Many in education suggest that to have studentsadopt healthy and active lifestyles, then theymust be offered meaning rich physical activityexperiences. This paper adds to thisconversation in two ways. First, this paperadds depth and richness to traditionalconceptualizations of the meaning in movement.In doing so, we interrogate the physical,cognitive and affective meaning that studentsmay derive from participation in movement.Second, this paper examines the role ofphysical activity in theme-based, integratedcurriculum. We highlight how physical activitycan be incorporated into theme-based units insubstantial and non-trivial ways.

It is widely agreed among health professionals that couples using donor insemination should be offered counselling on the topic of donor conception disclosure. However, it is clear from the literature that there has long been a lack of agreement about which counselling approach should be used in this case: a directive or a non-directive approach. In this paper we investigate which approach is ethically justifiable by balancing the two underlying principles of autonomy and beneficence. To overrule one principle in favour (...) of another, six conditions should be fulfilled. We analyse the arguments in favour of the beneficence principle, and consequently, a directive approach. This analysis shows that two conditions are not met; the principle of autonomy should not be overridden. Therefore, at this moment, a directive counselling approach on donor conception disclosure cannot be ethically justified. (shrink)

Although regulators have identified ethical lapses as a key factor contributing to auditors’ failure to detect their clients’ fraudulent financial reporting, research using ethical theory to examine auditors’ fraud detection remains limited. We provide evidence on the joint effect of ethical idealism and trait skepticism on auditors’ fraud judgments. Ethical idealism reflects an individual’s concern for the welfare of others while trait skepticism reflects an individual’s disposition to validating a proposition. Forsyth theorizes that there is an association between ethical idealism (...) and tolerance for deception. Drawing on that insight, we posit that ethical idealism and trait skepticism have a complementary effect on auditors’ fraud planning performance. This is because the former determines an auditor’s tolerance for allowing a client to get away with an ethically questionable act while the latter is important in determining how evidence is generally sought and evaluated. We used the Forsyth ethical position questionnaire to measure ethical idealism and the Hurtt :149–171, 2010) scale to measure trait skepticism. Our results indicate that there is a significant positive association between trait skepticism and the number of effective audit procedures but only for auditors who have high ethical idealism. The results highlight the importance of measuring and controlling for the effects of these traits when evaluating fraud detection performance. The paper also contributes by showing that an ethics theory can generate additional understanding of and insights into an important accounting phenomenon. (shrink)

Cinema has long played a crucial role in the way that societies remember and represent themselves. In the last quarter century, film has been an important medium in the public debate around the memory of the Holocaust and of Hiroshima; of the Algerian war for independence and of the Spanish Civil War; of the Allende legacy in Chile, the utopian dreams of 1968, and the aborted project of the German Democratic Republic; in identity formation in Palestine and in the African (...) diaspora. Hedges discusses the role of cinema within a global perspective that spans five continents, and proposes an original typology of cultural memory. In the process, she re-evaluates the contributions of major directors and uncovers hitherto neglected yet important works. The author develops her arguments in an approachable style that will encourage readers to rethink their own memories of films and to reflect on the way that cinema contributes to collective and cultural memory. The book's innovative approach should transform the way that we think of film and its social effects. (shrink)

Using an interpreter in qualitative interviews: does it threaten validity?There is an extensive literature on the problem of translating scales for use across cultures, but very little is published on the problems of conducting qualitative interviews in another language with assistance of an interpreter. The aim of this paper is to describe and discuss threats to validity that arise when conducting qualitative interviews using an interpreter. Ten female student nurses in two cities in Lithuania were interviewed about how they perceived (...) their educational program. All interviews were conducted in English with an interpreter. When using an interpreter to conduct interviews, potential threats to validity arise at various points in the interview process. A threat arises when the researcher, whose first language is Swedish, addresses a question in English to the interpreter, another during the translation by the interpreter from English to Lithuanian, and again when the interpreter translates the interviewee’s Lithuanian responses to English. In the last situation, the researcher may not know whether the interpreter has summarized and/or modified the responses. To mitigate these problems, the interpreter should not only have the required linguistic abilities, but also be trained in the research field. The researcher has to be aware of these threats to validity and make efforts to meet and limit their effects. (shrink)

