Although law is established on a strong presumption that persons younger than a certain age are not competent to consent, statutory age limits for asking children’s consent to clinical research differ widely internationally. From a clinical perspective, competence is assumed to involve many factors including the developmental stage, the influence of parents and peers, and life experience. We examined potential determining factors for children’s competence to consent to clinical research and to what extent they explain the variation in competence judgments.

BackgroundFor many decades, the debate on children’s competence to give informed consent in medical settings concentrated on ethical and legal aspects, with little empirical underpinnings. Recently, data from empirical research became available to advance the discussion. It was shown that children’s competence to consent to clinical research could be accurately assessed by the modified MacArthur Competence Assessment Tool for Clinical Research. Age limits for children to be deemed competent to decide on research participation have been studied: generally children of 11.2 (...) years and above were decision-making competent, while children of 9.6 years and younger were not. Age was pointed out to be the key determining factor in children’s competence. In this article we reflect on policy implications of these findings, considering legal, ethical, developmental and clinical perspectives.DiscussionAlthough assessment of children’s competence has a normative character, ethics, law and clinical practice can benefit from research data. The findings may help to do justice to the capacities children possess and challenges they may face when deciding about treatment and research options. We discuss advantages and drawbacks of standardized competence assessment in children on a case-by-case basis compared to application of a fixed age limit, and conclude that a selective implementation of case-by-case competence assessment in specific populations is preferable. We recommend the implementation of age limits based on empirical evidence. Furthermore, we elaborate on a suitable model for informed consent involving children and parents that would do justice to developmental aspects of children and the specific characteristics of the parent-child dyad.SummaryPrevious research outcomes showed that children’s medical decision-making capacities could be operationalized into a standardized assessment instrument. Recommendations for policies include a dual consent procedure, including both child as well as parents, for children from the age of 12 until they reach majority. For children between 10 and 12 years of age, and in case of children older than 12 years in special research populations of mentally compromised patients, we suggest a case-by-case assessment of children’s competence to consent. Since such a dual consent procedure is fundamentally different from a procedure of parental permission and child assent, and would imply a considerable shift regarding some current legislations, practical implications are elaborated. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work.This work is in the public domain in (...) the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Information is a recognized fundamental notion across the sciences and humanities, which is crucial to understanding physical computation, communication, and human cognition. The Philosophy of Information brings together the most important perspectives on information. It includes major technical approaches, while also setting out the historical backgrounds of information as well as its contemporary role in many academic fields. Also, special unifying topics are high-lighted that play across many fields, while we also aim at identifying relevant themes for philosophical reflection. There (...) is no established area yet of Philosophy of Information, and this Handbook can help shape one, making sure it is well grounded in scientific expertise. As a side benefit, a book like this can facilitate contacts and collaboration among diverse academic milieus sharing a common interest in information. . First overview of the formal and technical issues involved in the philosophy of information . Integrated presentation of major mathematical approaches to information, form computer science, information theory, and logic . Interdisciplinary themes across the traditional boundaries of natural sciences, social sciences, and humanities. (shrink)

Not only trauma, mourning and disease, but also disability has been recognised in the Book of Job in which the body plays an exceptional role. The protagonist is suffering physically, psychically and spiritually. Although the word, •–• [be sick, ill], never occurs in the book, his body is portrayed negatively being afflicted by some unknown illness, which would probably exclude him from the community described in Leviticus 13-14. While •’—’—“ [be silent] occurs several times in the book, it never has (...) the alternative meaning of deaf. Yet, his explicit empathy and sacrificial charity –’–’•’’— [for the blind] and –’–’’–’’•’ [for the lame] in 29:15 resonate with his own plight and undermine the possible discriminatory restrictions of like disabled in Leviticus 21:18. In this way, the Book of Job has a transgressive and yet liberating subtext, subverting the idealised body of his status quo. This subtle and veiled critique by the protagonist and therefore the book can be interpreted from a psychoanalytic perspective on physical disability and illness, where the symptoms and alleged imperfections of the body quietly cry out against social and cultural injustice of which they are the projections and mirrors when the context has silenced a concern for the body because of a lack of compassion as it is in the situation of Job. CONTRIBUTION: The intersection and cross-fertilisation of Biblical Studies, Disability Studies and psychoanalytic theory as interdisciplinary approach widens the horizons and deepens the insight of all three research fields, hopefully for the benefit of those who suffer from their bodies, their psyches and their societies. (shrink)

Essays over de actualiteit van het denken van de Deense filosoof en theoloog Kierkegaard (1813-1855) ten aanzien van bijvoorbeeld de enkeling, ethiek, het offer en zijn eigen schrijverschap.

Systematische uiteenzetting van de wijsbegeerte der wetsidee.

Amsterdam University Press is a leading publisher of academic books, journals and textbooks in the Humanities and Social Sciences. Our aim is to make current research available to scholars, students, innovators, and the general public. AUP stands for scholarly excellence, global presence, and engagement with the international academic community.

