When seriously ill patients reach the end of the standard treatment trajectory for their condition, they may qualify for the use of unapproved, investigational drugs regulated via expanded access programs. In medical-ethical discourse, it is often argued that expanded access to investigational drugs raises ‘false hope’ among patients and is therefore undesirable. We set out to investigate what is meant by the false hope argument in this discourse. In this paper, we identify and analyze five versions of the false hope (...) argument which we call: (1) the limited chance at benefit argument, (2) the side effects outweighing benefits argument, (3) the opportunity costs argument, (4) the impossibility of making informed decisions argument, and (5) the difficulty of gaining access argument. We argue that the majority of these five versions do not provide normative ground for disqualifying patients’ hopes as false. Only when hope is rooted in a mistaken belief, for example, about the likelihood of benefits or chances on medical risks, or when hope is directed at something that cannot possibly be obtained, should it be considered false. If patients are adequately informed about their odds of obtaining medical benefit, however small, and about the risks associated with an investigational treatment, it is unjustified to consider patients’ hopes to be false, and hence, to deny them access to investigational drug based on that argument. (shrink)

Mimesis or imitation comes in many forms, from animal and plant mimicry to artistic copies 'from life'. This book offers eighteen essays addressing mimesis from diverse perspectives. From the recreation of galaxies to Iron Age torcs, from counterfeit dragons to modern waxworks, each chapter explores facets of material mimesis from prehistory to the present day. The Matter of Mimesis invites readers to compare practices of imitating, faking, and synthesising materials and objects in nature, art and science, raising questions about skills, (...) techniques and politics of making that transcend historical and disciplinary boundaries and inform both our past and future worlds. (shrink)

The focus of this article is the analysis of generative mechanisms, a basic concept and phenomenon within the metatheoretical perspective of critical realism. It is emphasized that research questions and methods, as well as the knowledge it is possible to attain, depend on the basic view – ontologically and epistemologically – regarding the phenomenon under scrutiny. A generative mechanism is described as a trans empirical but real existing entity, explaining why observable events occur. Mechanisms are mostly possible to grasp only (...) indirectly by analytical work, based however on empirical observations. In order to achieve such an explanatory analysis, five methodological steps are suggested and discussed, among them abduction and retroduction. These steps are illustrated throughout by examples drawn from empirical research regarding social work practice. The article is concluded with a discussion of the need for knowledge of generative mechanisms. (shrink)

The aim of the present study was to describe variations in patient participation in decisions about care planning during the final phase of life for a group of gravely ill patients, and how the different actors’ manner of acting promotes or impedes patient participation. Thirty-seven qualitative research interviews were conducted with relatives of the patients. The patients’ participation in the decisions could be categorized into four variations: self-determination, co-determination, delegation and nonparticipation. The manner in which patients, relatives and caregivers acted (...) differed in the respective variations; this seemed either to promote or to impede the patients’ opportunities of participating in the decision making. The possibility for participation seems to be context dependent and affected by many factors such as the dying patient’s personality, the social network, the availability of different forms of care, cultural values, and the extent to which nurses and other caregivers of the different forms of care can and want to support the wishes of the patients and relatives in the decision-making process. (shrink)

The aim of the present study was to describe variations in patient participation in decisions about care planning during the final phase of life for a group of gravely ill patients, and how the different actors’ manner of acting promotes or impedes patient participation. Thirty-seven qualitative research interviews were conducted with relatives of the patients. The patients’ participation in the decisions could be categorized into four variations: self-determination, co-determination, delegation and nonparticipation. The manner in which patients, relatives and caregivers acted (...) differed in the respective variations; this seemed either to promote or to impede the patients’ opportunities of participating in the decision making. The possibility for participation seems to be context dependent and affected by many factors such as the dying patient’s personality, the social network, the availability of different forms of care, cultural values, and the extent to which nurses and other caregivers of the different forms of care can and want to support the wishes of the patients and relatives in the decision-making process. (shrink)

The aim of the present study was to investigate the association between work-related moral stress, moral climate and moral sensitivity in mental health nursing. By means of the three scales Hospital Ethical Climate Survey, Moral Sensitivity Questionnaire and Work-Related Moral Stress, 49 participants’ experiences were assessed. The results of linear regression analysis indicated that moral stress was determined to a degree by the work place’s moral climate as well as by two aspects of the mental health staff’s moral sensitivity. The (...) nurses’ experience of ‘moral burden’ or ‘moral support’ increased or decreased their experience of moral stress. Their work-related moral stress was determined by the job-associated moral climate and two aspects of moral sensitivity. Our findings showed an association between three concepts: moral sensitivity, moral climate and moral stress. Despite being a small study, the findings seem relevant for future research leading to theory development and conceptual clarity. We suggest that more attention be given to methodological issues and developing designs that allow for comparative research in other disciplines, as well as in-depth knowledge of moral agency. Copyright © 2011 by SAGE Publications. (shrink)

Sixteen essays discuss _De iure praedae_ – Hugo Grotius’s 1604-1605 commentary on booty –, its sources, circumstances and consequences, and explore how Grotius the humanist, the theologian, the jurist and the politician concur in this his first exercise in natural law and rights.