Already at a relatively early stage, modern sign language linguistics focused on the representation of (actions, locations, and motions of) referents (1) through the use of the body and its different articulators and (2) through the use of particular handshapes (in combination with an orientation, location, and/or movement). Early terminology for (1) includesrole playing, role shifting, androle takingand for (2)classifier constructions/predicatesandverbs of motion and location. More recently, however, new terms, includingenactmentandconstructed actionfor (1) anddepicting signsfor (2) have been introduced. This article (...) provides a brief overview of the history of enactment and depiction in the sign linguistic literature but mainly focuses on issues related to terminology (and terminology shifts). First, we consider the relation between role shifting and constructed action. We question the idea that these terms can be used interchangeably and rather suggest that they capture different, but related functions. Subsequently, we zoom in on the conceptualization of depicting signs, indicating verbs, pointing signs and fully lexical signs and the relation between these signs and the method of depicting. Where earlier research often associates depicting with the use of specific types of structures, we promote the idea that depicting is a semiotic diverse practice. In doing so, we show that the conceptualization of the different sign types and the terms that are used to refer to these phenomena do not accurately capture the way these signs are used in actual signed discourse and propose a reconceptualization of the different sign types in the lexico-grammar of Flemish Sign Language (VGT) as composite signs that can describe, depict and indicate meaning in various ways. In this way, this article illustrates (1) the risks that may come with the execution of terminology shifts and (2) the importance of making a clear distinction between form and function, i.e., we show that it is important to be careful with assuming a (too) exclusive relation between a certain function and one or more particular forms. (shrink)

J. Šmajs’ concept of evolutionary ontology has attracted much attention in recent years especially in Czech and Slovak academic circles, yet it remains, as some of its proponents claim, undervalued in Britain and the US. Even in the Czech Republic and Slovakia, there are, in addition to its strong supporters, several authors who almost a priori reject the concept, pointing to several questionable, contradictory or even mutually exclusive or self-refuting arguments. In this paper, mainly based on a comprehensive analysis of (...) the first part of Šmajs’ book, Evoluční ontologie kultury a problém podnikání [Evolutionary Ontology of Culture and The Issues Of Business], we attempt to demonstrate that the opponents of Šmajs’ concept are closer to the truth, since the concept, we believe, is just another variation on the extreme escalation of philosophical naturalism. (shrink)

Numinous spaces in British literature from William Wordsworth to Samuel Beckett -- Jesus figures in American literature from Ralph Waldo Emerson to Edward Albee -- Using Bakhtin's definitions to discover ethical voices in Solzhenitsyn and Tolstoy -- René Girard's categories of scapegoats in literature of the American South -- Hopkins's metaphysics of nature as sacred disclosure -- The book of job as mirrored in Hopkins's metaphysics -- Beckett's mythos of the absence of God.

Informed consent is a key condition for prenatal screening programmes to reach their aim of promoting reproductive autonomy. Reaching this aim is currently being challenged with the introduction of non‐invasive prenatal testing (NIPT) in first‐trimester prenatal screening programmes: amongst others its procedural ease—it only requires a blood draw and reaches high levels of reliability—might hinder women’s understanding that they should make a personal, informed decision about screening. We offer arguments for a renewed recognition and use of informed consent compared to (...) informed choice, and for a focus on value‐consistent choices and personalized informational preferences. We argue for a three‐step counselling model in which three decision moments are distinguished and differently addressed: (1) professionals explore women’s values concerning whether and why they wish to know whether their baby has a genetic disorder; (2) women receive layered medical‐technical information and are asked to make a decision about screening; (3) during post‐test counselling, women are supported in decision‐making about the continuation or termination of their pregnancy. This model might also be applicable in other fields of genetic (pre‐test) counselling, where techniques for expanding genome analysis and burdensome test‐outcomes challenge counselling of patients. (shrink)

