Doing research in a globalized context – regardless of the discipline – requires language decisions at different stages of the research process. Many of these language decisions have ethical implications. Existing literature and ethical guidance tend to focus on ethical concerns that arise in communication with participants who use a language different from the main research language. As this article shows, language decisions with potential ethical implications can occur in many additional ways. Two questions guided this work: how do language (...) decisions and research ethics intersect at different stages of the research process, and what potential harm is related to language decisions and how can such concerns be mitigated? Relevant literature – combined with practical research experiences – show that language decisions can potentially result in harm at the conception stage of research projects, when working with participants, during data analysis, interpretation, and dissemination, as well as when managing a research project. Thus, the article highlights that the role of language-related ethical dilemmas is not only organizational (e.g., ensuring participants can understand what the research is about), but also social (e.g., developing trust and relationships in research teams) as well as ideological (e.g., awareness of power structures and diverse worldviews). In order to support researchers in globalized contexts, this article offers a reflective framework that complements regulatory guidance issued by ethical bodies and facilitates a deeper awareness of ethical implications related to language decisions in a multilingual world. (shrink)

Widowhood is common in old age, can be accompanied by serious health consequences and is often linked to substantial changes in social network. Little is known about the impact of social isolation on the development of depressive symptoms over time taking widowhood into account. We provide results from the follow-up 5 to follow-up 9 from the longitudinal study AgeCoDe and its follow-up study AgeQualiDe. Depression was measured with GDS-15 and social isolation was assessed using the Lubben Social Network Scale (LSNS-6). (...) The group was aligned of married and widowed people in old age and education through entropy balancing. Linear mixed models were used to examine the frequency of occurrence of depressive symptoms for widowed and married elderly people depending on the risk of social isolation. Our study shows that widowhood alone does not lead to an increased occurrence of depressive symptoms. However, "widowed oldest old", who are also at risk of social isolation, have significantly more depressive symptoms than those without risk. In the group of "married oldest old", women have significantly more depressive symptoms than men, but isolated and non-isolated do not differ. Especially for people who have lost a spouse, the social network changes significantly and increases the risk for social isolation. This represents a risk factor for the occurrence of depressive symptoms. (shrink)

Im Rahmen des Modellvorhabens „Patienten als Partner—Tumorpatienten und ihr Mitwirken bei medizinischen Entscheidungen“ wurden zwischen März 2002 und August 2003 272 palliativ behandelte Tumorpatienten nach ihrer Einstellung zur Patientenverfügung und zur gewünschten Beteiligung an medizinischen Entscheidungen befragt. Von den Befragten kannten 30% Patientenverfügungen nicht, darunter signifikant mehr Befragte mit formal niedrigerem Bildungsabschluss. Es hatten bereits 11% eine Patientenverfügung abgeschlossen, 22% wollten wahrscheinlich eine abschließen, und 30% wollten keine abschließen. Es fand sich ein statistisch signifikanter Zusammenhang zwischen dem Abschluss einer Patientenverfügung (...) und dem Wunsch nach mehr eigener Entscheidungsverantwortung. Die Einstellung zur Patientenverfügung und der Wunsch nach partizipativer Entscheidungsfindung stehen in keinem statistisch signifikanten Zusammenhang. Patienten mit schriftlichen Vorausverfügungen haben einen erhöhten Kommunikations- und Rückkopplungsbedarf, auf den Ärzte sensibel eingehen sollten. Bei der Information über Patientenverfügungen sollten Menschen mit niedrigerem Bildungsstand mehr als bisher berücksichtigt werden. (shrink)

