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)

This article discusses the relation between environment and participation in the context of different stages of political modernisation. We focus on the dynamics of environmental policy on the one hand, and the organisation of political participation on the other. The central argument is that participation is inextricably linked to environmental issues, but that their relation differs substantially over the various stages of the institutionalisation of environmental policy. While in the 1970s supplementary forms of participation dominated, the societalisation and marketisation of (...) environmental policies from the late 1980s has given rise to new opportunities for participation, implying a more rule-altering potential. (shrink)

BackgroundThe Netherlands is one of the few countries where euthanasia is legal under strict conditions. This study investigates whether Dutch newspaper articles use the term ‘euthanasia’ according to the legal definition and determines what arguments for and against euthanasia they contain.MethodsWe did an electronic search of seven Dutch national newspapers between January 2009 and May 2010 and conducted a content analysis.ResultsOf the 284 articles containing the term ‘euthanasia’, 24% referred to practices outside the scope of the law, mostly relating to (...) the forgoing of life-prolonging treatments and assistance in suicide by others than physicians. Of the articles with euthanasia as the main topic, 36% described euthanasia in the context of a terminally ill patient, 24% for older persons, 16% for persons with dementia, and 9% for persons with a psychiatric disorder. The most frequent arguments for euthanasia included the importance of self-determination and the fact that euthanasia contributes to a good death. The most frequent arguments opposing euthanasia were that suffering should instead be alleviated by better care, that providing euthanasia can be disturbing, and that society should protect the vulnerable.ConclusionsOf the newspaper articles, 24% uses the term ‘euthanasia’ for practices that are outside the scope of the euthanasia law. Typically, the more unusual cases are discussed. This might lead to misunderstandings between citizens and physicians. Despite the Dutch legalisation of euthanasia, the debate about its acceptability and boundaries is ongoing and both sides of the debate are clearly represented. (shrink)

Patients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Yet these patients have shown to survive sometimes for decades. The role of the families is thought to be important. The aim of this study was to make an inventory of the professional perspective on conflicts in long-term (...) care of patients in VS/UWS. A qualitative study of transcripts on 2 Moral Deliberations (MD’s) in 2 cases of patients in VS/UWS in long-term care facilities. Six themes emerged: 1) Vision on VS/UWS; 2) Treatment and care plan; 3) Impact on relationships; 4) Feelings/attitude; 5) Communication; 6) Organizational aspects. These themes are related to professionals and to what families had expressed to the professionals. We found conflicts as well as contradictory feelings and thoughts to be a general feature in 4 of these themes, both in professionals and families. Conflicts were found in several actors: within families concerning all 6 themes, in nurse teams concerning the theme treatment and care plan, and between physicians concerning all 6 themes. Different visions, different expectations and hope on recovery, deviating goals and contradictory feelings/thoughts in families and professionals can lead to conflicts over a patient with VS/UWS. Key factors to prevent or solve such conflicts are a carefully established diagnosis, clarity upon visions, uniformity in treatment goals and plans, an open and empathic communication, expertise and understanding the importance of contradictory feelings/thoughts. Management should bridge conflicts and support their staff, by developing expertise, by creating stability and by facilitating medical ethical discourses. Shared compassion for the patient might be a key to gain trust and bridge the differences from non-shared to shared decision making. (shrink)

Within current debates about the future impact of Artificial Intelligence on human society, roughly three different perspectives can be recognised: the technology-centric perspective, claiming that AI will soon outperform humankind in all areas, and that the primary threat for humankind is superintelligence; the human-centric perspective, claiming that humans will always remain superior to AI when it comes to social and societal aspects, and that the main threat of AI is that humankind’s social nature is overlooked in technological designs; and the (...) collective intelligence-centric perspective, claiming that true intelligence lies in the collective of intelligent agents, both human and artificial, and that the main threat for humankind is that technological designs create problems at the collective, systemic level that are hard to oversee and control. The current paper offers the following contributions: a clear description for each of the three perspectives, along with their history and background; an analysis and interpretation of current applications of AI in human society according to each of the three perspectives, thereby disentangling miscommunication in the debate concerning threats of AI; and a new integrated and comprehensive research design framework that addresses all aspects of the above three perspectives, and includes principles that support developers to reflect and anticipate upon potential effects of AI in society. (shrink)