The relationships among character strengths (forgiveness and gratitude), happiness, and pro-social bystander behavior in bullying were analyzed. The sample includes 500 (early adolescents) and 500 (middle adolescents) of both genders, between 12 and 18 years old (M age = 14.70, SD = 1.58). Two structural equation models were calculated. Results of the first model indicated that forgiveness, gratitude, and happiness had a direct positive relation with pro-social bystander behavior. Furthermore, human strengths were indirectly related to prosocial behavior in bullying for (...) this effect in happiness. The second model showed that pro-social bystander behavior had a positive effect on human strengths and happiness. Multi-group analyses indicated that gender and stage of adolescence did not moderate the relations found in the model. Overall findings suggest a reciprocal relationship between character strengths, happiness, and pro-social bystander behavior. (shrink)

The idea that experience is essentially subjective rather than of the real world is paradoxical and deeply flawed. The external world is, much more than a mere constraint, essential to meaningfully describe experience and neural activity. This is illustrated by an analysis of the phenomenology of veridical perception and by the study of experience in psychopathology by the Experience Sampling Method (ESM).

This article describes the long-term trends in marital status mortality differences in the Netherlands using a unique dataset relating to the period 1850–1970. Poisson regression analysis was applied to calculate relative mortality risks by marital status. For two periods, cause-of-death by marital status could be used. Clear differences in mortality by marital status were observed, with strongly increasing advantages for married men and women and a relative increase in the mortality of widowed compared with non-married people. Excess mortality among single (...) and formerly married men and women was visible in many cause-of-death categories, and this became more widespread during the last decades of the nineteenth century. Hypotheses are formulated that might explain why married men and women underwent a stronger decrease in mortality up until the end of World War II. (shrink)

For each research protocol that they review, institutional review boards must assess whether the risks of the protocol are acceptable in relation to the potential direct benefits to study participants and/or society. This requirement means that an IRB should first identify risks that are not compensated by direct benefits to the subjects and then judge whether these so-called net risks are acceptable in relation to the benefits to society. We argue that the conventional approach to risk-benefit assessment is not accurate (...) enough to identify all net risks involved in any given protocol. Two relatively new approaches—the component analysis approach and the net risks test—can be of much more use to review boards, especially when used together. (shrink)

In 1990, Vermeerbergen started the first larger-scale corpus study with spontaneous language data from adult signers on the morpho-syntactic aspects of Flemish Sign Language. After this, a number of lexicographic projects, including the collection of a 90-h corpus, led to the launch of the first online bilingual Dutch/VGT—VGT/Dutch dictionary in 2004. Since then, researchers have developed several corpora of variable sizes, with the greatest realization being the VGT Corpus. The main focus of this chapter is twofold. On the one hand (...) the run-up to, the development and the use of the VGT Corpus will be discussed, while on the other hand smaller specific research corpora will be highlighted such as the corpus on early parent-child interaction and the multifocal eye-tracking corpus. The current chapter will discuss the research and community value of the corpora and future directions. Finally, it will elaborate on the need for corpus research, the associated advantages and disadvantages, and the obstacles faced in smaller deaf communities. (shrink)

In the Netherlands fertility doctors increasingly formulate protocols, which oblige patients to quit their unhealthy lifestyle before they are admitted to IVF procedures. We argue that moral arguments could justify parenting protocols that concern all future parents. In the first part we argue that want‐to‐be parents have moral responsibilities towards their future children to prevent them from harm by diminishing or eliminating risk factors before as well as during the pregnancy. This is because of the future children's potential to become (...) of a certain type, more specifically: a person that will be the want‐to‐be parents' child. Want‐to‐be parents intend to become pregnant and therefore have an additional moral reason to diminish the risks. Also, people who become pregnant unintentionally have the responsibility to prevent their children from harm, unless they become pregnant due to contraception failure. All people not wanting to become pregnant should use contraception methods carefully.In the second part of this paper we translate the want‐to‐be parents' responsibilities into practice. We distinguish four determinants of risk factors: modifiability, chance, severity and effort. We examine some evidence‐based risk factors based on these variables and deduce levels of responsibility.In conclusion, formulating informal requirements for want‐to‐be parents is morally required and therefore also for want‐to‐be parents in need of medical assistance. The protocols developed by fertility doctors in the Netherlands could be seen as the precursor for a general, informal Parenting Protocol that could be developed on the basis of an extended and thoroughly debated risk‐responsibility analysis. (shrink)