ZusammenfassungIm Rahmen des Modellvorhabens „Patienten als Partner—Tumorpatienten und ihr Mitwirken bei medizinischen Entscheidungen“ wurden zwischen März 2002 und August 2003 272 palliativ behandelte Tumorpatienten nach ihrer Einstellung zur Patientenverfügung und zur gewünschten Beteiligung an medizinischen Entscheidungen befragt. Von den Befragten kannten 30% Patientenverfügungen nicht, darunter signifikant mehr Befragte mit formal niedrigerem Bildungsabschluss. Es hatten bereits 11% eine Patientenverfügung abgeschlossen, 22% wollten wahrscheinlich eine abschließen, und 30% wollten keine abschließen. Es fand sich ein statistisch signifikanter Zusammenhang zwischen dem Abschluss einer Patientenverfügung (...) und dem Wunsch nach mehr eigener Entscheidungsverantwortung. Die Einstellung zur Patientenverfügung und der Wunsch nach partizipativer Entscheidungsfindung stehen in keinem statistisch signifikanten Zusammenhang. Patienten mit schriftlichen Vorausverfügungen haben einen erhöhten Kommunikations- und Rückkopplungsbedarf, auf den Ärzte sensibel eingehen sollten. Bei der Information über Patientenverfügungen sollten Menschen mit niedrigerem Bildungsstand mehr als bisher berücksichtigt werden. (shrink)

This article discusses the design methodology of the Benedictine monk-architect Dom Hans van der Laan, famous for his manifesto De Architectonische Ruimte, in which he proposed his ideal elementary architecture. In the past, this ideal achitecture was linked to Van der Laan’s proportional system and to his general approach as an architect rather than to his Catholic background. Consequently, the changing conceptual landscape in which he developed his ideas on the relation between religion and design was neglected. Yet, as this (...) article will argue, it is only by carefully exploring the relation between Van der Laan’s attempts to define a fundamental architecture and his ambition to understand the religious traditions they may have sprung from that one can understand how his religion and design methodology influenced each other. Based on unedited primary sources, this article reveals forgotten interconnections between Van der Laan’s religious and architectural thinking. By analysing these motifs, it offers new insights on the interrelationships between religion and architecture that go beyond the traditionalist-modernist dichotomy. (shrink)

Abstract‘Social inclusion’ is the leading ideal in services and care for people with intellectual disabilities in most countries in the Global North. ‘Social inclusion’ can refer simply to full equal rights, but more often it is taken to mean something like ‘community participation’. This narrow version of social inclusion has become so ingrained that it virtually goes unchallenged. The presumption appears to be that there is a clear moral consensus that this narrow understanding of social inclusion is good. However, that (...) moral consensus is not clear in the case of people with profound intellectual and/or multiple disabilities (PIMD), who are not able to express their needs and preferences verbally. Moreover, social inclusion has proven to be difficult to conceptualize and implement for people with PIMD. Therefore, it becomes imperative to ask about the ethical rationale of the narrow understanding of social inclusion. For what reasons do we think social inclusion is good? And do those reasons also apply for people with PIMD? This article addresses these questions by providing an ethical analysis of the ideal of social inclusion for people with PIMD. It discusses four ethical arguments for social inclusion and probes their relevance for people with PIMD. The article argues that none of these arguments fully convince of the value of the narrow understanding of social inclusion for people with PIMD. It ends with advocating for an ethical space for imagining a good life for people with PIMD otherwise. (shrink)

Nelson Goodman’s attempt to analyse the expressiveness of artworks in semantic terms has been widely criticised. In this paper I try to show how the use of an adapted version of his concept of exemplification, as proposed by Mark Textor, can help to alleviate the worst problems with his theory of expression. More particularly I argue that the recognition of an intention, which is central to Textor’s account of exemplification, is also fundamental to our understanding of expressiveness in art. Moreover (...) I propose that the recognition of this intention depends on our interpretation of the artwork – an insight Goodman tried to capture with his assertion that our attributions of expressive properties to artworks function metaphorically. The realisation of the context-dependence of our expressive judgements about art and, hence, of the central role interpretation plays in these judgements, I contend, counts in favour of theories of expression like Goodman’s that focus on semantic concerns. (shrink)

The Russian invasion of Ukraine on February 24, 2022, has already caused large amounts of greenhouse gas (GHG) emissions and will continue to do so for manyyears after hostilities have ceased mainly because of the emissions linked to the rebuilding of destroyed or damaged housing, public buildings, infrastructure, factories, and the like. My aim in this paper is to discuss how in a time of climate emergency such emissions of war should impact the political morality of states initiating, continuing, and (...) ending war (through a just and enduring peace) as understood by just war theory (JWT). My point of departure is a study by Lennard de Klerk and six co-authors detailing the emissions of the first year of the Russo-Ukrainian war. (shrink)

