. The CPDP appeared effective to some extent. The History teacher’s understanding of (...) DT, i.e. being a co-learner, appeared highly effective in implementing DT, whereas the Mathematics teacher’s understanding of DT, i.e. creating a democratic learning environment, seemed only effective to some extent. Focusing on both teachers’ understanding and practice when developing DT seemed fruitful in explaining differences in practice. Future research could further explore to what extent understanding DT as being a co-learner facilitates professional development. (shrink)

Classroom discussion is frequently proposes as an essential part of democratic citizenship education. Literature, however, pays little attention to what kind of discussion is most effective and how teachers can facilitate a discussion. This study aims to contribute to the development of a framework for analysing the characteristics of classroom discussions and the different roles teachers can adopt in guiding a discussion on controversial issues. In addition, we investigated how the way teachers guide the discussion is related to the structure (...) and content features of the discussion. The framework was used to analyse five classroom discussions in secondary education. Our framework appeared to be useful for revealing differences in the structure and content features of the classroom discussions and in the way teachers guide the discussion. The results also indicated that a high degree of teacher regulation was related to high content quality and more participation from students. A high degree of stu... (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)

This essay is a response to proposals to integrate patient-subjective or idiographic data into future versions of nosologies such as the DSM and the ICD. It argues that a nosology is not a suitable vehicle for disseminating psychopathological-phenomenological research results throughout the field. Drawing on the work of Ludwig Binswanger, it examines, on the basis of four postulates, how he applies the Husserlian concept of intentionality in psychiatry and thus arrives at a psychopathological phenomenology. For each individual postulate, we then (...) look in depth at the implications for the current debate around DSM. The conclusion we come to is that, both because of the objective of phenomenological research and because of the complexity of the kind of information involved in findings based on that research, it is impossible to integrate these findings into a nosology without deviating from either them or the nosology itself. (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)

The authors explore whether the need for ethical reflection on the part of designing engineers is dependent on the type of design process. They use Vincenti's distinction between normal and radical design and different levels of design hierarchy. These two dimensions are coupled with the concept of ill-structured problems, which are problems in which possible solutions cannot be ordered on a scale from better to worse. Design problems are better structured at lower hierarchical levels and in cases of normal design. (...) Better structured design problems require less ethical reflection on the part of designing engineers if such situations are characterized by the existence of generally accepted normative frameworks. Engineers could then deal with moral problems within the bounds of such frameworks and without the need for further reflection. On the basis of a number of empirical cases, the authors explore whether these ideas hold water. They discuss four cases ranging from a high-level radical design process to a low-level normal design process. (shrink)

BackgroundAs moral case deliberations (MCDs) have increasingly been implemented in health care institutions as a form of ethics support, it is relevant to know whether and how MCDs actually contribute to positive changes in care. Insight is needed on what actually happens in daily care practice following MCD sessions. This study aimed at investigating the impact of MCD and exploring how ‘impact of MCD’ should be conceptualized for future research.MethodsA multiple-case study was conducted in a care organization for people with (...) intellectual disabilities and/or acquired brain injury, by observing MCD sessions as ‘cases’, followed by interviews with health care professionals concerning the follow-up to these cases, and a focus group with involved MCD facilitators. A conceptual scheme concerning the possible impact formed the basis for analysis: (1) individual moral awareness; (2) the actions of health care professionals; (3) collaboration among health care professionals; (4) the concrete situation of the client; (5) the client’s quality of care and life; (6) the organizational and policy level.ResultsAccording to interviewees, their moral awareness and their collaboration, both among colleagues and with clients’ relatives, improved after MCD. Perceived impact on client situation, quality of care/life and the organizational level varied among interviewees or was difficult to define or link to MCD. Three aspects were added to the conceptual scheme concerning the impact of MCD: (a) preparations and expectations prior to the MCD session; (b) a translational step between the conclusions of the MCD session and practical events in the following period, and (c) collaboration with clients’ relatives. A negative impact of MCD was also found on misunderstandings among participants and disappointment about lack of follow-up.ConclusionsConcretizing and conceptualizing the ‘impact’ of MCD is complicated as many factors play a role either before or during the transition from MCD to practice. It is important to consider ‘impact’ in a broad sense and to relate it to the goals and context of the MCD in question. Future studies in this field should pay additional attention to the preparations, content and process involved in ethics support, including clients’ and relatives’ experiences. (shrink)