BACKGROUND: Delusions in schizophrenia are commonly approached as empirical false beliefs about everyday reality. Phenomenological accounts, by contrast, have suggested that delusions are more adequately understood as pertaining to a different kind of reality experience. How this alteration of reality experience should be characterised, which dimensions of experiential life are involved, and whether delusional reality might differ from standard reality in various ways is unclear and little is known about how patients with delusions value and relate to these experiential alterations. (...) This study aimed to investigate the nature of delusional reality experience, and its subjective apprehension, in individuals with lived experience of delusions and a schizophrenia-spectrum diagnosis. METHODS: In this qualitative phenomenological study, we recruited individuals with lived experience of delusions and a schizophrenia-spectrum diagnosis from two psychiatric-hospital services in Belgium using homogenous sampling. Criteria for participation were having undergone at least one psychotic episode with occurring delusional symptoms, present at least 1 year before participation, on the basis of clinical notes assessed by the attending psychiatrist; a schizophrenia-spectrum diagnosis, ascertained through clinical interview by the attending psychiatrist upon admission; being aged between 18 years and 65 years; and having the capacity to give informed consent. Exclusion criteria included worries concerning capacity to consent and risk of distress caused by participation. We did phenomenologically driven semi-structured interviews with the participants to explore the nature of delusional reality experience and their subjective valuation of these experiences. We used interpretative phenomenological analysis, a qualitative method tailored to the in-depth exploration of participants’ first-person perspective, to analyse their accounts. FINDINGS: Between March 2, 2020, and Sept 30, 2020, 18 adults participated in the interview study. The findings suggest that delusions are often embedded in wide-ranging alterations of basic reality experience, involving quasi-ineffable atmospheric and ontological qualities that undermine participants’ sense of the world as unambiguously real, fully present, and shared with others. We also found that delusional reality experience can differ from standard reality in various ways, across multiple dimensions, and that participants are often implicitly or explicitly aware of the distinction between delusional and standard reality. Delusional experience can have an enduring value and meaning that is not fully captured by a strictly medical perspective. INTERPRETATION: Increased awareness and recognition of the distinctive nature of delusional reality experience, in both clinical and research settings, can improve diagnostic accuracy, explanatory models, and therapeutic support for individuals with delusions whose lived realities are not always evident from an everyday perspective. FUNDING: FWO Flanders. TRANSLATION: For the Dutch translation of the abstract see Supplementary Materials section. (shrink)

In the Netherlands fertility doctors increasingly formulate protocols, which oblige patients to quit their unhealthy lifestyle before they are admitted to IVF procedures. We argue that moral arguments could justify parenting protocols that concern all future parents. In the first part we argue that want-to-be parents have moral responsibilities towards their future children to prevent them from harm by diminishing or eliminating risk factors before as well as during the pregnancy. This is because of the future children's potential to become (...) of a certain type, more specifically: a person that will be the want-to-be parents' child. Want-to-be parents intend to become pregnant and therefore have an additional moral reason to diminish the risks. Also, people who become pregnant unintentionally have the responsibility to prevent their children from harm, unless they become pregnant due to contraception failure. All people not wanting to become pregnant should use contraception methods carefully.In the second part of this paper we translate the want-to-be parents' responsibilities into practice. We distinguish four determinants of risk factors: modifiability, chance, severity and effort. We examine some evidence-based risk factors based on these variables and deduce levels of responsibility.In conclusion, formulating informal requirements for want-to-be parents is morally required and therefore also for want-to-be parents in need of medical assistance. The protocols developed by fertility doctors in the Netherlands could be seen as the precursor for a general, informal Parenting Protocol that could be developed on the basis of an extended and thoroughly debated risk-responsibility analysis. (shrink)