Route memory is frequently assessed in virtual environments. These environments can be presented in a fully controlled manner and are easy to use. Yet they lack the physical involvement that participants have when navigating real environments. For some aspects of route memory this may result in reduced performance in virtual environments. We assessed route memory performance in four different environments: real, virtual, virtual with directional information (compass), and hybrid. In the hybrid environment, participants walked the route outside on an open (...) field, while all route information (i.e., path, landmarks) was shown simultaneously on a handheld tablet computer. Results indicate that performance in the real life environment was better than in the virtual conditions for tasks relying on survey knowledge, like pointing to start and end point, and map drawing. Performance in the hybrid condition however, hardly differed from real life performance. Performance in the virtual environment did not benefit from directional information. Given these findings, the hybrid condition may offer the best of both worlds: the performance level is comparable to that of real life for route memory, yet it offers full control of visual input during route learning. (shrink)

This article investigates how companies make sense of CSR. It is based on an explorative comparative case study of 18 companies in the Netherlands using background information, interviews and annual reports. Initially, the sensemaking process of CSR is guided and coordinated by change agents who are specifically appointed to explore the implementation of CSR in their company. These change agents initiate the CSR process within their own organisations. The meaning they develop stems from their personal and organisational values and frames (...) of reference. By attuning the vocabulary of CSR to the language of their colleagues, they aim to gain support for this undertaking in their organisation. This sensemaking procedure can be divided into pragmatic, external, procedural, policy‐oriented and value‐driven processes. The capability of an organisation to embed CSR is the result of trial and error, personal preferences and the use of language by the change agent that fits the (dynamic) situation at hand. Thus, each organisation needs a tailor‐made approach to implement CSR successfully. (shrink)

This chapter contains sections titled: Law Morality From Morality to Law From Law to Morality Converging Law and Morality Diverging Law and Morality: Beyond the Liberal Model References Further reading.

To understand pre-Fregean theories of judgment and proposition, such as those found in Locke and the Port-Royal logic, it is important to distinguish between propositions in the modern sense and propositions in the pre-Fregean sense. By making this distinction it becomes clear that these pre-Fregean theories cannot be meant to solve the propositional attitude problem. Notwithstanding this fact, Locke and Arnauld are able to make a distinction between asserted and unasserted propositions (in their sense). The way Locke makes this distinction (...) turns out to be very different from the way it is made by Arnauld. (shrink)

We propose an epistemic logic in which knowledge is fully introspective and implies truth, although truth need not imply epistemic possibility. The logic is presented in sequential format and is interpreted in a natural class of partial models, called balloon models. We examine the notions of honesty and circumscription in this logic: What is the state of an agent that 'only knows φ' and which honest φ enable such circumscription? Redefining stable sets enables us to provide suitable syntactic and semantic (...) criteria for honesty. The rough syntactic definition of honesty is the existence of a minimal stable expansion, so the problem resides in the ordering relation underlying minimality. We discuss three different proposals for this ordering, together with their semantic counterparts, and show their effects on the induced notions of honesty. (shrink)

Swords turning into ploughshares is not peace – Peace (שָׁלֹום) in Isaiah 40−44. ‘Swords being turned into ploughshares’ are often portrayed as being tantamount to peace. Peace though has got a more extensive meaning than only the absence of war. Whilst war and destruction is on the forefront in Isaiah 1–39, the opposite is true in Isaiah 40–66. The intention of this article is therefore to demonstrate the extensive meaning of peace (שָׁלֹום) as it unfolds as a motive in Isaiah (...) 40–66. Because of a lack of space, only the first three passages directly mentioning שָׁלֹום [peace] will be discussed. Even though this discussion will be incomplete, it will reveal that peace is not part of man’s normal state, that not everyone will experience peace and that there is a direct link between peace and the rule of God. (shrink)