Episodic representations can be entertained either as “remembered” or “imagined”—as outcomes of experience or as simulations of such experience. Here, we argue that this feature is the product of a dedicated cognitive function: the metacognitive capacity to determine the mnemicity of mental event simulations. We argue that mnemicity attribution should be distinguished from other metacognitive operations (such as reality monitoring) and propose that this attribution is a “cognitive gadget”—a distinctively human ability made possible by cultural learning. Cultural learning is a (...) type of social learning in which traits are inherited through social interaction. In the case of mnemicity, one culturally learns to discriminate metacognitive “feelings of remembering” from other perceptual, emotional, action-related, and metacognitive feelings; to interpret feelings of remembering as indicators of memory rather than imagination; and to broadcast the interpreted feelings in culture- and context-specific ways, such as “I was there” or “I witnessed it myself.” We review evidence from the literature on memory development and scaffolding, metacognitive learning and teaching, as well as cross-cultural psychology in support of this view before pointing out various open questions about the nature and development of mnemicity highlighted by our account. (shrink)

Models are not adequately evaluated simply by whether they capture the data, after the fact. Other criteria are needed. One criterion is parsimony; but utility and generality are at least as important. Even with respect to parsimony, however, the case against feedback is not as straightforward as Norris et al. present it. We use feedback consistency effects to illustrate these points.

Protagoras of Abdera: The Man, His Measure makes a case for the Sophist Protagoras as a philosopher in his own right, while at the same time giving due weight to the complicated doxographical situation.

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)

In this review, we provide an overview of the dynamic changes within the microbiota and its metabolites that are implicated in establishing and maintaining gastrointestinal homeostasis during various stages of microbial colonization. The gradual conversion of the gut microbiota toward a mutualistic microbial community involves replacement of pioneer gut colonizers with bacterial taxa that are characteristic for the adult gut. An important microbial signature of homeostasis in the adult gut is the prevalence and activity of a diverse spectrum of bacterial (...) species that produce beneficial metabolites through metabolic interactions between microbial groups. Deciphering these microbial signatures and their metabolites that govern short and long‐term equilibrium, as well as imbalances in host‐microbial relationships, may provide novel diagnostic tools and/or therapeutic targets for specific disorders associated with intestinal dysbiosis and loss of homeostasis. (shrink)

BackgroundThe Netherlands is one of the few countries where euthanasia is legal under strict conditions. This study investigates whether Dutch newspaper articles use the term ‘euthanasia’ according to the legal definition and determines what arguments for and against euthanasia they contain.MethodsWe did an electronic search of seven Dutch national newspapers between January 2009 and May 2010 and conducted a content analysis.ResultsOf the 284 articles containing the term ‘euthanasia’, 24% referred to practices outside the scope of the law, mostly relating to (...) the forgoing of life-prolonging treatments and assistance in suicide by others than physicians. Of the articles with euthanasia as the main topic, 36% described euthanasia in the context of a terminally ill patient, 24% for older persons, 16% for persons with dementia, and 9% for persons with a psychiatric disorder. The most frequent arguments for euthanasia included the importance of self-determination and the fact that euthanasia contributes to a good death. The most frequent arguments opposing euthanasia were that suffering should instead be alleviated by better care, that providing euthanasia can be disturbing, and that society should protect the vulnerable.ConclusionsOf the newspaper articles, 24% uses the term ‘euthanasia’ for practices that are outside the scope of the euthanasia law. Typically, the more unusual cases are discussed. This might lead to misunderstandings between citizens and physicians. Despite the Dutch legalisation of euthanasia, the debate about its acceptability and boundaries is ongoing and both sides of the debate are clearly represented. (shrink)

Drawing on historical inisights, systematic reflections and empirical data, this book offers a substantive understanding of the complex relationship between religion and human rights and of the empirical impact of Christianity and Islam on the attitudes toward human rights, i.e. a human rights culture.

This volume contains four theoretical and four empirical articles that aim at conceptual clarification and descriptive and causal exploration on data from 14 countries about historical and current tensions within and between religions, Christiantity and Islam, and human rights in various contexts.

This volume is about the positive, ambivalent, null and negative effects in various historical periods by various religious denominations within Christianity, Islam and Hinduism on the attitudes towards human rights of the first, second and third generation.

This article discusses the relation between environment and participation in the context of different stages of political modernisation. We focus on the dynamics of environmental policy on the one hand, and the organisation of political participation on the other. The central argument is that participation is inextricably linked to environmental issues, but that their relation differs substantially over the various stages of the institutionalisation of environmental policy. While in the 1970s supplementary forms of participation dominated, the societalisation and marketisation of (...) environmental policies from the late 1980s has given rise to new opportunities for participation, implying a more rule-altering potential. (shrink)

Addressed here is the psychological complexity of meter, notated and heard, in The Firebird and Part II of The Rite of Spring. Of concern from the standpoint of the listener are the competing forces of meter, displacement, and parallelism; how these forces take precedence, with melody and harmony falling into place accordingly. Duly supplanted is the motivicism of the Classical style, as Theodor Adorno observed some time ago. Also of consequence here are octatonic harmony and the strict performance style favored (...) by the composer on a life-time basis. (shrink)