Results of two survey studies are presented. It is shown that attitudes of the public about "technology in general" are not stable and can easily be affected by how the subject is introduced. Eight areas of technology are compared on the basis of empirical relations in attitudinal judgments, in attribute ratings, in self- assigned importance weights of attributes, and in importance of reference groups and persons. On the basis of similarities in these four kinds of judgments, three clusters of technology (...) areas were identified: a cluster of modern reproductive technologies, an information cluster containing automation, computer, and communication technologies, and a cluster containing nuclear energy and military technology. The attitude toward "technology in general" can not be considered as an aggregation of attitudes toward these areas of technology: The relations between general attitude and specific attitudes are only moderate to negligible. (shrink)

This article presents standards for setting up and educating institutional ethics committees (IECs). These standards are based on experiences in the Netherlands, where IECs have been established in a large number of health care institutions. Though the IEC has become a generally accepted institution within Dutch health care, there are concerns over its effectiveness regarding the improving of the moral quality of clinical decision making. Health care practitioners and members of IECs too, experience a gap between the IEC and the (...) reality of the clinical environment. At this moment, there is interest in developing programmes which educate practitioners in moral issues and how to deal with them, using the method of a structured debate on the ward. The IEC will not be made obsolete by this development, but can play a guiding role in the implementation of such programmes. Current concerns are the lack of patient representation in the Dutch IEC, and the loss of contact with the local community of health care practitioners because of the merger of hospitals into bodies similar to UK National Health Service (NHS) trusts. (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.

The skopos of this new type of church Bible is: ‘How would the source texts of the Bible have sounded in Afrikaans in the context envisaged for its hypothesised first audience?’ Fully acknowledging the complexities of language as a dynamic and complex system embedded in the culture and conceptual world of its speakers, as well as the wide range of frames that are involved in the process of Bible translation as a difficult form of secondary communication, this article addresses two (...) of the challenges of this ambitious project. In the first section the incongruence between the world of the Old Testament and speakers of Afrikaans is treated. Examples are provided of instances where both the nature of difficult secondary intercultural communication as well as the subjective theories of the host audience constrains the ‘directness’ of the translation. In the second section, some of the challenges of distinguishing between the formal and functional features of Biblical Hebrew are dealt with. The article concludes that, although the notion ‘communicative clue’ provides a useful heuristic device to act as point of departure for negotiations on the construal of the meaning of the text in the source language and host language respectively, the notion has to be supplemented by insights from the fields of cultural anthropology, cognitive linguistics and linguistic typology. A better understanding of how meaning ‘works’ provides members of a translation team with some criteria to make informed decisions when they negotiate how the meaning of specific Biblical Hebrew constructions are to be construed ‘directly’ in Afrikaans.Keywords: Afrikaans Bibles; Bible translation; Biblical Hebrew; church Bible; code model; cognitive linguistics; cognitive semantics; communication model; communicative clue; direct translation; discourse marker; dynamic equivalent translation; functionalist tran. (shrink)

The participation of vulnerable patients in clinical research poses apparent ethical dilemmas. Depending on the nature of the vulnerability, their participation may challenge the ethical principles of autonomy, non-maleficence, or justice. On the other hand, non-participation may preclude the building of a knowledge base that is a prerequisite for defining the optimal clinical management of vulnerable patients. Such clinical uncertainty may also incur substantial economic costs. We present the participation of pre-menopausal women with atrial fibrillation in trials of novel oral (...) anticoagulant drugs as a case study. Due to their non-participation in pivotal trials, it is uncertain whether for them, the risks that are associated with these drugs are outweighed by the advantages compared with conventional treatment. We addressed the question whether research of this new class of drugs in this subgroup would be appropriate from both, an ethical as well an economic perspective. We used the method of specifying norms as a wider framework to resolve the apparent ethical dilemma, while incorporating the question whether research of oral anticoagulants in premenopausal women with atrial fibrillation can be justified on economic grounds. For the latter, the results of a value-of-information analysis were used. Further clinical research on NOACs in premenopausal women with atrial fibrillation can be justified on both, ethical and economic grounds. Addressing apparent ethical dilemmas by invoking a method such as specifying norms can improve the quality of public practical reasoning. As such, the method should also prove valuable to committees that have formally been granted the authority to review trial protocols and proposals for scientific research. (shrink)

Routledge is now re-issuing this prestigious series of 204 volumes originally published between 1910 and 1965. The titles include works by key figures such asC.G. Jung, Sigmund Freud, Jean Piaget, Otto Rank, James Hillman, Erich Fromm, Karen Horney and Susan Isaacs. Each volume is available on its own, as part of a themed mini-set, or as part of a specially-priced 204-volume set. A brochure listing each title in the "International Library of Psychology" series is available upon request.

What is the value of an early diagnosis of dementia in the absence of effective treatment? There has been a lively scholarly debate over this question, but until now patients have not played a large role in it. Our study supplements biomedical research into innovative diagnostics with an exlporation of its meanings and values according to patients. Based on seven focusgroups with patients and their care-givers, we conclude that stakeholders evaluate early diagnostics with respect to whether and how they expect (...) it to empower their capacity to care. They value it, for instance, with respect to whether it explains experienced complaints, allows to start a process of psychological acceptance and social adaptation to the expected degeneration, contributes to dealing with anxieties, informs adequately about when to start preparing for the end of life, informs the planning of a request for euthanasia, or allows society to deal with a growing amount of dementia patients. Our study suggests that information about disease is considered ‘harmful’ or ‘premature’ when recipients feel unable to act on that information in their care. The results of this research offers input to further ethical research. It invites to adopt a care perspective in evaluation and to seek ways to prevent the ‘harm’ that such diagnostic methods can bring about. (shrink)