A fresh look at the importance of natural and international law in the religious politics at the heartlands of the Reformation, from the Low Countries, the German principalities up to Transylvania; from Niels Hemmingsen to Gian Battista Vico; from religious reasons for the universalist claims of natural law to political arguments for the sacred polity, their tension and creative potential.

Perfect adaptation in a dynamical system is the phenomenon that one or more variables have an initial transient response to a persistent change in an external stimulus but revert to their original value as the system converges to equilibrium. With the help of the causal ordering algorithm, one can construct graphical representations of dynamical systems that represent the causal relations between the variables and the conditional independences in the equilibrium distribution. We apply these tools to formulate sufficient graphical conditions for (...) identifying perfect adaptation from a set of first-order differential equations. Furthermore, we give sufficient conditions to test for the presence of perfect adaptation in experimental equilibrium data. We apply this method to a simple model for a protein signalling pathway and test its predictions in both simulations and using real-world protein expression data. We demonstrate that perfect adaptation can lead to misleading orientation of edges in the output of causal discovery algorithms. (shrink)

SummaryGrotius has a rudimentary theory of sociability. Only with hindsight has a remark about appetitus societatis been promoted to the starting point of a theory that flourished in the writings of later natural jurists. In this article, I address the issue of the appearance in Grotius's natural law of sociability [as the 1715/38 English translation of John Morrice renders appetitus societatis, following Barbeyrac's sociabilité]. Writing in the just war tradition, Grotius is first of all interested in finding out the conditions (...) for peace, and although injustice is a condition of war, it is not per se true that injustice is a perversion of society. Apparently, not all societies are perfect and the violence of war and the legal actions of peace are both instruments for achieving a greater modicum of justice in this world. Yet appetitus et custodia societatis is called the foundation of justice. Grotius achieved this context for sociability in phases, through a series of writings from c. 1600 until De iure belli ac pacis of 1625, and its revision of 1631. In this development the notion of fides plays an intriguing role, through which we can obtain a better understanding of the meaning of appetitus societatis in the later work. The present article is a sequel to a previous publication, on fides in De iure praedae. Analysing the genesis of appetitus societatis in De iure belli ac pacis, I argue that Grotius was changing his strategy over the years, without however arriving at a definitive solution to the question of what commits men to the pursuit of justice. (shrink)

We present an extension of the lambda calculus with the letrec construct. In contrast to current theories, which impose restrictions on where the rewriting can take place, our theory is very liberal, e.g., it allows rewriting under lambda abstractions and on cycles. As shown previously, the reduction theory is non-confluent. Thus, we searched for and found a new property that resembles confluence and that is equivalent to uniqueness of infinite normal forms: skew confluence. This notion is based on the intuition (...) that some terms are better than others and that terms reduce to better terms. It states that if a term reduces to two other terms, the second of those terms can always be reduced to a term that is better than the first. Using skew confluence we define the infinite normal form of a term and show that the infinite normal form defines a congruence on the set of terms. We relate the lambda calculus plus letrec to the plain lambda calculus and to one of the infinitary lambda calculi. We also present a variant of our calculus, which follows the tradition of the explicit substitution calculi. (shrink)

This paper examines the two main motifs in the Συναξάριον τοῦ τιμη- μένου γαδάρου and the Γαδάρου, λύκου κι ἀλουποῦς διήγησις ὡραία: the Ass’s Confession and the Mule’s Hoof, tracing them back to Medieval western rather than Ancient Aesopic sources. The Appendix deals with the dating and geographical provenance of the common ancestor of these two texts.

ObjectiveSome people experience post-traumatic growth, entailing positive changes such as a greater appreciation of life following traumatic events. We examined PTG in the context of the negative consequences of the COVID-19 pandemic, notably working from home and social distancing. We aimed to assess whether distinct sub-groups of individuals experiencing PTG could be identified by how they appraised and coped with the COVID-19 pandemic.MethodFor this cross-sectional study, we used convenience sampling. In total, 951 participants from the general population completed an online (...) questionnaire with items focusing on primary and secondary appraisal, positive reappraisal, rumination, and coping flexibility. For the latent profile analysis, we selected a sample of 392 individuals who had experienced moderate degrees of pandemic-related PTG, reporting at least two of the 10 positive changes in the PTG Inventory-Short Form.ResultsWe identified two distinct profiles among people experiencing PTG. The first was characterised by low levels of primary appraisal and stressfulness and higher levels of secondary appraisal, increased coping flexibility and greater use of positive reappraisal. The second was characterised by higher levels of stressfulness and primary appraisal and greater use of rumination.ConclusionThe two sub-groups evidently appraised and coped with the COVID-19 pandemic differently. Therefore, future research should account for these different profiles of people experiencing PTG. (shrink)