BackgroundResearch ethics committees (RECs) are tasked to assess the risks and the benefits of a trial. Currently, two procedure-level approaches are predominant, the Net Risk Test and the Component Analysis.DiscussionBy looking at decision studies, we see that both procedure-level approaches conflate the various risk-benefit tasks, i.e., risk-benefit assessment, risk-benefit evaluation, risk treatment, and decision making. This conflation makes the RECs’ risk-benefit task confusing, if not impossible. We further realize that RECs are not meant to do all the risk-benefit tasks; instead, (...) RECs are meant to evaluate risks and benefits, appraise risk treatment suggestions, and make the final decision.ConclusionAs such, research ethics would benefit from looking beyond the procedure-level approaches and allowing disciplines like decision studies to be involved in the discourse on RECs’ risk-benefit task. (shrink)

We applaud De Neys for drawing attention to the interaction between intuiting and deliberating without committing to single- or dual process models. It remains unclear, however, how he conceptualizes the distinction between intuiting and deliberating. We propose several levels at which the distinction can be made and discuss the merits of defining intuiting and deliberating as different types of behavior.

Musical life became disrupted in 2020 due to the COVID-19 pandemic. Many musicians and venues turned to online alternatives, such as livestreaming. In this study, three livestreamed concerts were organized to examine separate, yet interconnected concepts—agency, presence, and social context—to ascertain which components of livestreamed concerts facilitate social connectedness. Hierarchical Bayesian modeling was conducted on 83 complete responses to examine the effects of the manipulations on feelings of social connectedness with the artist and the audience. Results showed that in concert (...) 1, where half of the participants were allowed to vote for the final song to be played, this option did not result in the experience of more agency. Instead, if their preferred song was played (regardless of voting ability) participants experienced greater connectedness to the artist. In concert 2, participants who attended the concert with virtual reality headsets experienced greater feelings of physical presence, as well as greater feelings of connectedness with the artist, than those that viewed a normal YouTube livestream. In concert 3, attendance through Zoom led to greater experience of social presence, but predicted less connectedness with the artist, compared to a normal YouTube livestream. Crucially, a greater negative impact of COVID-19 (e.g., loneliness) predicted feelings of connectedness with the artist, possibly because participants fulfilled their social needs with this parasocial interaction. Examining data from all concerts suggested that physical presence was a predictor of connectedness with both the artist and the audience, while social presence only predicted connectedness with the audience. Correlational analyses revealed that reductions in loneliness and isolation were associated with feelings of shared agency, physical and social presence, and connectedness to the audience. Overall, the findings suggest that in order to reduce feelings of loneliness and increase connectedness, concert organizers and musicians could tune elements of their livestreams to facilitate feelings of physical and social presence. (shrink)

This article deals with cultural theory in the version of Thompson, Ellis and Wildavsky. Cultural theory is important for research in the area of political and policy science because this theory has the pretension of pinning down endogenous preference formation. Using Durkheim's dimensions, ‘social integration’ and ‘regulation of the actions of individuals’, cultural theory distinguishes five ways of life or cultures, namely individualism, hierarchy, egalitarianism, fatalism and autonomy. The statement that there are only five ways of life is, however, the (...) result of a selective interpretation of the dimension, ‘regulation of the actions of individuals’. A broad perspective on this dimension — including the ‘horizontal’ aspects of human relations — will lead to the conclusion that there is a sixth culture existent that has been neglected by current cultural theory. This sixth culture is essentially ‘mutualism-driven’. In this mutualist way of life, people hold highly specialized positions and are closely associated. The production of goods and services within this culture is based on cooperation and mutual adjustment. Power is widely spread, but not because equal rights and duties are considered a good thing. Knowledge and skills are primary in mutualist settings, and power follows knowledge and skills. (shrink)

