BackgroundPatient-centeredness, respect for patient autonomy, and shared decision-making have now made it to center stage in discussions on quality of care. Knowing what actually counts in care and how it should be accomplished from the patients’ and nurses’ perspective seems crucial.AimTo explore how patients and their nurses perceive the importance and enactment of values in their healthcare.Research designAn observational, cross-sectional study using a self-developed questionnaire, consisting of 15 items related to seven values (e.g. uniqueness, autonomy, professionalism, compassion, responsiveness, partnership, and (...) empowerment) as described in the taxonomy of Bastemeijer et al.Participants and research contextThe survey was completed by 384 patients and 81 nurses. Participants were recruited on eight internal medicine wards of a 1000-bed university hospital in Belgium.Ethical considerationsThis study was approved by the ethical committee of the Ghent University Hospital (B670201836799).Findings(1) Patients and nurses prioritize values of care differently; (2) nurses report not being able to enact the values they prioritize in actual practice as much as one would like to; and (3) there is a gap in experienced delivery of a comprehensible explanation of all treatment options, a conversation based on equality, making shared decisions, and being non-judgmental between nurses and patients.DiscussionOur findings challenge nurses’ overemphasis on professional compassion and uniqueness while arguing for increased attention on authentic shared decision-making and empowerment. The first step to a patient-centered culture truly involving patients in their healthcare is communication and information provision, rather than focusing on tangible and normative constructs.ConclusionOur findings revealed differences in prioritization and actual enactment of values in care between patients and nurses. This was especially so for values related to communication, provision of complete unbiased information, and shared decision-making. Nurses should prioritize providing comprehensible information and using conversations based on equality to make decision together with patients. (shrink)

Ethical issues of information and communication technologies (ICTs) are important because they can have significant effects on human liberty, happiness, and people’s ability to lead a good life. They are also of functional interest because they can determine whether technologies are used and whether their positive potential can unfold. For these reasons, policy makers are interested in finding out what these issues are and how they can be addressed. The best way of creating ICT policy that is sensitive to ethical (...) issues pertain to being proactive in addressing such issues at an early stage of the technology life cycle. The present paper uses this position as a starting point and discusses how knowledge of ethical aspects of emerging ICTs can be gained. It develops a methodology that goes beyond established futures methodologies to cater for the difficult nature of ethical issues. The authors outline how the description of emerging ICTs can be used for an ethical analysis. (shrink)

In this paper, we consider the meaning, roles, and uses of trust in the economic and public domain, focusing on the task of designing systems for trust in information technology. We analyze this task by means of a survey of what trust means in the economic and public domain, using the model proposed by Lewicki and Bunker, and using the emerging paradigm of value-sensitive design. We explore the difficulties developers face when designing information technology for trust and show how our (...) analysis in conjunction with existing engineering design methods provides means to address these difficulties. Our main case concerns a concrete problem in the economic domain, namely the transfer of control from customs agencies to companies. Control of individual items is increasingly untenable and is replaced by control on the level of companies aimed at determining whether companies can be trusted to be in control of their business and to be in compliance with applicable regulations. This transfer sets the task for companies to establish this trust by means of information technology systems. We argue that this trust can be achieved by taking into account philosophical analyses of trust and by including both parties in the trust relationship as clients for whom the information technology systems are to be designed. (shrink)

Ethical issues of information and communication technologies (ICTs) are important because they can have significant effects on human liberty, happiness, their ability to lead a good life. They are also of functional interest because they can determine whether technologies are used and whether their positive potential can unfold. For these reasons policy makers are interested in finding out what these issues are and how they can be addressed. The best way of creating ICT policy that is sensitive to ethical issues (...) would be to be proactive and address such issues at early stages of the technology life cycle. The present paper uses this position as a starting point and discusses how knowledge of ethical aspects of emerging ICTs can be gained. It develops a methodology that goes beyond established futures methodologies to cater for the difficult nature of ethical issues. The paper goes on to outline some of the preliminary findings of a European research project that has applied this method. (shrink)

