Background Genuine uncertainty on superiority of one intervention over the other is called equipoise. Physician-investigators in randomized controlled trials need equipoise at least in studies with more than minimal risks. Ideally, this equipoise is also present in patient-participants. In pediatrics, data on equipoise are lacking. We hypothesize that 1) lack of equipoise at enrolment among parents may reduce recruitment; 2) lack of equipoise during participation may reduce retention in patients assigned to a less favoured treatment-strategy. Methods We compared preferences of (...) parents/patients at enrolment, documented by a questionnaire, with preferences developed during follow-up by an interview-study to investigate equipoise of child-participants and parents in the BeSt-for-Kids-study. This trial in new-onset Juvenile Idiopathic Arthritis-patients consists of three strategies. One strategy comprises initial treatment with a biological disease-modifying-antirheumatic-drug, currently not standard-of-care. Semi-structured interviews were conducted with 23 parents and 7 patients, median 11 months after enrolment. Results Initially most parents and children were not in equipoise. Parents/patients who refused participation, regularly declined due to specific preferences. Many participating families preferred the biological-first-strategy. They participated to have a chance for this initial treatment, and would even consider stopping trial-participation when not randomized for it. Their conviction of superiority of the biological-first strategy was based on knowledge from internet and close relations. According to four parents, the physician-investigator preferred the biological-first-strategy, but the majority stated that she had no preferred strategy. In phase 2, preferences tended to change to the treatment actually received. Conclusions Lack of equipoise during enrolment did not reduce study recruitment, mainly due to the fact that preferred treatment was only available within the study. Still, when developing a trial it is important to evaluate whether the physicians’ research question is in line with preferences of the patient-group. By exploring so-called ‘informed patient-group’-equipoise, successful recruitment may be enhanced and bias avoided. In our study, lack of equipoise during trial-participation did not reduce retention in those assigned to a less favoured option. We observed a change for preference towards treatment actually received, possibly explained by comparable outcomes in all three arms. (shrink)

People’s decisions and actions are informed, influenced, and constrained by socially constructed social arrangements. Usually, these social arrangements are pre-determined, and people joining institutions or organizations may have, at least initially, little control or influence over them. Occasionally, however, but increasingly commonly in the transition to the “Digital Society,” people have an opportunity to self-determine their social arrangements “from scratch.” The issues then are: how do people gain experience in such founding processes, experiment safely with alternative social arrangements, and gain (...) expertise so that they can participate meaningfully, for example in consultation events. In this research paper, we address these issues by presenting a framework for “computer-supported social arrangements” tools which would enable people to specify, learn, apply, evaluate, and innovate social arrangements. This would contribute to empowering people and communities with the necessary experience, experimentation, and expertise for effective and sustainable self-determination of their own social arrangements. (shrink)

Can the law benefit from an evolutionary perspective? This little book shows how the idea of survival of the fittest can help explain legal development and the rise and fall of legal institutions. The reader is invited to join in on a journey of discovery in which the world of Darwin is connected to the topics of legal change, convergence of law, legal complexity, law in hip-hop music and the adoption of the price-payment rule. Exploring these five themes from an (...) evolutionary angle indisputably upsets our traditional view of the law, but it does fit the author's view of academia as a place for cross-disciplinary research steered by curiosity. (shrink)

This book seeks to explain why different systems of sovereign states have built different types of fundamental institutions to govern interstate relations. Why, for example, did the ancient Greeks operate a successful system of third-party arbitration, while international society today rests on a combination of international law and multilateral diplomacy? Why did the city-states of Renaissance Italy develop a system of oratorical diplomacy, while the states of absolutist Europe relied on naturalist international law and "old diplomacy"? Conventional explanations of basic (...) institutional practices have difficulty accounting for such variation. Christian Reus-Smit addresses this problem by presenting an alternative, "constructivist" theory of international institutional development, one that emphasizes the relationship between the social identity of the state and the nature and origin of basic institutional practices. Reus-Smit argues that international societies are shaped by deep constitutional structures that are based on prevailing beliefs about the moral purpose of the state, the organizing principle of sovereignty, and the norm of procedural justice. These structures inform the imaginations of institutional architects as they develop and adjust institutional arrangements between states. As he shows with detailed reference to ancient Greece, Renaissance Italy, absolutist Europe, and the modern world, different cultural and historical contexts lead to profoundly different constitutional structures and institutional practices. The first major study of its kind, this book is a significant addition to our theoretical and empirical understanding of international relations, past and present. (shrink)