Since sound and music are powerful forces and drivers of human behavior and physiology, we propose the use of sonification to activate healthy breathing patterns in participants to induce relaxation. Sonification is often used in the context of biofeedback as it can represent an informational, non-invasive and real-time stimulus to monitor, motivate or modify human behavior. The first goal of this study is the proposal and evaluation of a distance-based biofeedback system using a tempo- and phase-aligned sonification strategy to adapt (...) breathing patterns and induce states of relaxation. A second goal is the evaluation of several sonification stimuli on 18 participants that were recruited online and of which we analyzed psychometric and behavioral data using, respectively questionnaires and respiration rate and ratio. Sonification stimuli consisted of filtered noise mimicking a breathing sound, nature environmental sounds and a musical phrase. Preliminary results indicated the nature stimulus as most pleasant and as leading to the most prominent decrease of respiration rate. The noise sonification had the most beneficial effect on respiration ratio. While further research is needed to generalize these findings, this study and its methodological underpinnings suggest the potential of the proposed biofeedback system to perform ecologically valid experiments at participants' homes during the COVID-19 pandemic. (shrink)

This study aims to contribute to emerging human-robot interaction research by adding longitudinal findings to a limited number of long-term social robotics home studies. We placed 70 robots in users’ homes for a period of up to six months, and used questionnaires and interviews to collect data at six points during this period. Results indicate that users’ evaluations of the robot dropped initially, but later rose after the robot had been used for a longer period of time. This is congruent (...) with the so-called mere-exposure effect, which shows an increasing positive evaluation of a novel stimulus once people become familiar with it. Before adoption, users focus on control beliefs showing that previous experiences with robots or other technologies allows to create a mental image of what having and using a robot in the home would entail. After adoption, users focus on utilitarian and hedonic attitudes showing that especially usefulness, social presence, enjoyment and attractiveness are important factors for long-term acceptance. (shrink)

BackgroundFor many decades, the debate on children’s competence to give informed consent in medical settings concentrated on ethical and legal aspects, with little empirical underpinnings. Recently, data from empirical research became available to advance the discussion. It was shown that children’s competence to consent to clinical research could be accurately assessed by the modified MacArthur Competence Assessment Tool for Clinical Research. Age limits for children to be deemed competent to decide on research participation have been studied: generally children of 11.2 (...) years and above were decision-making competent, while children of 9.6 years and younger were not. Age was pointed out to be the key determining factor in children’s competence. In this article we reflect on policy implications of these findings, considering legal, ethical, developmental and clinical perspectives.DiscussionAlthough assessment of children’s competence has a normative character, ethics, law and clinical practice can benefit from research data. The findings may help to do justice to the capacities children possess and challenges they may face when deciding about treatment and research options. We discuss advantages and drawbacks of standardized competence assessment in children on a case-by-case basis compared to application of a fixed age limit, and conclude that a selective implementation of case-by-case competence assessment in specific populations is preferable. We recommend the implementation of age limits based on empirical evidence. Furthermore, we elaborate on a suitable model for informed consent involving children and parents that would do justice to developmental aspects of children and the specific characteristics of the parent-child dyad.SummaryPrevious research outcomes showed that children’s medical decision-making capacities could be operationalized into a standardized assessment instrument. Recommendations for policies include a dual consent procedure, including both child as well as parents, for children from the age of 12 until they reach majority. For children between 10 and 12 years of age, and in case of children older than 12 years in special research populations of mentally compromised patients, we suggest a case-by-case assessment of children’s competence to consent. Since such a dual consent procedure is fundamentally different from a procedure of parental permission and child assent, and would imply a considerable shift regarding some current legislations, practical implications are elaborated. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work.This work is in the public domain in (...) the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

