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)

Two areas of research for testing Nell's theory are suggested. One is cruelty's seemingly negative correlation with age, which would confirm its linkage with testosterone, sex, and dominance. The other is the special field of leisure activity called thanatourism, that is, the transformation of loci of human horror into tourist attractions.

Two areas of research for testing Nell's theory are suggested. One is cruelty's seemingly negative correlation with age, which would confirm its linkage with testosterone, sex, and dominance. The other is the special field of leisure activity called thanatourism, that is, the transformation of loci of human horror into tourist attractions.

Nothing is gained by opposing and or by proclaiming the supremacy of one over the other. Instead, we should develop a unitary model of gene-culture coevolution, allowing for the complex interaction of both, and varying importance of each, all within our double, species-specific, adaptive, evolutionary track.

Chervenak and McCullough, authors of the most acknowledged ethical framework for maternal–fetal surgery, rely on the ‘ethical–obstetrical’ concept of the fetus as a patient in order to determine what is morally owed to fetuses by both physicians and the women who gestate them in the context of prenatal surgery. In this article, we reconstruct the argumentative structure of their framework and present an internal criticism. First, we analyse the justificatory arguments put forward by the authors regarding the moral status of (...) the fetus qua patient. Second, we discuss the internal coherence and consistency of the moral obligations those authors derive from that concept. We claim that some of the dilemmas their approach is purported to avoid, such as the debate about the independent moral status of the fetus, and the foundation of the moral obligations of pregnant women (towards the fetuses they gestate) are not, all things considered, avoided. Chervenak and McCullough construct the obligations of physicians as obligations towards entities with equal moral status. But, at the same time, they assume that the woman has an independent moral status while the moral status of the fetus is dependent on the decision of the woman to present it to a physician for care. According to the logic of their own argumentation, Chervenak and McCullough implicitly admit a different moral status of the woman and the fetus, which will lead to different ascription of duties of the physician than those they ascribed. (shrink)

This article focuses on maternal-fetal surgery (MFS) and on the concept of clinical equipoise that is a widely accepted requirement for conducting randomized controlled trials (RCT). There are at least three reasons why equipoise is unsuitable for MFS. First, the concept is based on a misconception about the nature of clinical research and the status of research subjects. Second, given that it is not clear who the research subject/s in MFS is/are, if clinical equipoise is to be used as a (...) criterion to test the ethical appropriateness of RCT, its meaning should be unambiguous. Third, because of the multidisciplinary character of MFS, it is not clear who should be in equipoise. As a result, we lack an adequate criterion for the ethical review of MFS protocols. In our account, which is based on Chervenak and McCullough's seminal work in the field of obstetric ethics, equipoise is abandoned. and RCT involving MFS can be ethically initiated when a multidisciplinary ethics review board (ERB), having an evidence-based assessment of the risks involved, is convinced that the value of answering the research hypothesis, for the sake of the health interests of future pregnant women carrying fetuses with certain congenital birth defects, justifies the actual risks research participants might suffer within a set limit of low/manageable. (shrink)

Patient-reported outcomes are frequently used for medical decision making, at the levels of both individual patient care and healthcare policy. Evidence increasingly shows that PROs may be influenced by patients’ response shifts and dispositions. We identify how response shifts and dispositions may influence medical decisions on both the levels of individual patient care and health policy. We provide examples of these influences and analyse the consequences from the perspectives of ethical principles and theories of just distribution. If influences of response (...) shift and disposition on PROs and consequently medical decision making are not considered, patients may not receive optimal treatment and health insurance packages may include treatments that are not the most effective or cost-effective. We call on healthcare practitioners, researchers, policy makers, health insurers, and other stakeholders to critically reflect on why and how such patient reports are used. (shrink)

