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Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)

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In this review, we bring together different strands of research focusing on rituals, social media and nature connectedness and interpret the intersection through a broad evolutionary niche construction lens. We argue that (a) humans have used rituals for a number of different purposes, with a particular emphasis on connecting human communities and managing emotional processes, (b) that these rituals were often centered around nature and seasonal cycles, and (c) that the runaway sociocultural niche construction driven by technological changes has disconnected (...) humans from both the environment and traditional rituals, which has many unintended side effects and consequences. However, we also acknowledge the intrinsic importance of rituals for humans and the great potential of emerging rituals in the digital space to connect individuals with each other, to disseminate information on nature at scale and to link individuals and communities back to nature. We provide some speculation on how social media and digital technology could be used creatively by individuals and communities to connect them with nature again and therefore help to protect nature and identify areas for future transdisciplinary research and theory development. (shrink)

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The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia.

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Healthcare professionals (HCPs) encounter various moral challenges in clinical practice. In various countries, clinical ethics support (CES) services are developed to support HCPs. One of these CES services is clinical ethics committees (CECs): they address moral challenges faced in healthcare settings and offer support for HCPs. However, in Tanzania, CECs have not yet been implemented. For implementation purposes, greater knowledge about how healthcare professionals navigate and respond to moral challenges, their understanding of CECs, and what they perceive as key needs (...) for implementing CECs in hospitals, are valuable. This study explores HCPs’ ways of dealing with their moral challenges at the moment and identifies key needs for establishing CECs in Tanzanian healthcare settings in the near future. The findings show that various implicit ways have been acknowledged as being useful in addressing moral challenges (e.g., regular meetings, family conferences, social welfare units, hospital procedures and guidelines, as well as consulting legal and management units). In addition, HCPs reported that a necessity exists for implementing more formal and systematic modalities to address moral challenges in clinical settings. The research in this paper has served as a preparation for establishing the first CEC in Tanzanian healthcare settings. (shrink)

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Society’s relationship with modern animal farming is an ambivalent one: on the one hand there is rising criticism about modern animal farming; on the other hand people appreciate certain aspects of it, such as increased food safety and low food prices. This ambivalence reflects the two faces of modernity: the negative (exploitation of nature and loss of traditions) and the positive (progress, convenience, and efficiency). This article draws on a national survey carried out in the Netherlands that aimed at gaining (...) a deeper understanding about the acceptance of modern dairy farming in Dutch society. People take two dimensions into account when evaluating different aspects of modern dairy farming: (1) the way living beings are used for production and (2) the way a dairy farm functions as a business. In both these dimensions people appeared to adopt cautious opinions: most people preferred relatively traditional and natural farms and were concerned about the use of nature and treatment of animals in modern production—although this did not imply an outright rejection of modern animal farming. The study also looked for (and sought to explain) differences of opinion between social groups. Besides socio-demographic factors such as age and gender, farming experience and value-orientation (such as socially minded and professional) appeared to be important variables. The values and convictions within modern society can help to explain why some people are greatly concerned about animal welfare while some show less concern. This diversity also helps to explain why general information campaigns are quite ineffective in allaying concerns about modern animal farming. (shrink)

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Based on the reconstruction of the development of 14 food supply chain initiatives in 7 European countries, we developed a conceptual framework that demonstrates that the process of increasing the sustainability of food supply chains is rooted in strategic choices regarding governance , embedding, and marketing and in the coordination of these three dimensions that are inextricably interrelated. The framework also shows that when seeking to further develop an initiative (e.g., through scaling up or product diversification) these interrelations need continuous (...) rebalancing. We argue that the framework can serve different purposes: it can be used as an analytical tool by researchers studying food supply chain dynamics, as a policy tool by policymakers that want to support the development of sustainable food supply chains, and as a reflexive tool by practitioners and their advisors to help them to position themselves, develop a clear strategy, find the right allies, develop their skills, and build the capacities that they need. In this paper, we elaborate upon the latter function of the framework and illustrate this briefly with empirical evidence from three of the initiatives that we studied. (shrink)