Research on value congruence rests on the assumption that values denote desirable behaviors and ideals that employees and organizations strive to approach. In the present study, we develop and test the argument that a more complete understanding of value congruence can be achieved by considering a second type of congruence based on employees’ and organizations’ counter-ideal values. We examined this proposition in a time-lagged study of 672 employees from various occupational and organizational backgrounds. We used difference scores as well as (...) polynomial regression and response surface analyses to test our hypotheses. Consistent with our hypotheses, results reveal that counter-ideal value congruence has unique relations to employees’ trust in the organization that go beyond the effects of ideal value congruence. We discuss theoretical and practical implications of this expanded perspective on value congruence. (shrink)

Recent policy developments in the area of livestock husbandry have suggested that, from the perspective of optimizing animal welfare, new animal husbandry systems should be developed that provide opportunities for livestock animals to be raised in environments where they are permitted to engage in “natural behavior.” It is not known whether consumers regard animal husbandry issues as important, and whether they differentiate between animal husbandry and other animal welfare issues. The responsibility for the development of such systems is allocated jointly (...) between farmers, regulators, different actors in the food chain, and consumers. This research focuses on understanding consumer attitudes and preferences regarding the development and introduction of such systems, to ensure that they are acceptable to consumers as well as producers, regulators, and scientists. Consumer perceptions of animal welfare and animal husbandry practices were evaluated using quantitative consumer survey, which focused on two animal husbandry issues – farmed pigs and farmed fish. Following pilot work, 1000 representative Dutch consumers were sampled about their attitudes to either pig or fish husbandry. The results indicated that consumers think about animal welfare in terms of two broad categories related to their health and living environment, but do not think about welfare issues at a more detailed level. Greater concern was expressed about the welfare of pigs compared to fish. Consumer trust in labeling also emerged as an important issue, since consumers need to trust different food chain actors with responsibility for promoting animal welfare, and are reluctant to consider the details of animal husbandry systems. As a consequence, a transparent, enforceable, and traceable monitoring system for animal welfare friendly products is likely to be important for consumers. (shrink)

Recent policy developments in the area of livestock husbandry have suggested that, from the perspective of optimizing animal welfare, new animal husbandry systems should be developed that provide opportunities for livestock animals to be raised in environments where they are permitted to engage in “natural behavior.” It is not known whether consumers regard animal husbandry issues as important, and whether they differentiate between animal husbandry and other animal welfare issues. The responsibility for the development of such systems is allocated jointly (...) between farmers, regulators, different actors in the food chain, and consumers. This research focuses on understanding consumer attitudes and preferences regarding the development and introduction of such systems, to ensure that they are acceptable to consumers as well as producers, regulators, and scientists. Consumer perceptions of animal welfare and animal husbandry practices were evaluated using quantitative consumer survey, which focused on two animal husbandry issues – farmed pigs and farmed fish. Following pilot work, 1000 representative Dutch consumers were sampled about their attitudes to either pig or fish husbandry. The results indicated that consumers think about animal welfare in terms of two broad categories related to their health and living environment, but do not think about welfare issues at a more detailed level. Greater concern was expressed about the welfare of pigs compared to fish. Consumer trust in labeling also emerged as an important issue, since consumers need to trust different food chain actors with responsibility for promoting animal welfare, and are reluctant to consider the details of animal husbandry systems. As a consequence, a transparent, enforceable, and traceable monitoring system for animal welfare friendly products is likely to be important for consumers. (shrink)

This interview study investigates the short- and long-term implications of incidental findings detected through brain imaging on research participants’ lives and their surroundings. For this study, nine participants of the Rotterdam Scan Study with an incidental finding were approached and interviewed. When examining research participants’ narratives on the impact of the disclosure of incidental findings, the authors identified five sets of tensions with regard to motivations for and expectations of research participation, preferences regarding disclosure, short- and long-term impacts and impacts (...) on self and others. The paper shows: that the impact of incidental findings may be greater than participants at first let on; incidental findings can have significant effects on participants’ social environment; and participants may not feel prepared for disclosure even if incidental findings have been discussed during the informed consent process. The authors call for investigators to be aware of research participants’ experiences and these short- and long-term impacts when designing suitable courses of action for the detection and management of incidental findings in research settings. (shrink)