This collection of essays delineates the history of the rather disparate intellectual tradition usually labeled as "Platonic" or "Neoplatonic". In chronological order, the book covers the most eminent philosophic schools of thought within that tradition. The most important terms of the Platonic tradition are studied together with a discussion of their semantic implications, the philosophical and theological claims associated with the terms, the sources that furnish the terms, and the intellectual traditions aligned with or opposed to them. The contributors thereby (...) provide a vivid intellectual map of the Middle Ages and the Early Modern period. Contributions are written in English or German. (shrink)

Dishonesty is ubiquitous in our world. The news is frequently filled with high-profile cases of corporate fraud, large-scale corruption, lying politicians, and the hypocrisy of public figures. On a smaller scale, ordinary people often cheat, lie, misreport their taxes, and mislead others in their daily life. Despite such prevalence of cheating, corruption, and concealment, people typically consider themselves to be honest, and often believe themselves to be more moral than most others. This book aims to resolve this paradox by addressing (...) the question of why people are dishonest all too often. What motivates dishonesty, and how are people able to perceive themselves as moral despite their dishonest behaviour? What personality and interpersonal factors make dishonesty more likely? And what can be done to recognize and reduce dishonesty? This is a fascinating overview of state-of-the-art research on dishonesty, with prominent scholars offering their views to clarify the roots of dishonesty. (shrink)

Steels & Belpaeme (S&B) are clearly interested in the possible test their models may provide for human language theories. However, they only superficially address the assumptions underlying their own agent architecture, while these are of crucial relevance to the topic of human language. These assumptions fit an Augustinian picture of language, which Wittgenstein challenges in his Philosophical Investigations. It is too early to draw conclusions regarding human language evolution from such models.

The recent development of RNA replicating protocells and capsules that enclose complex biosynthetic cascade reactions are encouraging signs that we are gradually getting better at mastering the complexity of biological systems. The road to truly cellular compartments is still very long, but concrete progress is being made. Compartmentalization is a crucial natural methodology to enable control over biological processes occurring within the living cell. In fact, compartmentalization has been considered by some theories to be instrumental in the creation of life. (...) With the advancement of chemical biology, artificial compartments that can mimic the cell as a whole, or that can be regarded as cell organelles, have recently received much attention. The membrane between the inner and outer environment of the compartment has to meet specific requirements, such as semi‐permeability, to allow communication and molecular transport over the border. The membrane can either be built from natural constituents or from synthetic polymers, introducing robustness to the capsule. (shrink)

Although law is established on a strong presumption that persons younger than a certain age are not competent to consent, statutory age limits for asking children’s consent to clinical research differ widely internationally. From a clinical perspective, competence is assumed to involve many factors including the developmental stage, the influence of parents and peers, and life experience. We examined potential determining factors for children’s competence to consent to clinical research and to what extent they explain the variation in competence judgments.

Purpose This study aims to explore how the public perceives the effectiveness of surveillance technology, and how people’s views on privacy and their views on effectiveness are related. Likewise, it looks at the relation between perceptions of effectiveness and opinions on the acceptable cost of surveillance technology. Design/methodology/approach For this study, surveys of Dutch students and their parents were conducted over three consecutive years. Findings A key finding of this paper is that the public does not engage in a trade-off (...) neither with regard to privacy-effectiveness nor with effectiveness-cost, but rather expects all three elements to be achieved simultaneously. This paper also found that the correlation between perceived effectiveness and perceived privacy was stronger for parents than for students. Research limitations/implications Participants for this study were exclusively in The Netherlands. Survey questions on the effectiveness of surveillance technology focused on one type of technology, and on private mobile device use in two scenarios. Social implications The public’s perceptions of the effectiveness of surveillance technology potentially influence its acceptance of the technology, which, in turn, can affect the legitimacy and use of the technology. Originality/value Within the much-discussed privacy-security debate lies a less-heard debate – that of the effectiveness of the surveillance technology in question. The public is one actor in this debate. This study examines the public’s perceptions of this less-heard debate. (shrink)