Our ability to select relevant information from the environment is limited by the resolution of attention – i.e., the minimum size of the region that can be selected. Neural mechanisms that underlie this limit and its development are not yet understood. Functional MRI was performed during an object tracking task in 7- and 11-year-old children, and in young adults. Object tracking activated canonical fronto-parietal attention systems and motion-sensitive area MT in children as young as 7 years. Object tracking performance improved (...) with age, together with stronger recruitment of parietal attention areas and a shift from low-level to higher-level visual areas. Increasing the required resolution of spatial attention – which was implemented by varying the distance between target and distractors in the object tracking task – led to activation increases in fronto-insular cortex, medial frontal cortex including anterior cingulate cortex (ACC) and supplementary motor area, superior colliculi, and thalamus. This core circuitry for attentional precision was recruited by all age groups, but ACC showed an age-related activation reduction. Our results suggest that age-related improvements in selective visual attention and in the resolution of attention are characterized by an increased use of more functionally specialized brain regions during the course of development. (shrink)

Background A team-based approach has been advocated for advance care planning in nursing homes. While nurses are often put forward to take the lead, it is not clear to what extent other professions could be involved as well. Objectives To examine to what extent engagement in advance care planning practices, knowledge and self-efficacy differ between nurses, care assistants and allied care staff in nursing homes. Design Survey study. Participants/setting The study involved a purposive sample of 14 nursing homes in Flanders, (...) Belgium. Nurses, care assistants and allied care staff completed a survey. Ethical considerations The study was approved by the University Hospital of Brussels, as part of a cluster randomized controlled trial. Results One hundred ninety-six nurses, 319 care assistants and 169 allied staff participated. After adjusting for confounders, nurses were significantly more likely than care assistants to have carried out advance care planning conversations and documented advance care planning ; differences not found between allied staff and care assistants. Advance care planning knowledge total scores differed significantly, with nurses ; 95% confidence interval 0.08–0.17; p < 0.001) and allied staff scoring higher than care assistants. We found no significant differences regarding self-efficacy. Discussion While nursing home nurses conducted more advance care planning conversations and documentation than allied care staff and care assistants, these two professional groups may be a valuable support to nurses in conducting advance care planning, if provided with additional training. Conclusions Allied care staff and care assistants, if trained appropriately, can be involved more strongly in advance care planning to enhance relational and individual autonomy of nursing home residents, alongside nurses. Future research to improve and implement advance care planning should consider this finding at the intervention development stage. (shrink)

This article starts with a case outlining ethical challenges encountered in participatory action research (PAR) on vaccine hesitancy in rural India during Covid-19. Community researchers were recruited by a not-for-profit organisation, with the aim of both discovering the reasons for vaccine hesitancy and encouraging take-up. This raised issues about the roles and responsibilities of local researchers in their own communities, where they might be blamed for adverse reactions to vaccination. They and their mentor struggled with balancing societal protection against individual (...) rights to make choices. These themes are explored in two commentaries discussing the difficulties in balancing ethics in public health (prioritising societal benefits), social research (protecting participants from harm and respecting their rights not to be involved) and participatory research practices (maximising democratic participation and decision-making). As discussed in the first commentary, often these cohere, but tensions can arise. The second commentary also raises the issue of epistemic justice, questioning the extent to which the villagers could have a say in the design, implementation and interpretation of the research, and the dangers of not hearing the voices and arguments of people who reject vaccination. The case and commentaries highlight the complexities of PAR and additional challenges in a public health context. (shrink)

BackgroundReducing the number of animals used in experiments has become a priority for the governments of many countries. For these reductions to occur, animal-free alternatives must be made more available and, crucially, must be embraced by researchers.MethodsWe conducted an international online survey for academics in the field of animal science (N = 367) to explore researchers’ attitudes towards the implementation of animal-free innovations. Through this survey, we address three key questions. The first question is whether scientists who use animals in (...) their research consider governmental goals for animal-free innovations achievable and whether they would support such goals. Secondly, responders were asked to rank the importance of ten roadblocks that could hamper the implementation of animal-free innovations. Finally, responders were asked whether they would migrate (either themselves or their research) if increased animal research regulations in their country of residence restricted their research.ResultsWhile nearly half (40%) of the responders support governmental goals, the majority (71%) of researchers did not consider such goals achievable in their field within the near future. In terms of roadblocks for implementation of animal-free methods, ~ 80% of the responders considered ‘reliability’ as important, making it the most highly ranked roadblock. However, all other roadblocks were reported by most responders as somewhat important, suggesting that they must also be considered when addressing animal-free innovations. Importantly, a majority reported that they would consider migration to another country in response to a restrictive animal research policy. Thus, governments must consider the risk of researchers migrating to other institutes, states or countries, leading to a ‘brain-drain’ if policies are too strict or suitable animal-free alternatives are not available.ConclusionOur findings suggest that development and implementation of animal-free innovations are hampered by multiple factors. We outline three pillars concerning education, governmental influence and data sharing, the implementation of which may help to overcome these roadblocks to animal-free innovations. (shrink)

