Background: Although genetic research into Alzheimer disease (AD) is increasing, the ethical aspects of this kind of research and the differences between ethical issues related to genetic and non-genetic research into AD have not yet received much attention. Objectives: (1) To identify and compare the five ethical issues considered most important by surveyed expert panellists in non-genetic and genetic AD research and (2) to compare our empirical findings with ethical issues in genetic research in general as described in the literature. (...) Method: A modified Delphi study in two rounds Results: Genetic and non-genetic research into AD generated an approximately equal number of topics with a considerable overlap. Different priorities in the ethics of both types of research were found. Genetic research raised new topics such as “confidentiality of genetic information” and “implications of research for relatives” which changes the impact and application of existing ethical topics such as “informed consent” and is judged to have more impact on both individuals and society. A difference with the results of more theoretical approaches on ethical aspects related to AD research was also found. Conclusions: Different priorities are given to ethical issues in genetic and non-genetic research. These arise partly because genetic research causes unique and new questions, mostly related to the position of family members and the status of and access to genetic information. Differences found between the results of our empirical study and the more theoretical literature, suggest an additional value for empirical research in medical ethics. (shrink)

Bijdragen over de actuele betekenis van de filosofie, met name de Reformatorische Wijsbegeerte.

The explanatory gap refers to the lack of concepts for understanding “how it is that . . . a state of consciousness comes about as a result of irritating nervous tissue.” By assuming that there are colours in the outside world, Block needlessly widens this gap and Lycan and Kitcher simply fail to see the gap. When such assumptions are abandoned, an unnecessary and incomprehensible constraint disappears. It then becomes clear that the brain can use its own neural language for (...) representing aspects of the outside world. While this may not close the gap, it becomes clearer where we need new concepts. (shrink)

Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of this study was to evaluate one way of organizing MCD in two Dutch nursing homes. In both of these nursing homes the MCD groups had a heterogeneous composition and were organized (...) apart from existing institutional communication structures. As part of a naturalistic evaluation, systematic observations, interviews and focus groups were completed. The findings indicate that the heterogeneous composition and MCD meetings separate from existing structures have benefits. However, the participants also reported negative experiences. This gives rise to the question whether a mixed MCD group which meets separately is an effective way to embed MCD as an instrument for reflection on moral issues in daily practice. We conclude that there is no single answer to that question. In the end, the two implementation strategies (i.e. within existing communication structures and a mixed MCD group) can be complementary to each other. (shrink)

Our study presents an overview of the issues that were brought forward by participants of a moral case deliberation (MCD) project in two elderly care organizations. The overview was inductively derived from all case descriptions (N = 202) provided by participants of seven mixed MCD groups, consisting of care providers from various professional backgrounds, from nursing assistant to physician. The MCD groups were part of a larger MCD project within two care institutions (residential homes and nursing homes). Care providers are (...) confronted with a wide variety of largely everyday ethical issues. We distinguished three main categories: ‘resident’s behavior’, ‘divergent perspectives on good care’ and ‘organizational context’. The overview can be used for agendasetting when institutions wish to stimulate reflection and deliberation. It is important that an agenda is constructed from the bottom-up and open to a variety of issues. In addition, organizing reflection and deliberation requires effort to identify moral questions in practice whilst at the same time maintaining the connection with the organizational context and existing communication structures. Once care providers are used to dealing with divergent perspectives, inviting different perspectives (e.g. family members) to take part in the deliberation, might help to identify and address ethical ‘blind spots’. (shrink)

Background: Debates over legalisation of physician-assisted suicide or euthanasia often warn of a “slippery slope”, predicting abuse of people in vulnerable groups. To assess this concern, the authors examined data from Oregon and the Netherlands, the two principal jurisdictions in which physician-assisted dying is legal and data have been collected over a substantial period.Methods: The data from Oregon comprised all annual and cumulative Department of Human Services reports 1998–2006 and three independent studies; the data from the Netherlands comprised all four (...) government-commissioned nationwide studies of end-of-life decision making and specialised studies. Evidence of any disproportionate impact on 10 groups of potentially vulnerable patients was sought.Results: Rates of assisted dying in Oregon and in the Netherlands showed no evidence of heightened risk for the elderly, women, the uninsured , people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations. The only group with a heightened risk was people with AIDS. While extralegal cases were not the focus of this study, none have been uncovered in Oregon; among extralegal cases in the Netherlands, there was no evidence of higher rates in vulnerable groups.Conclusions: Where assisted dying is already legal, there is no current evidence for the claim that legalised PAS or euthanasia will have disproportionate impact on patients in vulnerable groups. Those who received physician-assisted dying in the jurisdictions studied appeared to enjoy comparative social, economic, educational, professional and other privileges. (shrink)