Ernest Mandel theorised the capitalist world economy as an articulated system of capitalist, semi-capitalist and precapitalist relations of production, linked to each other by capitalist relations of exchange and domination by the capitalist world market. This seems to be an interesting starting point for an historically well-founded theory, building on and going beyond Marx's work, of the worldwide expansion of the capitalist mode of production from its origins to the present. In his attempt to formulate his theory, Mandel did not (...) succeed in resolving all difficulties, however. His main works – Marxist Economic Theory and Late Capitalism – show a number of dangling loose ends. The central question is whether these loose ends are merely technical difficulties or whether they reveal fatal flaws in the theory as a whole. In order to come a step closer to answering this question, a conference was organised in Amsterdam, November 2003. This introduction formulates the five, closely interrelated issues that were highlighted at this conference. (shrink)

Masters Thesis -- Stellenbosch University, 2019.

As humans, we frequently engage in mental time travel, reliving past experiences and imagining possible future events. This study examined whether similar factors affect the subjective experience associated with remembering the past and imagining the future. Participants mentally “re-experienced” or “pre-experienced” positive and negative events that differed in their temporal distance from the present , and then rated the phenomenal characteristics associated with their representations. For both past and future, representations of positive events were associated with a greater feeling of (...) re-experiencing than representations of negative events. In addition, representations of temporally close events contained more sensorial and contextual details, and generated a stronger feeling of re-experiencing than representations of temporally distant events. It is suggested that the way we both remember our past and imagine our future is constrained by our current goals. (shrink)

Human cognition is unique in the way in which it relies on combinatorial (or compositional) structures. Language provides ample evidence for the existence of combinatorial structures, but they can also be found in visual cognition. To understand the neural basis of human cognition, it is therefore essential to understand how combinatorial structures can be instantiated in neural terms. In his recent book on the foundations of language, Jackendoff described four fundamental problems for a neural instantiation of combinatorial structures: the massiveness (...) of the binding problem, the problem of 2, the problem of variables, and the transformation of combinatorial structures from working memory to long-term memory. This paper aims to show that these problems can be solved by means of neural “blackboard” architectures. For this purpose, a neural blackboard architecture for sentence structure is presented. In this architecture, neural structures that encode for words are temporarily bound in a manner that preserves the structure of the sentence. It is shown that the architecture solves the four problems presented by Jackendoff. The ability of the architecture to instantiate sentence structures is illustrated with examples of sentence complexity observed in human language performance. Similarities exist between the architecture for sentence structure and blackboard architectures for combinatorial structures in visual cognition, derived from the structure of the visual cortex. These architectures are briefly discussed, together with an example of a combinatorial structure in which the blackboard architectures for language and vision are combined. In this way, the architecture for language is grounded in perception. Perspectives and potential developments of the architectures are discussed. Key Words: binding; blackboard architectures; combinatorial structure; compositionality; language; dynamic system; neurocognition; sentence complexity; sentence structure; working memory; variables; vision. (shrink)

In a range of contexts, one comes across processes resembling inference, but where input propositions are not in general included among outputs, and the operation is not in any way reversible. Examples arise in contexts of conditional obligations, goals, ideals, preferences, actions, and beliefs. Our purpose is to develop a theory of such input/output operations. Four are singled out: simple-minded, basic (making intelligent use of disjunctive inputs), simple-minded reusable (in which outputs may be recycled as inputs), and basic reusable. They (...) are defined semantically and characterised by derivation rules, as well as in terms of relabeling procedures and modal operators. Their behaviour is studied on both semantic and syntactic levels. (shrink)

This paper is on the update semantics for might of Veltman. Threeconsequence relations are introduced and studied in an abstract setting.Next we present sequent-style systems for each of the consequence relations.We show the logics to be complete and decidable. The paper ends with asyntactic cut elimination result.

