Editorial independence is crucial for the viability of a journal and editors have many masters - the public, the readers, the authors and the owners. Negotiating the resultant minefield requires a purposeful and independent stance. This is particularly so in instances of a relatively modern phenomenon: concerted attempts by clinical groups to influence, or even abort, publication of articles, which may threaten their practice. Moreover, modern social media facilitates this manipulation.

The International Committee of Medical Journal Editors is a working group of editors of selected medical journals that meets annually. Founded in Vancouver, Canada, in 1978, it currently consists of 11 member journals and a representative of the US National Library of Medicine. The major purpose of the Committee is to address and provide guidance for the conduct and publishing of biomedical research and the ethical tenets underpinning these activities. This advice is detailed in the Committee's Uniform Requirements for Manuscripts (...) Submitted to Biomedical Journals: Writing and Editing for Biomedical Publication . Recently, the ICMJE has adopted an interventionist role to ensure transparency of conflict of interest revelations in the conduct and publication of industry supported research. It also pursues a policy for the lodgement with trial registries of specified details of Phase III clinical trials. Failure to comply would jeopardise publication of trial outcomes in ICMJE member journals. This policy has resulted in the coming on stream of trial registries, international agreement on trial minimal datasets and compliance with trial registration requirements. (shrink)

BackgroundUnderstanding representations of disease in various art genres provides insights into how patients and health care providers view the diseases. It can also be used to enhance patient care and stimulate patient self-management.MethodsThis paper reviews how cardiovascular diseases are represented in novels, films, and paintings: myocardial infarction, aneurysm, hypertension, stroke, heart transplantation, Marfan’s disease, congestive heart failure. Various search systems and definitions were used to help identify sources of representations of different cardiovascular diseases. The representations of the different diseases were (...) considered separately. The Common Sense Model was used a theoretical model to outline illness perceptions and self-management in the various identified novels, films, and paintings.ResultsMyocardial infarction followed by stroke were the most frequently detailed diseases in all three art genres. This reflects their higher prevalence. Representations ranged from biomedical details through to social and psychological consequences of the diseases.ConclusionsArtistic representations of cardiovascular diseases reflect cognitions, emotions, and images of prevalent disease. These representations shape views and behaviour of ill and healthy persons regarding heart diseases. As these representations are amenable to change, they deserve further research, which may be instrumental in improving the quality of life of persons struck by cardiovascular diseases. Changing illness perceptions appears to be a method to improve self-management and thereby quality of life in patients with various cardiovascular diseases. (shrink)

We appreciate that the theme “ethics of ethics conferences” that we introduced in 2023 (Van der Graaf et al. 2023) was echoed by the previous and current presidents of the International Association...

: The transplantation of adult human neural stem cells into prenatal non-humans offers an avenue for studying human neural cell development without direct use of human embryos. However, such experiments raise significant ethical concerns about mixing human and nonhuman materials in ways that could result in the development of human-nonhuman chimeras. This paper examines four arguments against such research, the moral taboo, species integrity, "unnaturalness," and human dignity arguments, and finds the last plausible. It argues that the transfer of human (...) brain or retinal stem cells to nonhuman embryos would not result in the development of human-nonhuman chimeras that denigrate human dignity, provided such stem cells are dissociated. The article provides guidelines that set ethical boundaries for conducting such research that are consonant with the requirements of human dignity. (shrink)

The next World Congress of Bioethics will be held in Doha, Qatar. Although this location provides opportunities to interact with a more culturally diverse audience, to advance dialogue between cultures and religions, offer opportunities for mutual learning, there are also huge moral concerns. Qatar is known for violations of human rights ‐ including the treatment of migrant workers and the rights of women ‐ corruption, criminalization of LGBTQI+ persons, and climate impact. Since these concerns are also key (bio)ethical concern we (...) call for a broad debate within the bioethics community whether organizing and attending the World Congress in Qatar is ethically problematic and how ethical concerns should be dealt with. (shrink)

Interactive technology assessment (iTA) provides an answer to the ethical problem of normative bias in evaluation research. This normative bias develops when relevant perspectives on the evaluand (the thing being evaluated) are neglected. In iTA this bias is overcome by incorporating different perspectives into the assessment. As a consequence, justification of decisions based on the assessment is provided by stakeholders having achieved agreement. In this article, agreement is identified with wide reflective equilibrium to show that it indeed has the potential (...) of justifying decisions. We work out several conditions for this agreement to be achievable and just. (shrink)