Human enhancement issues are not merely academic: the technologies and trends involved give rise to new needs and social demands, provide opportunities for individuals and society, and present new risks. They also challenge crucial cultural notions, social concepts and views of the human condition, and may cause new forms of social pressure and social exclusion. This chapter reports on a systematic attempt by the European Technology Assessment Group (ETAG), conducted on behalf of the Science and Technology Options Assessment (STOA) panel (...) of the European Parliament, to suggest policy options on the issue of human enhancement. It outlines and discusses a number of strategies for dealing with the issue in a European policy context, identifying a reasoned pro‐enhancement approach, a reasoned restrictive approach, and a systematic case‐by‐case approach as viable options. (shrink)

Classification of sciences; Moslem scholars; Africa, North.

Rahat Naqvi and Hans Smits' edited collection, "Thinking about and Enacting Curriculum in 'Frames of War'" is centered on the theme of how the current global order creates precarious conditions for human life. The contributors respond to the challenges Judith Butler posed about the fragility of life and questions about how we apprehend, and take up ethically, our responsibilities for those who are considered "Other." The overarching objective of the book is the meaning of a call to ethics, and how (...) discussion of framing and frames is a provocation to think about our responsibilities as curriculum scholars and practitioners"-- Provided by publisher. (shrink)

We live today in the first global system of sovereign states in history, encompassing all of the world's polities, peoples, religions and civilizations. Christian Reus-Smit presents a new account of how this system came to be, one in which struggles for individual rights play a central role. The international system expanded from its original European core in five great waves, each involving the fragmentation of one or more empires into a host of successor sovereign states. In the most important, (...) associated with the Westphalian settlement, the independence of Latin America, and post-1945 decolonization, the mobilization of new ideas about individual rights challenged imperial legitimacy, and when empires failed to recognize these new rights, subject peoples sought sovereign independence. Combining theoretical innovation with detailed historical case studies, this book advances a new understanding of human rights and world politics, with individual rights deeply implicated in the making of the global sovereign order. (shrink)

The quality of our theoretical argumentation, the diversity and insights of our methods, and our general level of understanding are markedly better than a generation ago. However, this progress has been driven by a division of labor with increased specialization that has led each part of the field to become narrower.

Under poor circumstances, co-residence of a grandmother is generally considered to be beneficial for children. Empirical evidence does not unequivocally support this expectation and suggests that the grandmother’s importance depends on the family’s circumstances. We study the relationship between grandmother’s co-residence and children’s schooling in sub-Saharan Africa under a broad range of circumstances. Results make clear that the effect of a co-residing grandmother varies but is almost always positive. Grandmothers over age 60 are most effective in helping their children. They (...) are particularly important for girls, and when the mother is deceased or not living in the household. Grandmothers are less effective in situations with few opportunities, as in very poor regions or in communities with few schooling opportunities. Our findings indicate that providing support to grandmothers should not be overlooked when designing policies aimed at strengthening the position of women and children in the sub-Saharan African context. (shrink)

In Practicing Safe Sects F. LeRon Shults provides scientific and philosophical resources for having “the talk” about religious reproduction: where do gods come from – and what are the costs of bearing them in our culturally pluralistic, ecologically fragile environment?

In The Construction of Social Reality, John Searle develops a theory of institutional facts and objects, of which money, borders and property are presented as prime examples. These objects are the result of us collectively intending certain natural objects to have a certain status, i.e. to ‘count as’ being certain social objects. This view renders such objects irreducible to natural objects. In this paper we propose a radically different approach that is more compatible with standard economic theory. We claim that (...) such institutional objects can be fully understood in terms of actions and incentives, and hence the Searlean apparatus solves a non-existent problem. (shrink)

Contemporary theories of institutions as clusters of stable solutions to recurrent coordination problems can illuminate and explain some unresolved difficulties and problems adhering to institutional definitions of art initiated by George Dickie and Arthur Danto. Their account of what confers upon objects their institutional character does not fit well with current work on institutions and social ontology. The claim that “the artworld” confers the status of “art” onto objects remains utterly mysterious. The “artworld” is a generic notion that designates a (...) sphere of human activity that involves practices that create goals that have led to the emergence of formal and informal institutions. But those institutions, rather than magically “creating” objects subjected to esthetic appreciation, merely solve familiar and ubiquitous coordination problems created by artistic activity in ways other institutions in other areas solve similar and/or analogous coordination problems. (shrink)