Background: Issues concerning legislation and regulation with respect to the role of nurses in euthanasia and physician-assisted suicide gave the Minister for Health reason to commission a study of the role of nurses in medical end-of-life decisions in hospitals, home care and nursing homes.Aim: This paper reports the findings of a study of the role of nurses in euthanasia and physician-assisted suicide, conducted as part of a study of the role of nurses in medical end-of-life decisions. The findings for hospitals, (...) home care and nursing homes are described and compared.Method: A questionnaire was sent to 1509 nurses, employed in 73 hospitals, 55 home care organisations and 63 nursing homes. 1179 responses were suitable for analysis. The questionnaire was pilot-tested among 106 nurses, with a response rate of 85%.Results: In 37.0% of cases, the nurse was the first person with whom patients discussed their request for euthanasia or physician-assisted suicide. Consultation between physicians and nurses during the decision-making process took place quite often in hospitals and nursing homes and less frequently in home care situations . In some cases , nurses administered the euthanatics.Conclusions: The results show substantial differences between the intramural sector and the extramural sector , which are probably linked to the organisational structure of the institutions. Consultation between physicians and nurses during the decision-making process needs improvement, particularly in home care. Some nurses had administered euthanatics, although this task is by law exclusively reserved to physicians. (shrink)

Social dilemmas occur when the pursuit of self-interest by individuals in a group leads to less than optimal collective outcomes for everyone in the group. A critical assumption in the human sciences is that people's choices in such dilemmas are individualistic, selfish, and rational. Hence, cooperation in the support of group welfare will only occur if there are selfish incentives that convert the social dilemma into a nondilemma. In recent years, inclusive fitness theories have lent weight to such traditional views (...) of rational selfishness on Darwinian grounds. To show that cooperation is based on selfish incentives, however, one must provide evidence that people donotcooperatewithoutsuch incentives. In a series of experimental social dilemmas, subjects were instructed to make single, anonymous choices about whether or not to contribute money for a shared “bonus” that would be provided only if enough other people in the group also contributed their money. Noncontributors cited selfish reasons for their choices; contributors did not. If people are allowed to engage in discussion, they will contribute resources at high rates, frequently on irrational grounds, to promote group welfare. These findings are consistent with previous research on ingroup biasing effects that cannot be explained by “economic man” or “selfish gene” theories. An alternative explanation is that sociality was a primary factor shaping the evolution ofHomo sapiens. The cognitive and affective mechanisms underlying such choices evolved under selection pressures on small groups for developing and maintaining group membership and for predicting and controlling the behavior of other group members. This sociality hypothesis organizes previously inexplicable and disparate phenomena in a Darwinian framework and makes novel predictions about human choice. (shrink)

This article reports the findings of a study into the role of Dutch nurses in the alleviation of pain and symptoms with a life-shortening intention, conducted as part of a study into the role of nurses in medical end-of-life decisions. A questionnaire survey was carried out using a population of 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The response rate was 82.0%; 78.1% were suitable for analysis. The results show that in about half of (...) the cases nurses were involved in the decision making by the physician and that nurses were frequently involved in administering the medication. The authors' conclusion is that alleviation of pain and symptoms with a life-shortening intention represents a `grey' area, in which physicians and nurses act on the basis of personal ethical norms rather than legal rules, professional guidelines or shared moral values. (shrink)

The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia.

Subliminal primes are assumed to produce weaker and short-lived effects on subsequent behavior compared to clearly visible primes. However, this difference in priming effect may be due to differences in signal strength, rather than level of awareness. In the present study we manipulated prime discriminability by using metacontrast masks and pseudomasks, while keeping the prime strength equal. This manipulation resulted in large differences in discriminability of the primes. However, both immediate response priming and long-term response priming was equal for the (...) poorly discriminable and well discriminable primes, and equal for groups that differed markedly in terms of how well they could discriminate the primes. Our findings imply that discriminability of information is independent of both the immediate and long-term effects that information can have on behavior. (shrink)