Is it morally justifiable to force non-consenting pregnant women to submit to caesarean surgery to save their fetus in distress? Even though proponents and opponents largely agree on the interests at stake, such as the health and life of the fetus and the respect for bodily integrity and autonomy of pregnant women, they disagree on which moral weight to attach to these interests. This is why disagreements about the justifiability of forced caesareans tend to be pervasive and intractable. To sidestep (...) this deadlock, we will focus on conditions that give rise to the ‘caesarean dilemma’ in the first place, namely the conflict between inherent norms and values medical professionals are committed to by virtue of being a medical professional. Using the reflective equilibrium, we will test the opponents’ and proponents’ considered judgments about forced caesareans against the norms and values they—as medical professionals—are committed to and determine whether they are coherent. Subsequently we will identify the proponents’ incoherencies between the considered judgments and norms and values they are committed to and conclude that as long as these incoherencies are in place, forced caesareans are morally impermissible. (shrink)

Over the last few decades there has been a revival of interest in virtue ethics, with the emphasis on the virtuous caregiver. This paper deals with the ‘virtuous patient’, specifically the patient with End Stage Renal Disease (ESRD). We believe that a virtue approach provides insights not available to current methods of studying coping styles and coping strategies. Data are derived from seven semi-structured in-depth interviews. The transcripts of the interviews were subjected to an Interpretative Phenomenological Analysis (IPA). The focus (...) of the analysis was on ‘living well with chronic illness’. It appears that the moral challenges faced by patients with an ESRD are manifold. When they are invited to tell the story of their illness, they do not explicitly speak of virtues, but they often refer to moral qualities, and to attitudes that can be regarded as virtuous. We identify several such concepts in the narratives of patients with ESRD. We conclude that the Aristotelian model of virtue ethics is particularly descriptively (and possibly also normatively) relevant to the explanation of the life narratives and the moral challenges of patients with an ESRD. (shrink)

The prelims comprise: Introduction Chance, Choice, and Circumstances Genes and Lifestyle Third Parties' Susceptibilities Conclusion Notes.

Part 12: The fall of the house of ethics‘Sometimes a cliché is the best way to make ones point’From: Whatever works.For some seconds Gordon is blinded by the lights the television crews direct at him. More than 20 cameras focus on him, and one journalist yells “there he is!” Even Gordon is not used to that much attention, but vanity is a speedy advisor. Within seconds he has clad himself in the aura of important person, and knowledgeable ethicist, even if (...) he has no idea what that many journalists expect from him at precisely this moment. Particularly when he has little time, preparing for the world conference on bioethics in Singapore. Then a wave of disappointment hits the gathered gossip-mongering press. The floodlights are turned off, microphones are lowered, the buzzing quiets down.“Guys, this is not Testosterone Tony.”This Tony, the athlete who participated in the Olympic Games in Beijing, at that moment leaves the hospital by a back door, far away from the paparazzi. The armoured car of his sponsor Nanosock disappears from sight softly humming and brings him to a private clinic where he will be pampered and detoxified. His career in sports is over, but his reputation can certainly sell sports socks with nanofibres against sweaty feet. The only price he has to pay is to admit he has sweaty feet, not true, but a small price to pay considering the alternatives. In front of the hospital the disappointed and somewhat offended Gordon tries to save his ego and asks the journalists:“Maybe I can be of help? Do you want an ethical analysis of Testosterone Tony and enhancing evolution? My name is Gordon Mc….” Nobody listens, nobody reacts.A day later. Nurses Jake and Gwen return from the medication round. Jake looks at the unlit room in the Nuttree …. (shrink)

Given the plethora of weight loss interventions, Devine and Barnhill rightly propose to also investigate unintended consequences. I agree. Some questions need to be raised: unintended consequences is a messy concept. How to distinguish between surprises and pseudo-unintended consequences? How to make sure that such research is not a box-ticking formality? And will results be implemented?