BackgroundAlthough a large number of clinical trials on interventions demonstrating efficacy (or lack thereof) are conducted annually, much of this evidence is not accessible to scientists and clinicians.ObjectivesWe aimed to determine the publication rate of posttraumatic stress disorder (PTSD) trials that have been registered in clinical trial registries, and the factors associated with publication.MethodsTrials, completed on January 15, 2015, were identified via the US National Institutes of Health clinical trials registry, the European Union Clinical Trials Register and the WHO International (...) Clinical Trials Registry Platform. A systematic search for publications (published by the end of March 2018) related to each of the registered trials were then performed.ResultsFour hundred and thirty-eight of 1982 potentially eligible trials were included. Only 34% of interventional trials were registered prior to initiation, 9% were registered within 2 months of starting and 20% after trial completion. Of the 438 included trials, 72% had generated peer-reviewed publications, while an additional 7% had disseminated results in some other form (such as on the trial database), 26 months after trial completion. Randomisation of a trial was the only factor individually associated with publication, in logistic regression analysis (p < 0.001). Intervention type, university as sponsor and study registration prior to completion were factors that influenced the time to publication, using Cox regression (p < 0.001).ConclusionsThis study underscores the importance of timely and accurate publication and dissemination of trial results, in order to avoid the potential waste of resources and to ensure research integrity and patient safety. We suggest that authors and journal editors adhere to conditions set out by the International Committee of Medical Journal Editors and that more diligent data sharing is encouraged through prospective trial registration and trial reporting websites. (shrink)

When thinking about ethics, technology is often only mentioned as the source of our problems, not as a potential solution to our moral dilemmas. When thinking about technology, ethics is often only mentioned as a constraint on developments, not as a source and spring of innovation. In this paper, we argue that ethics can be the source of technological development rather than just a constraint and technological progress can create moral progress rather than just moral problems. We show this by (...) an analysis of how technology can contribute to the solution of so-called moral overload or moral dilemmas. Such dilemmas typically create a moral residue that is the basis of a second-order principle that tells us to reshape the world so that we can meet all our moral obligations. We can do so, among other things, through guided technological innovation. (shrink)

In computer ethics, as in other branches of applied ethics, the problem of the justification of moral judgment is still unresolved. I argue that the method which is referred to as “The Method of Wide Reflective Equilibrium” (WRE) offers the best solution to it. It does not fall victim to the false dilemma of having to choose either case‐based particularist or principle‐based universalist approaches to the problem of moral justification. I claim that WRE also provides the best model of practical (...) moral reasoning available for computer ethics. It does not pretend to provide quasi‐algorithmic procedures for moral decision‐making, but neither does it abandon the regulative ideal of communicative transparency in discursive public justification. (shrink)

In this interview with Jan Hendrik van den Berg, the Dutch phenomenologist and psychiatrist addresses the origins of his work, his most significant influences, and the purpose of metabletic phenomenology in the modern age. In the course of the interview. Dr. Van den Berg provides a basic overview of his work, and highlights the central finding of his metabletic analyses: a loss of wonder before nature, which results from the more fundamental loss of genuine spirituality in the modern world.