The account of punishment in De iure belli ac pacis develops most fully the relationship Grotius understands between strict rights and those claims arising from dignity or merit, which he associates with ‘expletive’ and ‘attributive’ standards of justice, respectively. The purpose of this article is to provide a philosophical reconstruction of two particular puzzles that arise out of the role Grotius assigns to the concepts of right and merit in the theory of punishment. How, in the first place, can a (...) right to punish be legitimated if not on the grounds that the offender merits punishment for the crime? And then, if merit does not provide the grounds for punishment, why must the penalty be strictly limited to what the offender merits? A reconstruction of Grotius’s arguments grounding the right to punish and justifying the role of penal merit brings out the underlying coherence in Grotius’s theory of punishment, while also revealing that the norms of expletive and attributive justice are inextricably linked in Grotius’s system of natural right. (shrink)

Dutch decline is usually studied as a topic in economic history: when did it really start, what shape did it take? In this article an attempt is made to show the actual awareness of the strengths and weaknesses of the Dutch economy, in the terms used by participants in three public debates. The classical Dutch discourse of decay and decline evolved in response to national and international political reality. The Bickerse Beroerten debate of 1650 shows the conflict between neo-Roman and (...) neo-Athenian tendencies. Subsequently, the explanation of Dutch decline (the effect of luxury) by the Anglo-Dutch pamphleteer Bernard Mandeville is shown to be markedly different from his advice to the English (to allow luxury). Finally, the 1630s Dutch debate between Lieven de Beaufort and his critics represents the maturing of the Dutch vocabulary of decline, including its failure to take into account the organisational preconditions of modern society. (shrink)

In this introduction, the meaning and relevance of the study of De iure praedae, as one of the juvenilia of Grotius, is discussed and the contending approaches are described. A survey of the volume is provided.

The idea that peace prevails in the relations among liberal democratic states, given its first expression in Kant’s essay “Toward Perpetual Peace,” has gathered a great deal of attention in the post-Cold War period as both a testable hypothesis and a proposal for expanding peace through democratization. This article examines the explanations for how a democratic peace is achieved and sustained. It argues that, despite tendencies within democratic state relations toward peaceful conflict resolution, such a peace is destabilized by continued (...) adherence to a set of assumptions and practices which we might call, following Jane Addams and John Dewey, ‘the war system.’ In the context of the ideological and institutional supports of militarism, democratic states remain subject to the dynamics of conflict escalation that produce occasions for war. This war system is the undoing of the democratic peace. (shrink)

_ Source: _Volume 35, Issue 1, pp 1 - 18 This introduction to the papers of the 2011 conference in Potsdam on De veritate aims to put the reception of the work during the Enlightenment into perspective, while introducing the several articles and their distinctive takes on Grotius and his theology. The importance of early-modern apologetics, its relations to natural theology, to rationalism and Deism, as well as to the changing self-image of Calvinism, are discussed. De veritate has been – (...) and maybe still is – a mirror to reflect important issues of Enlightenment and religion. (shrink)

In this introduction, the meaning and relevance of the study of De iure praedae, as one of the juvenilia of Grotius, is discussed and the contending approaches are described. A survey of the volume is provided.

In this introduction, the meaning and relevance of the study of De iure praedae, as one of the juvenilia of Grotius, is discussed and the contending approaches are described. A survey of the volume is provided.

Drawing on ethical and legal frameworks in the Netherlands, the United States and France, we examine whether physicians are expected to inform patients about potentially relevant opportunities for expanded access to investigational drugs. While we found no definitive legal obligation, we argue that physicians have a moral obligation to discuss opportunities for expanded access with patients who have run out of treatment options to prevent inequality, to promote autonomy, and to achieve beneficence.

The goal of this paper is to describe the link between financial performance and the level of sustainability. In a novel approach, the paper classifies firms based on past financial success to address a potentially reciprocal relationship. For the groups of better and worse performing firms and for the entire sample, the above link is then tested, also accounting for non‐linearity in the relationship. We show that environmental management system (EMS) implementation as a proxy for a firm's sustainability level is (...) only positively associated with the financial performance of financially well‐performing firms. Conversely, it has a negative association with the performance of less good firms. We show that this implies that firms cannot change from good to bad performance, and vice versa, solely through the implementation of an EMS, and also that the result remains when introducing non‐linearity in the link. Based on this result, we discuss implications for the direction of causality. (shrink)

The theory of justice that Hugo Grotius developed in De Jure Belli ac Pacis (The Law of War and Peace, 1625) set itself against a certain reading of Aristotle, according to which justice is conceived of as a mean between taking too much and taking too little. I argue that we can best understand the implications of Grotius' mature conception by considering the ends to which he had deployed this Aristotelian notion in his earlier work. Grotius came to perceive that (...) his earlier understanding of justice too easily ruled out the sorts of humanitarian concerns that could have a moderating effect. (shrink)