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The original Specker–Blatter theorem (1983) was formulated for classes of structures $\mathcal {C}$ of one or several binary relations definable in Monadic Second Order Logic MSOL. It states that the number of such structures on the set $[n]$ is modularly C-finite (MC-finite). In previous work we extended this to structures definable in CMSOL, MSOL extended with modular counting quantifiers. The first author also showed that the Specker–Blatter theorem does not hold for one quaternary relation (2003).If the vocabulary allows a constant (...) symbol c, there are n possible interpretations on $[n]$ for c. We say that a constant c is hard-wired if c is always interpreted by the same element $j \in [n]$. In this paper we show: (i)The Specker–Blatter theorem also holds for CMSOL when hard-wired constants are allowed. The proof method of Specker and Blatter does not work in this case.(ii)The Specker–Blatter theorem does not hold already for $\mathcal {C}$ with one ternary relation definable in First Order Logic FOL. This was left open since 1983.Using hard-wired constants allows us to show MC-finiteness of counting functions of various restricted partition functions which were not known to be MC-finite till now. Among them we have the restricted Bell numbers $B_{r,A}$, restricted Stirling numbers of the second kind $S_{r,A}$ or restricted Lah-numbers $L_{r,A}$. Here r is a non-negative integer and A is an ultimately periodic set of non-negative integers. (shrink)

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The South African-Dutch research group responsible for this article started its activities in 2012 by looking at religious tolerance as a means of addressing the tendency for religious intolerance, extremism and fundamentalism. While tolerance seemed to be a promising way to counter religious intolerable behaviour, some shortcomings also became apparent. For example, the concept of tolerance includes an aspect of passivity towards others who adhere to another religion. The concept also does not appear to be able to respond to attitudes (...) and values such as respect, human rights and diversity. Accurate investigation of this problem, both conceptually and empirically, led to the understanding that hospitality is a concept that embodies more active adaptation to those who are different. Hospitality, therefore, seems to be a more promising concept than tolerance for reducing religious tension between individuals and groups. The inner contradiction discovered by Derrida in the notion of hospitality does not detract from the concept of being defined from a Biblical point of view. Hospitality can also be taught to young people. Although there are no formal provisions for hospitality in the national curricula, an analysis of the Dutch and South African national curricula shows that there is room for hospitality education. (shrink)

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Society’s relationship with modern animal farming is an ambivalent one: on the one hand there is rising criticism about modern animal farming; on the other hand people appreciate certain aspects of it, such as increased food safety and low food prices. This ambivalence reflects the two faces of modernity: the negative (exploitation of nature and loss of traditions) and the positive (progress, convenience, and efficiency). This article draws on a national survey carried out in the Netherlands that aimed at gaining (...) a deeper understanding about the acceptance of modern dairy farming in Dutch society. People take two dimensions into account when evaluating different aspects of modern dairy farming: (1) the way living beings are used for production and (2) the way a dairy farm functions as a business. In both these dimensions people appeared to adopt cautious opinions: most people preferred relatively traditional and natural farms and were concerned about the use of nature and treatment of animals in modern production—although this did not imply an outright rejection of modern animal farming. The study also looked for (and sought to explain) differences of opinion between social groups. Besides socio-demographic factors such as age and gender, farming experience and value-orientation (such as socially minded and professional) appeared to be important variables. The values and convictions within modern society can help to explain why some people are greatly concerned about animal welfare while some show less concern. This diversity also helps to explain why general information campaigns are quite ineffective in allaying concerns about modern animal farming. (shrink)

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Philosophical arguments often assume that the folk tends towards moral objectivism. Although recent psychological studies have indicated that lay persons’ attitudes to morality are best characterized in terms of non-objectivism-leaning pluralism, it has been maintained that the folk may be committed to moral objectivism _implicitly_. Since the studies conducted so far almost exclusively assessed subjects’ metaethical attitudes via explicit cognitions, the strength of this rebuttal remains unclear. The current study attempts to test the folk’s implicit metaethical commitments. We present results (...) of a newly developed Implicit Association Test (IAT) for metaethical attitudes which indicate that the folk generally tend towards moral non-objectivism on the implicit level as well. We discuss implications of this finding for the philosophical debate. (shrink)