In this paper a formal framework is proposed in which variousinformative actions are combined, corresponding to the different ways in whichrational agents can acquire information. In order to solve the variousconflicts that could possibly occur when acquiring information fromdifferent sources, we propose a classification of the informationthat an agent possesses according to credibility. Based on this classification, we formalize what itmeans for agents to have seen or heard something, or to believesomething by default. We present a formalization of observations,communication actions, (...) and the attempted jumps to conclusions thatconstitutes default reasoning. To implement these informative actionswe use a general belief revision action which satisfies theAGM postulates; dependent on the credibility of the incominginformation this revision action acts on one or more parts ofthe classified belief sets of the agents. The abilities of agents formalizeboth the limited capacities of agents to acquire information, and the preference of one kind of information acquisition to another. A very important feature of our approach is that it shows how to integratevarious aspects of agency, in particular the (informational) attitudesof dealing with information from observation, communication and defaultreasoning into one coherent framework, both model-theoretically andsyntactically. (shrink)

Health technology assessment (HTA) is often biased in the sense that it neglects relevant perspectives on the technology in question. To incorporate different perspectives in HTA, we should pursue agreement about what are relevant, plausible, and feasible research questions; interactive technology assessment (iTA) might be suitable for this goal. In this way a kind of procedural ethics is established. Currently, ethics too often is focussed on the application of general principles, which leaves a lot of confusion as to what really (...) is the matter in specific cases; in an iTA clashes of values should not be approached by use of such ethics. Instead, casuistry, as a tool used within the framework of iTA, should help to articulate and clarify what is the matter, as to make room for explication and consensus building. (shrink)

Unconsented episiotomies and other procedures during labour are commonly reported by women in several countries, and often highlighted in birth activism. Yet, forced caesarean sections aside, the ethics of consent during labour has received little attention. Focusing on episiotomies, this paper addresses whether and how consent in labour should be obtained. We briefly review the rationale for informed consent, distinguishing its intrinsic and instrumental relevance for respecting autonomy. We also emphasise two non-explicit ways of giving consent: implied and opt-out consent. (...) We then discuss challenges and opportunities for obtaining consent in labour and birth, given its unique position in medicine.We argue that consent for procedures in labour is always necessary, but this consent does not always have to be fully informed or explicit. We recommend an individualised approach where the antenatal period is used to exchange information and explore values and preferences with respect to the relevant procedures. Explicit consent should always be sought at the point of intervening, unless women antenatally insist otherwise. We caution against implied consent. However, if a woman does not give a conclusive response during labour and the stakes are high, care providers can move to clearly communicated opt-out consent. Our discussion is focused on episiotomies, but also provides a useful starting point for addressing the ethics of consent for other procedures during labour, as well as general time-critical medical procedures. (shrink)

Why is a Reformational philosophy needed in Africa? It is necessary, because something is missing in African Christianity. Most Western missionaries taught Africans a “broken” or dualistic worldview. This caused a divorce between traditional culture and their new Christian religion. The Christian faith was perceived as something remote, only concerned with a distant past and a far-away future . It could not become a reality in their everyday lives. It could not develop into an all-encompassing worldview and lifestyle. Because Reformational (...) philosophy advocates the Biblical, holistic approach of a comprehensive worldview, it is welcomed on our continent. It contains a healing and liberating message to our bleeding and lost continent. What Africans, however, neither want nor can afford, is an ivory tower philosophy, playing intellectual games; a philosophy which does not do or change anything. They want a philosophy which is a “marriage” between abstract ideas and the facts on the ground. They need a Christian philosophy with compassion that may even contribute to the alleviation of their poverty! (shrink)

As of October 23, 2020, almost 42 million cases of COVID-19 have been reported globally. Although many different treatments have been applied in infected...

In this article we will describe the emergence of a great number of small, regionally concentrated, innovative biotech companies. We see these organizations as “hosts” of concepts and ideas, greatly influencing their spreading over the sector. We have chosen an evolutionary perspective following individual companies in their struggle for survival, describing it as “obtaining food” and “fooling predators.” This struggle gives insight in the behavior of the biotech companies and related institutions as a “system of innovation.” One of our findings (...) is that the variety of biotech companies is conditioned by their selection environment, but that this selection environment allows great variety and even encourage variety by keeping the companies small. (shrink)