In the Netherlands fertility doctors increasingly formulate protocols, which oblige patients to quit their unhealthy lifestyle before they are admitted to IVF procedures. We argue that moral arguments could justify parenting protocols that concern all future parents. In the first part we argue that want‐to‐be parents have moral responsibilities towards their future children to prevent them from harm by diminishing or eliminating risk factors before as well as during the pregnancy. This is because of the future children's potential to become (...) of a certain type, more specifically: a person that will be the want‐to‐be parents' child. Want‐to‐be parents intend to become pregnant and therefore have an additional moral reason to diminish the risks. Also, people who become pregnant unintentionally have the responsibility to prevent their children from harm, unless they become pregnant due to contraception failure. All people not wanting to become pregnant should use contraception methods carefully.In the second part of this paper we translate the want‐to‐be parents' responsibilities into practice. We distinguish four determinants of risk factors: modifiability, chance, severity and effort. We examine some evidence‐based risk factors based on these variables and deduce levels of responsibility.In conclusion, formulating informal requirements for want‐to‐be parents is morally required and therefore also for want‐to‐be parents in need of medical assistance. The protocols developed by fertility doctors in the Netherlands could be seen as the precursor for a general, informal Parenting Protocol that could be developed on the basis of an extended and thoroughly debated risk‐responsibility analysis. (shrink)

Is it morally justifiable to force non-consenting pregnant women to submit to caesarean surgery to save their fetus in distress? Even though proponents and opponents largely agree on the interests at stake, such as the health and life of the fetus and the respect for bodily integrity and autonomy of pregnant women, they disagree on which moral weight to attach to these interests. This is why disagreements about the justifiability of forced caesareans tend to be pervasive and intractable. To sidestep (...) this deadlock, we will focus on conditions that give rise to the ‘caesarean dilemma’ in the first place, namely the conflict between inherent norms and values medical professionals are committed to by virtue of being a medical professional. Using the reflective equilibrium, we will test the opponents’ and proponents’ considered judgments about forced caesareans against the norms and values they—as medical professionals—are committed to and determine whether they are coherent. Subsequently we will identify the proponents’ incoherencies between the considered judgments and norms and values they are committed to and conclude that as long as these incoherencies are in place, forced caesareans are morally impermissible. (shrink)

The reversible phosphorylation of proteins on serine/threonine residues preceding proline (Ser/Thr‐Pro) is a major regulatory mechanism for the control of a series of cell cycle events. Although phosphorylation is thought to regulate protein function by inducing conformational changes, little is known about most of these conformational changes and their significance. Recent studies indicate that the conformation and function of a subset of these phosphorylated proteins are controlled by the prolyl isomerase Pin1 through isomerization of specific phosphorylated Ser/Thr‐Pro bonds. Furthermore, compelling (...) evidence supports the idea that proline‐directed phosphorylation and subsequent isomerization play a critical role not only in cell cycle control, but also in the development of Alzheimer's disease, where postmitotic neurons display various cell cycle markers, especially mitotic events, prior to degeneration. BioEssays 25:174–181, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

Retractions solicited by authors following the discovery of an unintentional error—what we henceforth call a “self-retraction”—are a new phenomenon of growing importance, about which very little is known. Here we present results of a small qualitative study aimed at gaining preliminary insights about circumstances, motivations and beliefs that accompanied the experience of a self-retraction. We identified retraction notes that unambiguously reported an honest error and that had been published between the years 2010 and 2015. We limited our sample to retractions (...) with at least one co-author based in the Netherlands, Belgium, United Kingdom, Germany or a Scandinavian country, and we invited these authors to a semi-structured interview. Fourteen authors accepted our invitation. Contrary to our initial assumptions, most of our interviewees had not originally intended to retract their paper. They had contacted the journal to request a correction and the decision to retract had been made by journal editors. All interviewees reported that having to retract their own publication made them concerned for their scientific reputation and career, often causing considerable stress and anxiety. Interviewees also encountered difficulties in communicating with the journal and recalled other procedural issues that had unnecessarily slowed down the process of self-retraction. Intriguingly, however, all interviewees reported how, contrary to their own expectations, the self-retraction had brought no damage to their reputation and in some cases had actually improved it. We also examined the ethical motivations that interviewees ascribed, retrospectively, to their actions and found that such motivations included a combination of moral and prudential considerations. These preliminary results suggest that scientists would welcome innovations to facilitate the process of self-retraction. (shrink)