The contention in this paper is that the theological-political disputes Spinoza was concerned with 350 years ago are similar to the conspiratorial disputes we experience today. The world in Spinoza’s Tractatus theologico-politicus, a political intervention in his time, serves as a “mirror image”, that is to say, it deals with the same problem we face today albeit in a different mode. Understanding our contemporary condition under the auspices of a Spinozist perspective, problems in countermeasures to the conspiratorial disputes come to (...) light. Scholarly work and practice focus on the epistemological dimension of conspiracy theories, tying in the extent to which they are problematic to the degree in which they deal in untruth. However, the lesson from Spinoza’s analysis of the theological-political disputes is that such theories do not deal in truth, but, in affect, they do not spring from a lack of education but a lack of certainty. The work of Spinoza opens up a different approach, and if our aim is like that of the TTP, to defend political life against the threat of civil war, such a different approach is in order. (shrink)

In this thesis, I investigate realist, anti-realist and pluralist views in the philosophy of science and the philosophy of complexity. The philosophy of science can inform the philosophy of complexity and vice versa because we can consider scientific inquiry to largely involve the study of complex systems. I however find that the relevant realist, anti-realist and pluralist views are problematic in various ways, and that a version of pragmatism suggests a promising alternative. This version of pragmatism incorporates elements of pluralism, (...) but maintains a commitment to epistemic hierarchy, convergence and progress. The way to develop such a version of pragmatism is, I argue, by rebooting William Whewell’s 19th century philosophy of science. Whewell however held to the following two transcendental claims: 1. Empirical inquiry undertaken in science properly practiced can reveal necessary truths. 2. The revelation of such necessary truths grants us a glimpse of the mind of God. Such transcendental claims are obviously at odds with pragmatism. There are however core features of Whewell’s view that are notably pragmatist in nature, features that explicitly inspired Charles Sanders Piece’s convergent pragmatism. These are as follows: 3. Subject and object (or mind and world) are inextricably entwined during scientific inquiry; they are not separated by anything like a correspondence relationship. 4. Science progresses via what Whewell calls the consilience of inductions (an ongoing merging of scientific theories, a merging that increases our understanding of the world over time). I modify Whewell’s view by stripping away its transcendental elements while maintaining its pragmatist elements. What remains is, I argue, a robust and novel kind of pragmatism suitable for being introduced into the contemporary philosophy of science. Whewell suitably-pragmatised can offer new insights into ongoing debates, particularly those around the nature of scientific progress, scientific truth and scientific understanding. (shrink)

The notion of cognitive act is of importance for an epistemology that is apt for constructive type theory, and for epistemology in general. Instead of taking knowledge attributions as the primary use of the verb 'to know' that needs to be given an account of, and understanding a first-person knowledge claim as a special case of knowledge attribution, the account of knowledge that is given here understands first-person knowledge claims as the primary use of the verb 'to know'. This means (...) that a cognitive act is an act that counts as cognitive from a first-person point of view. The method of linguistic phenomenology is used to explain or elucidate our epistemic notions. One of the advantages of the theory is that an answer can be given to some of the problems in modern epistemology, such as the Gettier problem. (shrink)

In a range of contexts, one comes across processes resembling inference, but where input propositions are not in general included among outputs, and the operation is not in any way reversible. Examples arise in contexts of conditional obligations, goals, ideals, preferences, actions, and beliefs. Our purpose is to develop a theory of such input/output operations. Four are singled out: simple-minded, basic (making intelligent use of disjunctive inputs), simple-minded reusable (in which outputs may be recycled as inputs), and basic reusable. They (...) are defined semantically and characterised by derivation rules, as well as in terms of relabeling procedures and modal operators. Their behaviour is studied on both semantic and syntactic levels. (shrink)

Sound and complete axiomatizations are provided for a number of different logics involving modalities for the knowledge of multiple agents and operators for branching time, extending previous work of Halpern, van der Meyden and Vardi [to appear, SIAM Journal on Computing] for logics of knowledge and linear time. The paper considers the system constraints of synchrony, perfect recall and unique initial states, which give rise to interaction axioms. The language is based on the temporal logic CTL*, interpreted with respect to (...) a version of the bundle semantics. (shrink)