Most analyses of whistleblowing are concerned with the whistleblower as an actor or with the act of whistleblowing itself. However, as soon as the whistleblower enters the public arena, a social dynamic emerges of interdependent actors with different responsibilities and different interests.Such a dynamic demands a more comprehensive approach in which the motives of the different actors in the public debate are taken into account.This approach is developed here using an exemplary case of whistleblowing that took place in a Dutch (...) research institute.The intensive media attention damaged both the institute and the whistleblower.In retrospect this could have been avoided.In our analysis we give extra attention to the motives involved and to the inevitability of media logic.In order to avoid unnecessary damage we recommend guidelines to the three basic actors:the whistleblower, the organization and the media. (shrink)

If someone commits the mereological fallacy, then he ascribes psychological predicates to parts of an animal that apply only to the (behaving) animal as a whole. This incoherence is not strictly speaking a fallacy, i.e. an invalid argument, since it is not an argument but an illicit predication. However, it leads to invalid inferences and arguments, and so can loosely be called a fallacy. However, discussions of this particular illicit predication, the mereological fallacy, show that it is often misunderstood. Many (...) misunderstandings concern the use of this illicit predication in the course of discussions of understanding the mind/body problem. Our aim here is to provide an accessible overview through discussing common misconceptions of the fallacy. We also discuss how conceptual investigations of the relation between living organisms and their parts fit within the framework of modern evolutionary theory, i.e. inclusive fitness theory. (shrink)

Ethics for Enemies comprises three original philosophical essays on torture, terrorism, and war. F. M. Kamm deploys ethical theory in her challenging new treatments of these most controversial practical issues. First she considers the nature of torture and the various occasions on which it could occur, in order to determine why it might be wrong to torture a wrongdoer held captive, even if this were necessary to save his victims. In the second essay she considers what makes terrorism wrong--whether it (...) is the intention to harm civilians, rather than harm to them being 'collateral damage,' or something else--and whether terrorism is always wrong. The third essay discusses whether having a right reason, in the sense of a right intention, is necessary in order for a war to be just. Kamm then examines ways in which the harms of war can be proportional to the achievement of the just cause and other goods that war can bring about, so as to make the declaration of war permissible. (shrink)

In the study of expertise, few debates come as big as that between constructivists and realists. This chapter discusses the signal debate between realists and constructivists about expertise. It sets out a view that includes aspects of both the constructivist and realist position to show that insights from what is often considered to be rival camps can be incorporated in a position that does justice to both. The chapter argues that, while expertise is real, there are two distinct social dimensions (...) to the concept of expertise. It attempts to demonstrate two distinct ways in which expertise has a social dimension. First, the chapter develops an account according to which 'is an expert' is a triadic predicate. Second, it considers the fact that attributions of expertise are often done by institutions, i.e. by medical boards certifying doctors, etc. Both dimensions can be acknowledged without undermining the basic case for realism about expertise. (shrink)

The distinction between concept and intuition is of the utmost importance for understanding Kant’s critical philosophy. For, as Kant himself claimed, all the distinctive claims of this philosophy rest on, and develop out of, a detailed account of the way all our cognition of things requires both intuitions and concepts.

When international relations scholars think about international law they either ignore culture or offer highly deterministic accounts of its role. For the majority of scholars, international law is a rational construction, an institutional solution to the problem of order in an anarchical system, a body of rules and practices that reflect the contending interests and capabilities of major states. Issues of culture barely rate a mention. For others, culture is the deep foundation of international law, the structuring “mentality” that gives (...) law its form and content. International law, from this perspective, is a Western cultural artifact, globalized through centuries of imperialism and hegemony. These contrasting views lead to different expectations about the future of international law in today's culturally diverse international order. For rationalists, law's fate will be determined by the shifting configuration of interests that accompany new functional challenges and great power transitions. For the more culturally attuned, there are two possibilities. One is that functional utility will replace culture as law's foundation. International law may well be a Western cultural artifact, but “rational buy-in” will sustain it in a multicultural world. The other, more pessimistic, expectation is that the rule of international law will be fundamentally undermined by cultural diversity, particularly as rising non-Western powers articulate and promote markedly different cultural norms and values. (shrink)