The King Report on Corporate Governance (1994) evoked unprecedented interest in corporate governance in South Africa. This does not mean that corporate governance was not an issue of concern before the release of this historical report. To the contrary, corporate governance in its broader sense has been at stake since the inception of the first publicly owned companies in South Africa. This article intends to give an overview of corporate governance in South Africa. It starts by making a distinction between (...) broad and narrow conceptions of corporate governance. Before applying this distinction to the practice of corporate governance in South Africa, a brief overview of the corporate landscape in South Africa is provided. Then the South African situation with regard to broad and narrow corporate governance respectively is analysed. The article ends with a discussion of the review of corporate governance that currently is in the making in South Africa. Throughout the article both the financial and ethical dimensions of corporate governance is attended to. (shrink)

Health technology assessment consists of thesystematic study of the consequences of theintroduction or continued use of the technology in aparticular context, with the explicit objective toarrive at a judgment of the value or merit of thetechnology. Ideally, it is aimed at assessing allaspects of a given technology or group oftechnologies, including non-technical, e.g.socio-ethical, aspects. However, methods for assessingsocio-ethical implications of health technology arerelatively undeveloped and few mechanisms exist totake action based on the results of such evaluations.Still, the examples of cochlear (...) inplants and other cases illustratethat HTA is not a matter of merely collecting thefacts about a technology. The facts must beplausible and relevant from a particular framework,which is not always shared by different groups. It ishere that socio-ethical aspects are encountered. Ifhealth technology assessment aims to enhance theaccountability of the decision making processregarding funding and use of health technology, it isa major challenge to assessors of health technologiesto deal adequately with existing value pluralism. Inthis respect interactive evaluation may have somethingto offer. (shrink)

This article reviews the development of social quality indicators and the challenges ahead. First, through a review of recent Asian and Australian work carried out on social quality indicators, and the World Bank related work on “social development indicators,” the article argues that social quality indicators research should move beyond the empirical level of particular policy areas. Therefore, it should be guided by a clear methodological perspective regarding the role of indicators as part of a social quality theory (SQT) and (...) their relation to the social quality approach (SQA). Second, the article opens a debate about the rationale behind distinguishing between three different functions of social quality indicators. Indicators should address the change in the conditional factors in daily life, as manifested in its economic, socio-political, socio-cultural and environmental dimensions, in order to examine the consequences of general trends and contradictions in (1) societal circumstances, (2) the development (or lack of development) toward sustainability, and (3) the related issue of sustainable urban development. Before 2010 social quality scholars mainly concentrated on the first issue. Recently, however, they are approaching all three issues. It is essential to delve deeper into SQT and the SQA for understanding these three issues separately and integrally. This has implications for the nature of social quality indicators and their comparison to those of other mainstream approaches; the article introduces this agenda of work. (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% (1179) were suitable for analysis. The results show that in about half (...) of the cases (55.8%) nurses were involved in the decision making by the physician and that nurses were frequently (81.5%) 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)

In the recently published Papyrus Bodmer 30 one of the six poems deals with the story of Genesis 22. At many places the poem drastically deviates from the biblical text, and the editors of the papyrus are insufficiently aware of the background of these deviations. In this article the authors demonstrate that almost all of them have their background in a centuries long process of both Jewish and Christian reflection on this biblical chapter. It is the very specific ‘Wirkungsgeschichte’ of (...) Gen. 22 that explains most of the poem’s specifics. (shrink)

Arthur G. Tansley never accepted Frederic E. Clements’ view that succession is a developmental process whose final stage, the climax formation, is determined primarily by regional climate and that all other types of vegetation are some kind of successional stage or arrested successional stage. Tansley was convinced that in a given region a variety of environmental factors could produce different kinds of climax formations. At the heart of their dispute was Clements’ organicist view of succession, i.e., the formation was a (...) complex organism with an ontogeny and phylogeny. As early as 1905, Tansley offered an alternative to Clements’ complex organism, the quasi-organism, but Clements in private and public rejected this compromise. Tansley and other plant ecologists continued to criticize Clements’ theories for the next 20 years, but with no impact on Clements. John Phillips, a South African plant ecologist who was a follower of Clements, published a series of papers in 1934 and 1935 defending Clementsian ecology. These papers were triggered by the publication of a letter by another ecologist working in Africa who claimed that there was a strong correlation between soils and various kinds of climax vegetation, which was contrary to what was predicted by Phillips and Clements. In 1935, Tansley published an attack on Phillips and Clements and their developmental theory of succession. In it, he proposed the concept of the ecosystem as a way to get around Clements’ monoclimax theory by making the physical environment (e.g., soil chemistry, soil texture, soil moisture) as important a factor as climate, plants and other organisms in determining the composition and characteristics of ecological entities, i.e., ecosystems. Tansley’s ecosystem concept quickly replaced Clements’ monoclimax theory as a dominant paradigm in ecology. (shrink)

This volume is a study of the influence of Timaeus on the development of Western cosmology in three axial periods of European culture: Late Antiquity, Middle Ages and Renaissance.