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Optimism has reigned supreme for a long time regarding the potential of education (schooling) to address the many societal ailments that humankind has had to deal with. The outbreak of the COVID-19 pandemic in March 2020 shifted all such aspirations to the back-burner. Now, after just more than a year after the initial outbreak of the pandemic, the question can be raised whether those who managed the pandemic in the educational context followed the correct policies and instituted the correct (ethical, (...) moral) measures in combatting the pandemic. This comparison between the situation in the Netherlands and South Africa reveals that although the role-players in both countries had a good understanding of the situation and of their duties in such conditions, they tended to treat education as just another facet of society, thereby demonstrating a lack of empathy with the unique demands of education (schooling). CONTRIBUTION: In this article, the authors investigate the governance performance of two different countries during the first year of the COVID-19 pandemic concerning education and judge that performance based on a Biblically driven ethical-moral-pedagogical framework. (shrink)

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Experiences are interpreted as conscious mental occurrences that are of phenomenal character. There is already a kind of (weak) intentionality involved with this phenomenal interpretation. A stricter conception of experiences distinguishes between purely phenomenal experiences and intentional experiences in a narrow sense. Wittgenstein’s account of psychological (experiential) verbs is taken over: Usually, expressing mental states verbally is not describing them. According to this, I believe can be seen as an expression of one’s own belief, but not as an expression of (...) a belief about one’s belief. Hence, the utterance I believe it is raining shows that I believe that it is raining, although it is not said by these words that I believe that it is raining. Thinking thoughts such as I believe it is raining, but it is not raining (a variant of Moore’s paradox) is an absurdity between what is already said by silently uttering It is not raining and what is shown by silently uttering I believe it is raining. The paper agrees with a main result of Wittgenstein’s considerations of Moore’s paradox, namely the view that logical structure, deducibility, and consistency cannot be reduced solely to propositions—besides a logic of propositions, there is, for example, a logic of assertions and of imperatives, respectively. (shrink)

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Religion in education in South Africa and the Netherlands: A comparative study. The aim of this article is the reconstruction and comparison of the historical evolution of the place and role of religion in education in South Africa and in the Netherlands. The article commences with an overview of the historical evolution of the place and role of religion in education, up to the present, and a discussion of the dissatisfaction and objections which could be and which have been levelled (...) against the current situation. The Netherlands has followed a more accommodating policy and practice regarding religious beliefs and diversity than the international norm. While South Africa can learn much from the Dutch approach to the problem of religion in education, this approach has also been challenged in recent times. In both systems, controversy about the accommodation of religion in education has given rise to tension between the notions of freedom, tolerance and accommodation, on the one hand, and the acknowledgement of human rights and the need for social cohesion on the other. Other considerations to be taken into account in this regard are the downsides of providing a partisan, confessional type of education that could hinder learners in maintaining themselves in the outside world. The trend in modern society is towards individualised belief systems, not collective ones. And the warning to be heeded is that the line between education and indoctrination is thin. The current Dutch model, despite the problems that it currently encounters, could provide direction in respect of all these issues. Contribution: The article concludes with an educational-philosophical perspective regarding the question as to how educationists and educators could guide learners to a state where they can independently decide about their personal religious orientation, given the fact that they are now living in a time when relativism prevails, also in terms of religion and faith. (shrink)

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BackgroundAlthough the number of reporting guidelines has grown rapidly, few have gone through an updating process. The STARD statement (Standards for Reporting Diagnostic Accuracy), published in 2003 to help improve the transparency and completeness of reporting of diagnostic accuracy studies, was recently updated in a systematic way. Here, we describe the steps taken and a justification for the changes made.ResultsA 4-member Project Team coordinated the updating process; a 14-member Steering Committee was regularly solicited by the Project Team when making critical (...) decisions. First, a review of the literature was performed to identify topics and items potentially relevant to the STARD updating process. After this, the 85 members of the STARD Group were invited to participate in two online surveys to identify items that needed to be modified, removed from, or added to the STARD checklist. Based on the results of the literature review process, 33 items were presented to the STARD Group in the online survey: 25 original items and 8 new items; 73 STARD Group members (86 %) completed the first survey, and 79 STARD Group members (93 %) completed the second survey.Then, an in-person consensus meeting was organized among the members of the Project Team and Steering Committee to develop a consensual draft version of STARD 2015. This version was piloted in three rounds among a total of 32 expert and non-expert users. Piloting mostly led to rewording of items. After this, the update was finalized. The updated STARD 2015 list now consists of 30 items. Compared to the previous version of STARD, three original items were each converted into two new items, four original items were incorporated into other items, and seven new items were added.ConclusionsAfter a systematic updating process, STARD 2015 provides an updated list of 30 essential items for reporting diagnostic accuracy studies. (shrink)