Growing interest in Pacific issues has meant a surge in Pacific research across the globe. Sadly, some research on Pacific people has been done without Pacific knowledge, wisdom and culture. As Pacific researchers, we understand the importance of outputs that interweave our ancestral and cultural wisdom, whilst centring and privileging our people’s narratives. Through the birth of our Moanaroa Pacific Research group, we explore the importance of a research collective which decolonises and re indigenises research as we know it.

In the debate surrounding the introduction of non-invasive prenatal testing in prenatal screening programmes, the concept of routinisation is often used to refer to concerns and potential negative consequences of the test. A literature analysis shows that routinisation has many different meanings, which can be distinguished in three major versions of the concept. Each of these versions comprises several inter-related fears and concerns regarding prenatal screening and particularly regarding NIPT in three areas: informed choice, freedom to choose and consequences for (...) people with a disability. Three of the strongest arguments raised under the flag of routinisation are assessed for their validity: the threat that NIPT poses to informed choice, the potential increase in uptake of first-trimester prenatal screening and its consequences for social pressure to participate in screening or terminate affected pregnancies, and the negative consequences for disabled people. These routinisation arguments lack empirical or normative ground. However, the results of this analysis do not imply that no attention should be paid to possible problems surrounding the introduction of NIPT. At least two problems remain and should be addressed: there should be an ongoing debate about the requirements of informed choice, particularly related to an expanded scope of prenatal screening. Also, reproductive autonomy can only be achieved when expecting parents’ options are variegated, real and valuable, so that they can continue to choose whether or not to screen or to terminate a pregnancy. (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)

Informed consent is a key condition for prenatal screening programmes to reach their aim of promoting reproductive autonomy. Reaching this aim is currently being challenged with the introduction of non-invasive prenatal testing (NIPT) in first-trimester prenatal screening programmes: amongst others its procedural ease—it only requires a blood draw and reaches high levels of reliability—might hinder women’s understanding that they should make a personal, informed decision about screening. We offer arguments for a renewed recognition and use of informed consent compared to (...) informed choice, and for a focus on value-consistent choices and personalized informational preferences. We argue for a three-step counselling model in which three decision moments are distinguished and differently addressed: (1) professionals explore women’s values concerning whether and why they wish to know whether their baby has a genetic disorder; (2) women receive layered medical-technical information and are asked to make a decision about screening; (3) during post-test counselling, women are supported in decision-making about the continuation or termination of their pregnancy. This model might also be applicable in other fields of genetic (pre-test) counselling, where techniques for expanding genome analysis and burdensome test-outcomes challenge counselling of patients. (shrink)

There is an increasing interest in the possibility of using nudges to promote people's health. Following the advances in developmental biology and epigenetics, it is clear that one's health is not always the result of one's own choices. In the period surrounding pregnancy, maternal choice behaviour has a significant influence on perinatal morbidity and mortality as well as the development of chronic diseases later in life. One's health is thus a matter of one's own as well as one's maternal choices. (...) Therefore, self-regarding and other-regarding nudges should be considered as viable strategies to promote health. In this article, we introduce the concept of other-regarding nudges. We use the harm principle and the principle of beneficence to justify these other-regarding nudges. We conclude by stressing the importance of a fair assessment of expectations towards the nudgee, when determining whether a nudge is aimed at preventing harm or promoting a good. (shrink)