In this paper, we introduce the methodology and techniques of meta-argumentation to model argumentation. The methodology of meta-argumentation instantiates Dung’s abstract argumentation theory with an extended argumentation theory, and is thus based on a combination of the methodology of instantiating abstract arguments, and the methodology of extending Dung’s basic argumentation frameworks with other relations among abstract arguments. The technique of meta-argumentation applies Dung’s theory of abstract argumentation to itself, by instantiating Dung’s abstract arguments with meta-arguments using a technique called flattening. (...) We characterize the domain of instantiation using a representation technique based on soundness and completeness. Finally, we distinguish among various instantiations using the technique of specification languages. (shrink)

Due to its extraordinary predictive power and the great generality of its mathematical structure, quantum theory is able, at least in principle, to describe all the microscopic and macroscopic properties of the physical world, from the subatomic to the cosmological level. Nevertheless, ever since the Copen hagen and Gottingen schools in 1927 gave it the definitive formu lation, now commonly known as the orthodox interpretation, the theory has suffered from very serious logical and epistemologi cal problems. These shortcomings were immediately (...) pointed out by some of the principal founders themselves of quantum theory, to wit, Planck, Einstein, Ehrenfest, Schrodinger, and de Broglie, and by the philosopher Karl Popper, who assumed a position of radical criticism with regard to the standard formulation of the theory. The aim of the participants in the workshop on Open Questions in Quantum Physics, which was held in Bari (Italy), in the Department of Physics of the University, during May 1983 and whose Proceedings are collected in the present volume, accord ingly was to discuss the formal, the physical and the epistemo logical difficulties of quantum theory in the light of recent crucial developments and to propose some possible resolutions of three basic conceptual dilemmas, which are posed respectively ~: (a) the physical developments of the Einstein-Podolsky-Rosen argument and Bell's theorem, i. e. (shrink)

Bei der Suche nach dem Geist handelt es sich seit Jahrhunderten um ein zentrales Unterfangen in der Philosophie, das u.a. durch die folgenden Fragen charakterisiert ist: Was sind Merkmale des Geistes? Welche Arten geistiger Zustände lassen sich unterscheiden? Ist eine naturwissenschaftliche oder physikalische Erklärung des Geistes möglich? Lässt sich das Geistige auf das Physikalische reduzieren? Ist das Physikalische kausal abgeschlossen? Was heißt es eigentlich, dass etwas physikalisch ist? Wie kann der Geist Handlungen bewirken? Können wir denn so handeln, wie wir (...) wollen? Ist unser Wille frei? Welche Rolle spielen neurowissenschaftliche Ergebnisse für die Entwicklung einer guten Theorie des Geistes? Und welche Rolle spielen philosophische Gedankenexperimente? Was macht überhaupt eine gute Theorie des Geistes aus? Dieser Band, der auch an Einsteiger gerichtet ist, versammelt Beiträge zur Suche nach dem Geist von Andreas Hüttemann, Holger Lyre, Jan G. Michel, Gernot Münster, Martine Nida-Rümelin, Achim Stephan und Henrik Walter. (shrink)

The book begins with a discussion of the debates on history education as they developed in Great Britain during the last decades of the previous century. In these debates, reference is often made to the views of the philosopher and historian R. G. Collingwood. However, according to the author, his philosophy of history is usually misunderstood. Besides correcting the various misinterpretations of Collingwood's views on history, special attention is paid to his theory of (historical) imagination. In the final part of (...) the book, the relevance of Collingwood's philosophy for more general educational issues is discussed and compared with the views of Hirst, Bloom and Bruner. (shrink)

Synthetic biology is an emerging technology that asks for inclusive reflection on how people frame the field. To unravel how we can facilitate such reflection, this study evaluates the Frame Reflection Lab. Building upon playfulness design principles, the FRL comprises a workshop with video-narratives and co-creative group exercises. We studied how the FRL facilitated frame reflection by organizing workshops with various student groups. Analysis of 12 group conversations and 158 mini-exit surveys yielded patterns in first-order reflection as well as patterns (...) in second-order reflection. Also patterns in participants’ framing of synthetic biology could be induced; participants’ viewpoints converged to some extent, yet with openness to individual viewpoint differences. Although the FRL method fortified the reflection processes of participants, the narratives and the workshop’s flexible format could inhibit the reflection too. Therefore, we advise designers of future frame reflection methods to apply stronger conversational facilitation and narratives of slightly mysterious yet identifiable narrators, in case e.g. video-narratives are created and used to scaffold the reflection process. Nevertheless, we argue that the use of a playful frame reflection method like the FRL could function well as a step to precede more application-specific deliberation or decision-making on synthetic biology and as a method for the collection of contemporary citizen viewpoints plus rationales underlying these, for the further responsible development of the emerging field. (shrink)