There is widespread understanding of the close connection between religion and the ecological crisis, and that in order to amend this crisis, theological resources are needed. This monograph seeks to contribute to this endeavor by engaging the theology of Dietrich Bonhoeffer. His theology is particularly suitable in this context, due to its open-ended nature, and to the prophetic and radical nature of the questions he was prepared to ask--that is why there are many other attempts to contextualize Bonhoeffer's theology in (...) areas that he himself has not directly written about. In this monograph, Steven van den Heuvel first of all addresses the question of how to translate Bonhoeffer's theology in a methodologically sound way. He settles on a modified form of the general method of correlation. Then, secondly, van den Heuvel sets out to describe five major concepts in Bonhoeffer's work, bringing these into critical interplay with discussions in environmental ethics and eco-theology. In making the correlations he thoroughly describes each concept, situating it in the historic and intellectual background of Bonhoeffer's time. He then transposes these concepts to contemporary environmental ethics, describing what contribution Bonhoeffer's theology can make. - back of book. (shrink)

Het ethos waarin de mens leeft en handelt is in verandering zolang de mens leeft en handelt. In De maakbare moraal reflecteren verschillende filosofen over de antwoorden die het moderne en hedendaagse denken kunnen bieden op vragen die net door dat veranderend ethos tot stand worden gebracht. De idee dat moraal 'maakbaar' zou zijn houdt meteen ook een kritisch standpunt in: wat precies is er in onze morele omgang met elkaar dat beheersbaar, expliciteerbaar, voorstelbaar... zou kunnen zijn? De maakbare moraal (...) bundelt bijdragen van Daniel Acke, Hans Alma, Sonja Lavaert, Julia Maria Mönig, Johan Stuy en Adelheid Rigo, Marc Van den Bossche, Yoni Van Den Eede, Karl Verstrynge en Else Walravens. De reeks Humanismen wil het denken over de hedendaagse condition humaine op een prikkelende en eigenzinnige manier stimuleren. Het begrip humanisme krijgt hier een zeer ruime omschrijving: respect voor de mens in zijn diversiteit en pluraliteit en voor de manier waarop individuen zoeken naar identiteit en zingeving. De reeks komt tot stand onder begeleiding van prof. dr. Marc Van den Bossche van de vakgroep Wijsbegeerte en Moraalwetenschappen van de Vrije Universiteit Brussel. (shrink)

While anonymity is a widely-held goal in research-ethics review policies, it is a virtually unachievable goal in ethnographic and qualitative research. This paper explores how anonymity is undermined in the data-gathering, analysis, and publication stages in ethnography. It also examines problems associated with maintaining a collective identity. What maintains anonymity, however, are the natural accretions of daily life, the underuse of data, and the remoteness of place and time between the gathering-data stage and the eventual publications of findings.

The topic of recognition has come to occupy a central place in debates in social and political theory. Developed by George Herbert Mead and Charles Taylor, it has been given expression in the program for Critical Theory developed by Axel Honneth in his book The Struggle for Recognition. Honneth's research program offers an empirically insightful way of reflecting on emancipatory struggles for greater justice and a powerful theoretical tool for generating a conception of justice and the good that enables the (...) normative evaluation of such struggles. This 2007 volume offers a critical clarification and evaluation of this research program, particularly its relationship to the other major development in critical social and political theory; namely, the focus on power as formative of practical identities proposed by Michel Foucault and developed by theorists such as Judith Butler, James Tully, and Iris Marion Young. (shrink)

This article provides insight into one form of audience involvement with celebrities: parasocial relationships. To address several shortcomings in PSR research – focus on TV, confusion between PSI and PSR, use of student samples, neglect of socio-demographic variables – a representative online survey was conducted with 1000 Flemish adults who indicated 382 celebrities as favorites. A new scale reveals that PSR contain two important elements: emotional connections and an analogy with social relationships. Confirming previous research, most favorite celebrities are male, (...) and cultural proximity is especially important for older respondents. In one combined model, respondents’ and celebrities’ characteristics are included as potential PSR predictors. This model nuances previous research and reveals that people who are male, older, more lowly-educated, and interested in celebrity news have stronger PSR. Further, stronger PSR are found for local and religious, political, sports, and music celebrities than for film celebrities. (shrink)