Background Notwithstanding the need to produce evidence-based knowledge on medications for pregnant women, they remain underrepresented in clinical research. Sometimes they are excluded because of their supposed vulnerability, but there are no universally accepted criteria for considering pregnant women as vulnerable. Our aim was to explore whether and if so to what extent pregnant women are vulnerable as research subjects. Method We performed a conceptual and empirical analysis of vulnerability applied to pregnant women. Analysis A conceptual analysis supports Hurst's definition (...) of vulnerability. Consequently, we argue that pregnant women are vulnerable if they encounter an identifiably increased likelihood of incurring additional or greater wrong. According to the literature, this increased likelihood could exist of four alleged features for pregnant women's vulnerability: informed consent, susceptibility to coercion, higher exposure to risk due to lack of knowledge, vulnerability of the fetus. Discussion Testing the features against Hurst's definition demonstrates that they all concern the same issue: pregnant women are only vulnerable because a higher exposure to risk due to lack of scientific knowledge comprises an increased wrong. Research Ethics Committees have a responsibility to protect the vulnerable, but a higher exposure to risk due to lack of scientific knowledge is a much broader issue and also needs to be addressed by other stakeholders. Conclusions The only reason why pregnant women are potentially vulnerable is to the extent that they are increasingly exposed to higher risks due to a lack of scientific knowledge. Accordingly, the discussion can advance to the development of practical strategies to promote fair inclusion of pregnant women in clinical research. (shrink)

The concept of meaningful work is used to evaluate the quality of work. Typical cases of meaningless work that have been used to clarify this concept are assembly line work, and work involving other types of mindless tasks, but also David Graeber's ‘bullshit jobs’. I argue that there are at least two fundamental reasons to care about meaningful work: reasons from the wellbeing of the worker and reasons pertaining to meaningfulness of the worker's life. I first argue that a concept (...) of meaningful work needs to reflect these two values, but that these two values may come apart. Because of this, accounts that provide a single answer to the question to what extent a particular work context is meaningful work for a particular worker are unable to reflect these two values. I then survey three promising accounts of meaningful work: perfectionism, which captures the self-interested aspect of meaningful work well but fails to capture the meaningfulness aspect appropriately; consequentialism, which captures the meaningfulness aspect well but fails to capture the self-interested aspect; and Wolf's Fitting Fulfilment View of meaningful projects, which can be read as addressing both concerns but leads to implausible judgments about meaningful work. I then argue that we should conceive of the concerns that fall under the notion of meaningful work as two separate concepts and values. The best work incorporates both these dimensions but falling short on either dimension is problematic for different reasons. (shrink)

There is a growing body of literature on ethical or socially responsible investment across a range of disciplines. This paper highlights the key themes in the field and identifies some of the major theoretical and practical challenges facing both scholars and practitioners. One of these challenges is understanding better the complexity of the relationship between such investment practices and corporate behaviour. Noting that ethical investment is seldom characterised by agreement about what it actully constitutes, and that much of the extant (...) research focuses on a narrow set of issues, the paper argues that there are benefits associated with examining ethical investment as a process. (shrink)

The philosophical aspects of Greek medicine are now more widely appreciated, not only by historians of science and medicine but also by students of philosophy in a more narrow sense. There has also been a greater appreciation of the fact that Greek medical writers not only reflect a derivative awareness of developments in philosophy but that they also actively contributed to the formation of philosophical thought more strictly defined, for instance by developing concepts and methodologies for the acquisition of knowledge (...) and understanding. Yet the consequences of this for a renewed study of the formation of Greek philosophy have yet to be drawn; and disciplinary boundaries between historians of medicine on the one hand and philosophers and historians of philosophy on the other still pose obstacles to an integrated account of Greek thought that takes on board the contributions by the medical writers. Some preliminary remarks may therefore be in order. (shrink)

We analyze the cognitive strategies underlying performance in the Number task, a Math game that requires both arithmetic fluency and mathematical creativity. In this game all elements in a set of numbers have to be used precisely once to create a target number with basic arithmetic operations. We argue that some instances of this game are NP complete, by showing its relation to the well-known Partition problem. We propose heuristics based on the distinction in forward and backward reasoning. The Number (...) Game is part of Math Garden, a popular online educational platform for practicing and monitoring math skills using innovations in computerized adaptive testing. These educational games generate enormous amounts of rich data on children's cognitive development. We found converging evidence for the use of forward proximity heuristics in the data of Math Garden, consisting of more than 20 million answers to 1,700 items. Item difficulties and the structure of correct answers were analyzed. (shrink)