BackgroundObtaining informed consent for intravenous thrombolysis in acute ischemic stroke can be challenging, and little is known about if and how the informed consent procedure is performed by neurologists in clinical practice. This study examines the procedure of informed consent for intravenous thrombolysis in acute ischemic stroke in high-volume stroke centers in the Netherlands.MethodsIn four high volume stroke centers, neurology residents and attending neurologists received an online questionnaire concerning informed consent for thrombolysis with tissue-type plasminogen activator (tPA). The respondents were (...) asked to report their usual informed consent practice for tPA treatment and their considerations on whether informed consent should be obtained.ResultsFrom the 203 invited clinicians, 50% (n = 101) completed the questionnaire. One-third of the neurology residents (n = 21) and 21% of the neurologists (n = 8) reported that they always obtain informed consent for tPA treatment. If a patient is not capable of providing informed consent, 30% of the residents (n = 19) reported that they start tPA treatment without informed consent. In these circumstances, 53% of the neurologists (n = 20) reported that the resident under their supervision would start tPA treatment without informed consent. Most neurologists (n = 21; 55%) and neurology residents (n = 45; 72%) obtained informed consent within one minute. None of the respondents used more than five minutes for informed consent. Important themes regarding obtaining informed consent for treatment were patients’ capacity, and medical, ethical and legal considerations.ConclusionThe current practice of informed consent for thrombolysis in acute ischemic stroke varies among neurologists and neurology residents. If informed consent is obtained, most clinicians stated to obtain informed consent within one minute. In the future, a shortened information provision process may be applied, making a shift from informed consent to informed refusal, while still considering the patient’s capacity, stroke severity, and possible treatment delays. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Herman Daly’s Economics for a Full World: His Life and Ideas by Peter VictorJeroen Van Den Bergh (bio)Victor, Peter (2022). Herman Daly’s Economics for a Full World: His Life and Ideas. Routledge, Oxon UK and New York USA (ISBN: 978–0–367-55694-5).Herman Daly (1938–2022) spent a lifetime thinking about how to achieve a sustainable economy. In an inclusive biography, Canadian economist and environmental scientist Peter Victor discusses his ideas, (...) critiques and debates with others, while clarifying his motivations and struggles. Daly has greatly influenced others, as reflected by numerous prizes awarded to him. This influence is confirmed by original text boxes in the book that contain statements of many colleagues about his work and person, obtained through a questionnaire survey by the author.As a young man, Daly decided to study economics as he imagined it combined humanities and science. He was disappointed in it being less scientific than hoped, but his environmental concern motivated him to work on reestablishing the foundations of the field in environmental science and ethics. Daly is best known for his critique of economic growth and his alternative of the “steady-state economy.” He contributed, however, many other novel concepts and ideas during his lifetime, such as the ends-means spectrum, empty vs full world, uneconomic growth and optimal scale.Victor explains these ideas in a calm pace, showing a deep knowledge of Daly’s work. He, moreover, is able to connect it to ongoing sustainability research. He does all this in the course of thirteen chapters, covering Daly’s early life, education and career, his views on economics, his personal philosophy and the role of religion, his proposal for a steady-state economy, and his opinions on economic growth, population and migration, money and banking, and the perils of trade. [End Page 117]Ultimate endsMany consider Herman Daly to be a heterodox and even heretic economist. He associates himself with ecological economics, the field he co-founded. But while some of his ideas seem radical, many of his core proposals do not deviate substantially from mainstream economics. For instance, his “ultimate ends” concept is perfectly consistent with the broad notion of “welfare” in standard economics. In line with this, many welfare economists—such as Samuelson (1961), Mishan (1967), Hirsch (1976), Sen (1976), Scitovsky (1976) and Frank (1985)—have expressed themselves as critical of GDP (gross domestic product) dominance and growthmania (van den Bergh 2009). In fact, neoclassical economics is not married to economic growth—this is more the empirical side of macroeconomics. While Daly recognizes these subtleties, some of his followers do not.Daly sees his Protestant religion as delivering the ultimate ends, but Victor notes that this has not led to concrete suggestions. Ultimate ends based in Christian religion may be motivated by the promise of eternal (after)life, which in effect means gratifying selfish preferences. Instead, a humanistic perspective—which Daly also seems to embrace—would stress solidarity with future generations and a bioethical view of solidarity with other species. These distinct viewpoints, combined with diversity of human preferences and experiences, suggest that it will be difficult if not impossible for democratic societies to agree upon ultimate means.The Index of Sustainable Economic Welfare (ISEW), a kind of greened or sustainable GDP metric, is Daly’s most concrete elaboration of ultimate means (Daly and Cobb 1989). For many OECD (Organization for Economic Cooperation and Development) countries, it indicates a stabilization of welfare, despite continued GDP growth (Lawn 2003; Posner and Costanza 2011). As clarified by Victor, The ISEW remains close to GDP, produces a monetary measure, has a simple and transparent calculation method, and received considerably attention from theoretical and empirical angles. In view of this, it may well represent the best candidate for a beyond-GDP metric that can replace the GDP. What urgently fails is an effective institutional procedure to achieve its widespread adoption (van den Bergh 2022).Religion, evolution and biodiversityDaly’s religious standpoint make him skeptical of the modern scientific worldview which regards the world to be governed by materialism and evolution, with no role for a higher purpose or an ultimate end. This led him... (shrink)

In the present study it has been examined how children?s creative writing tasks may contribute to teachers? understanding of children?s values. Writings of 300 elementary school children about what they would do if they were the boss of The Netherlands were obtained and seemed to reflect different types of values. Most children were concerned with charity. Also, writings concerned materialist values and socio?political topics, such as human rights, power and tolerance. Analyses of group?specific differences showed girls to write more about (...) charity and health when compared to boys. Children from low socio?economic backgrounds wrote less about environmental issues compared to children from middle and high socio?economic backgrounds. Children from ethnic minority backgrounds who wrote more about obtaining goods for themselves and less about environmental issues than Dutch?origin children. In addition, age differences were found in line with an increase in social and moral development. These differences are discussed in light of differential socialisation practices. (shrink)

Between 7 June and 10 June 1979, the first elections of the representatives of the European Parliament by direct universal suffrage will be held in all the Member States of the European Community.Within that period, the elections shall be held on a date fixed by each Member State. The electoral procedure, except for the common provisions of the annexed Act to the Council Decision on directelections of 20 September 1976, shall be governed in each Member State by its national procedures. (...) There will be nine parallel national elections. The Council Decision and the annexed Act of 20 September 1976 are considered in retrospect and then analysed, as are the national electoral laws, which will be used for the European elections in the different Member States. Their mutual differences and contradictions are discussed.Changes from the electoral procedure in use for national elections are traced. Broadly speaking, one of the aims of the article is to show that the potential influence of an individual vote of a «European citizenl» on the composition of the European Parliament wilt differ considerably from one Member State to another.In the closing remarks, the European elections are put into the perspective of furthering the democratisation of the European Communities. (shrink)