Andrew Feenberg’s critical theory of technology features a sophisticated analysis of the ways by which social forces influence processes of technological design, production and use. While Feenberg is foremostly read as a critical theorist, this essay argues that his call to democratize technology stands on distinct phenomenological grounds. This is based on the way he illustrates the role of experience in subtending potentials for the progressive transformation of the sociotechnical sphere. Against this background, this essay identifies an important shift in (...) the way Feenberg articulates experience, from relating it to lifelong processes of learning and identity-construction (Bildung) to an emphasis on visceral immediacy (Erlebnis). This shift manifests a newfound focus on material, embodied meanings over-against linguistic ones, and results in a considerable tension between Feenberg’s appeal to experiential self-evidence and his critical position toward technology. The discussion of the two modes of experience exemplifies the current that underlies Feenberg’s work, namely the creation of traffic between ontological and ontic accounts of sociotechnical entities, practices and relations. (shrink)

Information technology is an integral part of the practices and institutions of post-industrial society. It is also a source of hard moral questions and thus is both a probing and relevant area for moral theory. In this volume, an international team of philosophers sheds light on many of the ethical issues arising from information technology, including informational privacy, digital divide and equal access, e-trust and tele-democracy. Collectively, these essays demonstrate how accounts of equality and justice, property and privacy benefit from (...) taking into account how information technology has shaped our social and epistemic practices and our moral experiences. Information technology changes the way that we look at the world and deal with one another. It calls, therefore, for a re-examination of notions such as friendship, care, commitment and trust. (shrink)

We introduce constructive and classical systems for nonstandard arithmetic and show how variants of the functional interpretations due to Gödel and Shoenfield can be used to rewrite proofs performed in these systems into standard ones. These functional interpretations show in particular that our nonstandard systems are conservative extensions of E-HAω and E-PAω, strengthening earlier results by Moerdijk and Palmgren, and Avigad and Helzner. We will also indicate how our rewriting algorithm can be used for term extraction purposes. To conclude the (...) paper, we will point out some open problems and directions for future research, including some initial results on saturation principles. (shrink)

The paper uses the formalism of indexed categories to recover the proof of a standard final coalgebra theorem, thus showing existence of final coalgebras for a special class of functors on finitely complete and cocomplete categories. As an instance of this result, we build the final coalgebra for the powerclass functor, in the context of a Heyting pretopos with a class of small maps. This is then proved to provide models for various non-well-founded set theories, depending on the chosen axiomatisation (...) for the class of small maps. (shrink)

Much clinical and ethnographic evidence suggests that humans, like many other organisms, are selected to avoid close inbreeding because of the fitness costs of inbreeding depression. The proximate mechanism of human inbreeding avoidance seems to be precultural, and to involve the interaction of genetic predispositions and environmental conditions. As first suggested by E. Westermarck, and supported by evidence from Israeli kibbutzim, Chinese sim-pua marriage, and much convergent ethnographic and clinical evidence, humans negatively imprint on intimate associates during a critical period (...) of early childhood.There is also much evidence that, like other social animals, humans do not seek to maximize outbreeding, but rather to maintain an optimal balance between outbreeding and inbreeding.Closeinbreeding reduces fitness through inbreeding depression, butsomeinbreeding brings the benefits of nepotism. For simple, stateless, horticultural societies, the optimal balance seems to be achieved by a combination of precultural inbreeding avoidance of relatives with anr≤·25 and cultural rules of preferential marriage with kin withr≥·25. Adjustment of the coefficient of inbreeding to other ecological settings seems to be largely cultural. An interactive model of “culture in nature” is presented, in which culture is seen as coevolving with genes to produce the maxiniization of individual inclusive fitness. (shrink)

This essay takes Arthur Danto’s end-of-art thesis as a case in point of a substantive philosophy of history. Such philosophy explains the direction that art has taken and why that direction could not have been different. Danto never scrutinized the philosophy of history that his end-of-art thesis presumes. I aim to do that by drawing a distinction between what I refer to as the common view of history and the philosophical view of history, and by arguing that we need the (...) latter if we want to properly assess the plausibility of the end-of-art thesis. (shrink)

Biology in the Critical Philosophy and the Opus postumum Hein van den Berg. Parts of Chap. 2 have been previously published in Hein van den Berg (2011), “ Kant's Conception of Proper Science.” Synthese 183 (1): 7–26. Parts of Chap.