Argumentation as the public exchange of reasons is widely thought to enhance deliberative interactions that generate and justify reasonable public policies. Adopting an argumentation-theoretic perspective, we survey the norms that should govern public argumentation and address some of the complexities that scholarly treatments have identified. Our focus is on norms associated with the ideals of correctness and participation as sources of a politically legitimate deliberative outcome. In principle, both ideals are mutually coherent. If the information needed for a correct deliberative (...) outcome is distributed among agents, then maximising participation increases information diversity. But both ideals can also be in tension. If participants lack competence or are prone to biases, a correct deliberative outcome requires limiting participation. The central question for public argumentation, therefore, is how to strike a balance between both ideals. Rather than advocating a preferred normative framework, our main purpose is to illustrate the complexity of this theme. (shrink)

Previous research showed that the repeated approaching of one stimulus and avoiding of another stimulus typically leads to more positive evaluations of the former stimuli. In the current study, we examined whether approach and avoidance training effects on evaluations of neutral stimuli can be modulated by introducing a regularity between the approach-avoidance actions and a positive or negative stimulus. In an AAT task, participants repeatedly approached one neutral non-word and avoided another neutral non-word. Half of the participants also approached a (...) negative fear-conditioned stimulus and avoided a conditioned safe stimulus. The other half of the participants avoided the CS+ and approached the CS−. Whereas participants in the avoid CS+ condition exhibited a typical AAT effect, participants in the approach CS+ condition exhibited a reversed AAT effect. These findings provide evidence for the malleability of the AAT effect when strongly valenced stimuli are approached or avoided. We discuss the practical and theoretical implications of our findings. (shrink)

From 1991 to 1994 the Dutch Health Insurance Council financed research on Extracorporeal Membrane Oxygenation (ECMO). This is a technique for providing cardiopulmonary bypass to patients with pulmonary and/or cardiac failure. Most often, these patients are premature neonates. During ECMO, blood is drained from the right atrium, pumped along a membrane where gas exchange takes place, and then redirected to the aorta. To prevent blood clotting, heparin is added. However, with the heparin added, the risk of hemorrhage is considerably increased. (...) Therefore, both the chance of surviving and the chance of severe disability are higher with ECMO than with conventional treatment (i.e., ventilator support). (shrink)

From 1991 to 1994 the Dutch Health Insurance Council financed research on Extracorporeal Membrane Oxygenation . This is a technique for providing cardiopulmonary bypass to patients with pulmonary and/or cardiac failure. Most often, these patients are premature neonates. During ECMO, blood is drained from the right atrium, pumped along a membrane where gas exchange takes place, and then redirected to the aorta. To prevent blood clotting, heparin is added. However, with the heparin added, the risk of hemorrhage is considerably increased. (...) Therefore, both the chance of surviving and the chance of severe disability are higher with ECMO than with conventional treatment. (shrink)

As part of the Dutch national science program “Professional Games for Professional Skills” we developed a stress-exposure biofeedback training in virtual reality for the Dutch police. We aim to reduce the acute negative impact of stress on performance, as well as long-term consequences for mental health by facilitating physiological stress regulation during a demanding decision task. Conventional biofeedback applications mainly train physiological regulation at rest. This might limit the transfer of the regulation skills to stressful situations. In contrast, we provide (...) the user with the opportunity to practice breathing regulation while they carry out a complex task in VR. This setting poses challenges from a technical – as well as from a user-experience perspective. We illustrate how we approach these challenges in our training and hope to contribute a useful reference for researchers and developers in academia or industry who are interested in using biosignals to control elements in a dynamic virtual environment. (shrink)