In this article we will describe the emergence of a great number of small, regionally concentrated, innovative biotech companies. We see these organizations as “hosts” of concepts and ideas, greatly influencing their spreading over the sector. We have chosen an evolutionary perspective following individual companies in their struggle for survival, describing it as “obtaining food” and “fooling predators.” This struggle gives insight in the behavior of the biotech companies and related institutions as a “system of innovation.” One of our findings (...) is that the variety of biotech companies is conditioned by their selection environment, but that this selection environment allows great variety and even encourage variety by keeping the companies small. (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)

Flow is a state of full task engagement that is accompanied with low-levels of self-referential thinking. Flow is considered highly relevant for human performance and well-being and has, therefore, been studied extensively. Yet, the neurocognitive processes of flow remain largely unclear. In the present mini-review we focus on how the brain's locus coeruleus-norepinephrine (LC-NE) system may be involved in a range of behavioral and subjective manifestations of flow. The LC-NE system regulates decisions regarding task engagement vs. disengagement. This is doneviadifferent (...) modes of baseline and stimulus-evoked norepinephrine release. We emphasize the theoretical and empirical overlap between the LC-NE system and flow. For both, a match between a person's skill and task challenge is important in order to induce high levels task-related attention. Moreover, psychophysiological indicators of LC-NE system activity, such as eye pupil diameter and arousal are also sensitive to flow states. Flow is related to arousal in an inverted U-shape. Similarly, in theories on the LC-NE system, task engagement is highest with intermediate levels of arousal. We argue that knowledge about the role of the LC-NE system in establishing the flow experience may help to gain fundamental knowledge of flow and can contribute to unifying various empirical findings on this topic. (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)

Grime in a recently developed theory distinguished three basic plant strategies: stress tolerance,ruderality and competition. He relates them to environments characterized in terms of stress and disturbance. Classifications of strategies and environments both are ultimately defined in terms of production. This tends to make the theory tautological. If the theory is to make sense, environments had better be defined in independent terms.

In this position paper, we describe a number of methodological and philosophical challenges that arose within our interdisciplinary Digital Humanities project CatVis, which is a collaboration between applied geometric algorithms and visualization researchers, data scientists working at OCLC, and philosophers who have a strong interest in the methodological foundations of visualization research. The challenges we describe concern aspects of one single epistemic need: that of methodologically securing (an increase in) trust in visualizations. We discuss the lack of ground truths in (...) the (digital) humanities and argue that trust in visualizations requires that we evaluate visualizations on the basis of ground truths that humanities scholars themselves create. We further argue that trust in visualizations requires that a visualization provides provable guarantees on the faithfulness of the visual representation and that we must clearly communicate to the users which part of the visualization can be trusted and how much. Finally, we discuss transparency and accessibility in visualization research and provide measures for securing transparency and accessibility. (shrink)

The term “evolution” is often used in the administrative sciences to designate dynamic processes of change in general. In biology, evolution has a very specific meaning, namely the application of a generative variation-selective retention scheme to change. Applying this to the administrative sciences is more exacting: describing what the variation consists of, how replication of the generated variation occurs and delineating the population from which the selection is made are far from easy. While it is the intention of this special (...) issue as a whole to provide some empirical examples of evolutionary change in the public and private sectors, this introduction will lay out the main lines of thought in what is often referred to as universal Darwinism and what this means in the administrative sciences. Key concepts here are generative variation, selective retention, and selective institutional environment. According to the authors, the Darwinian scheme of evolutionary theory focuses on how new ideas or concepts arise, how they propagate and influence wider actor thinking and on how the institutional environment in which they operate affects their differential survival. This evolutionary process is an interplay between actors and replicators (sounds, images, and in this context mostly words) in which it cannot be said in advance which one is fooling the other. (shrink)

The term “evolution” is often used in the administrative sciences to designate dynamic processes of change in general. In biology, evolution has a very specific meaning, namely the application of a generative variation-selective retention scheme to change. Applying this to the administrative sciences is more exacting: describing what the variation consists of, how replication of the generated variation occurs and delineating the population from which the selection is made are far from easy. While it is the intention of this special (...) issue as a whole to provide some empirical examples of evolutionary change in the public and private sectors, this introduction will lay out the main lines of thought in what is often referred to as universal Darwinism and what this means in the administrative sciences. Key concepts here are generative variation, selective retention, and selective institutional environment. According to the authors, the Darwinian scheme of evolutionary theory focuses on how new ideas or concepts arise, how they propagate and influence wider actor thinking and on how the institutional environment in which they operate affects their differential survival. This evolutionary process is an interplay between actors and replicators (sounds, images, and in this context mostly words) in which it cannot be said in advance which one is fooling the other. (shrink)