Kant’s teleology as presented in the Critique of Judgment is commonly interpreted in relation to the late eighteenth-century biological research of Johann Friedrich Blumenbach. In the present paper, I show that this interpretative perspective is incomplete. Understanding Kant’s views on teleology and biology requires a consideration of the teleological and biological views of Christian Wolff and his rationalist successors. By reconstructing the Wolffian roots of Kant’s teleology, I identify several little known sources of Kant’s views on biology. I argue that (...) one of Kant’s main contributions to eighteenth-century debates on biology consisted in demarcating biology from metaphysics. Kant rejected Wolffian views on the hierarchy of sciences, according to which propositions specifying the functions of organisms are derived from theological truths. In addition, Kant argued that organic self-organization necessitates a teleological description in order to show that self-organization does not support materialism. By demarcating biology and metaphysics, Kant made a small yet important contribution to establishing biology as a science. (shrink)

Vladimir Solov'ev (1853-1900- is regarded as the most original and systematic of the Russian philosophers in the 19th century. He has once again become the subject of international scholarly attention both in Slavic countries and the West. This volume contains selected papers presented at the international conference on Vladimir Solov'ev held at Nijmegen University, the Netherlands, in September 1998. The scope of this conference was wide-ranging, dealing with theological, metaphysical, philosophical and historical themes. Though Solov'ev's broad intellectual activity defies any (...) strict attempt at categorisation, the editors have classified its major themes under the dual characteristic of reconciliation and polemics. Solov'ev was passionately committed to the reconciliation of all beings under the idea of all-unity, which he attemted to achieve by engaging in uncompromising polemics with his contemporaries, The thirty contributors to this volume are specialists from Russia, Ukraine, Bulgaria, Western Europe and the United States. The volume makes a significant contribution to the intellectual reassesment of Vladimir Solov'ev since the rediscovery of his philosophical heritage in his own homeland in the 1980s. (shrink)

In the first part of the paper an argument is developed to the effect that (1) there is no moral ground for individual persons to feel responsible for or guilty about crimes of their group to which they have in no way contributed; and (2) since there is no irreducibly collective responsibility nor guilt at any time, there is no question of them persisting over time. In the second part it is argued that there is nevertheless sufficient reason for innocent (...) individual members of a group (that persists over time) to take on responsibility and guilt for the evil other (earlier) members have committed. The reason depends on the acceptability of a particular psychological theory of personal identity. (shrink)

The paper is meant to be a contribution to the study of Indian and comparative ethics. It treats the Vajjālaggam, an anthology of Prākrit stanzas (subhāsita literature) dealing with a variety of topics. Focusing on the ‘ethical’ sections of the VL, it tries to describe and analyse its underlying ethical system. In Part I the different ethical themes of the VL (Valour and Destiny, Virtues and Vices, Masters and Servants, Friendship and Affection, Poverty and Charity) are described in detail. In (...) Part II it is shown that the VL. offers a clear example of a virtue ethic with a strong emphasis on self‐regarding virtues (gunas), based on a pluralistic and instrumental theory of the good. The paper also treats the crucial ethical problem of the relationship between personal well‐being and virtuousness as described in the VL. (shrink)

Vaccination programmes against infectious diseases aim to protect individuals from serious illness but also offer collective protection once a sufficient number of people have been immunized. This so-called ‘herd immunity’ is important for individuals who, for health reasons, cannot be immunized or who respond less well to vaccines. For these individuals, it is pivotal that others establish group protection. However, herd immunity can be compromised when people deliberately decide not to be immunized and benefit from the herd’s protection. These agents (...) are often referred to as free riders: their omissions are deemed to be unfair to those who do contribute to the collective’s health. This article addresses the unfairness of such ‘free riding’. An argument by Garett Cullity is examined, which asserts that the unfairness of moral free riding lies neither in one’s intentions, nor in one’s reluctance to embrace a public good. This argument offers a strong basis for justifiably arguing that free riding is unfair. However, it is then argued that other considerations also need to be taken into account before simply holding free riding against non-compliers. (shrink)