In this paper, we examine the relationship between Christian religiosity, attitudes towards corporate social responsibility, and CSR behavior of executives. We distinguish four types of CSR attitudes and five types of CSR behavior. Based on empirical research conducted among 473 Dutch executives, we find that CSR attitudes mediate the influence of religiosity on CSR behavior. Intrinsic religiosity positively affects the ethical CSR attitude and negatively affects the financial CSR attitude, whereas extrinsic religiosity stimulates the philanthropic CSR attitude. Financial, ethical, and (...) philanthropic CSR attitudes significantly affect some types of CSR behaviors. However, because religiosity has opposing effects on the three attitudes, the joint mediation effect of the three attitudes is negligible. Furthermore, we find a direct negative influence of intrinsic religiosity on diversity and a direct positive influence on charity. (shrink)

There is ambiguity with regard to what counts as an acceptable level of risk in clinical research in pregnant women and there is no input from stakeholders relative to such research risks. The aim of our paper was to explore what stakeholders who are actively involved in the conduct of clinical research in pregnant women deem an acceptable level of risk for pregnant women in clinical research. Accordingly, we used the APOSTEL VI study, a low-risk obstetrical randomised controlled trial, as (...) a case-study. We conducted a prospective qualitative study using 35 in-depth semi-structured interviews and one focus group. We interviewed healthcare professionals, Research Ethics Committee members and regulators who are actively involved in the conduct of clinical research in pregnant women, in addition to pregnant women recruited for the APOSTEL VI case-study in the Netherlands. Three themes characterise the way stakeholders view risks in clinical research in pregnant women in general. Additionally, one theme characterises the way healthcare professionals and pregnant women view risks with respect to the case-study specifically. First, ideas on what constitutes an acceptable level of risk in general ranged from a preference for zero risk for the foetus up to minimal risk. Second, the desirability of clinical research in pregnant women in general was questioned altogether. Third, stakeholders proposed to establish an upper limit of risk in potentially beneficial clinical research in pregnant women in order to protect the foetus and the pregnant woman from harm. Fourth and finally, the case-study illustrates that healthcare professionals’ individual perception of risk may influence recruitment. Healthcare professionals, RECs, regulators and pregnant women are all risk adverse in practice, possibly explaining the continuing underrepresentation of pregnant women in clinical research. Determining the acceptable levels of risk on a universal level alone is insufficient, because the individual perception of risk also influences behaviour towards pregnant women in clinical research. Therefore, bioethicists and researchers might be interested in changing the perception of risk, which could be achieved by education and awareness about the actual benefits and harms of inclusion and exclusion of pregnant women. (shrink)

Fabi and Goldberg have helpfully shed some light on the wrongs perpetuated by the current funding architecture on research, sponsorship, and career development in the field of bioethics. The...

In most Western countries, health law bioethics are strongly intertwined. This strong connection is the result of some specific factors that, in the early years of these disciplines, facilitated a rapid development of both. In this paper, I analyse these factors and construe a development theory existing of three phases, or ideal‐typical models. In the moralistic‐paternalistic model, there is almost no health law of explicit medical ethics and the little law there is is usually based on traditional morality, combined with (...) paternalist motives, the objections to this modal are that its paternalism and moralism are unacceptable, that it is too static and knows no external control mechanisms. In the liberal model, which is now dominant on most Western countries, law and ethics closely cooperate and converge, both disciplines use the same framework for analysis: they are product‐oriented rather than practice‐oriented; they use the same conceptual categories, they focus on the minimally decent rather than the ideal, and they are committed to the same substantive normative theory in which patient autonomy and patient rights are central. However, each of these four characteristics also result in a certain one‐sidedness. In some countries, a third model is emerging. In this postliberal model, health law is more modest and acknowledges its inherent and normative limits, whereas ethics takes a richer and most ambitious self image. As a result health law and ethics will partly diverge again. (shrink)