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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)

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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)

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It is often assumed that graphemes are a crucial level of orthographic representation above letters. Current connectionist models of reading, however, do not address how the mapping from letters to graphemes is learned. One major challenge for computational modeling is therefore developing a model that learns this mapping and can assign the graphemes to linguistically meaningful categories such as the onset, vowel, and coda of a syllable. Here, we present a model that learns to do this in English for strings (...) of any letter length and any number of syllables. The model is evaluated on error rates and further validated on the results of a behavioral experiment designed to examine ambiguities in the processing of graphemes. The results show that the model (a) chooses graphemes from letter strings with a high level of accuracy, even when trained on only a small portion of the English lexicon; (b) chooses a similar set of graphemes as people do in situations where different graphemes can potentially be selected; (c) predicts orthographic effects on segmentation which are found in human data; and (d) can be readily integrated into a full-blown model of multi-syllabic reading aloud such as CDP++ (Perry, Ziegler, & Zorzi, 2010). Altogether, these results suggest that the model provides a plausible hypothesis for the kind of computations that underlie the use of graphemes in skilled reading. (shrink)

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The present study investigated the extent to which moral disengagement and the tendency to consider moral rules as socio-conventional rules are distinct dimensions of morality, and their association with three different forms of participation in bullying. These two types of moral cognitions have been theorized in different models of morality and are usually studied independently, even if research on moral shifts suggests some possible overlaps. A group of 276 Italian students from primary and middle school completed self-reports assessing moral disengagement, (...) socio-conventional perception of moral rules, and participation in bullying as bully, defender of the victim and passive bystander. Results from structural equation modeling analysis confirmed that moral disengagement and socio-conventional comprehension of aggressions are separate and moderately connected morality dimensions. Controlling for age, gender and SES, only moral disengagement was positively associated with perpetrating bullying. These results point to moral disengagement as the critical component of moral cognitions to be addressed in interventions. (shrink)

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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)

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In logic, including the designer logics of artificial intelligence, and in the philosophy of science, one is often concerned with qualitative, comparative orderings on the states of a system, or on theories expressing information about the system. States may be compared with respect to normality, or some preference criterium, or similarity to some given (set of) state(s). Theories may be compared with respect to logical power, or to truthlikeness, or to how well they capture certain information. We explain a number (...) of these relations, study their properties, and unravel some of their interrelationships. (shrink)

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Glenberg's conception of “meaning from and for action” is too narrow. For example, it provides no satisfactory account of the “logic of Elfland,” a metaphor used by Chesterton to refer to meaning acquired by being told something. All that we call spirit and art and ecstasy only means that for one awful instant we remember that we forget. G. K. Chesterton.

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Academics and/or scholars increasingly feel that their academic voice (combined or individual) has been squelched by the demands of performativity in its various guises, and resultantly, that they have been caught up in a process of steady disempowerment. Rather, it should be their right to be free to use their positions in the pursuit of scholarship as their conscience and their expert knowledge of their subject dictate. Academics should be free to question for themselves the boundaries of their limitations, and (...) not have these i mposedon them by the state or government bureaucracy. In order to help empower academics to regain their academic voice and identity, this article transposes six of the philosophical ideas of Belgian philosopher Rudi Visker to the world of academia. It explores the possibilities of using these ideas as instruments for the promotion and maintenance of academic freedom. Key concepts: academic freedom, managerialism, institutions of higher learning, Rudi Visker. (shrink)

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Peter Abelard (1079–1142 ce) was the most wide‐ranging philosopher of the twelfth century. He quickly established himself as a leading teacher of logic in and near Paris shortly after 1100. After his affair with Heloise, and his subsequent castration, Abelard became a monk, but he returned to teaching in the Paris schools until 1140, when his work was condemned by a Church Council at Sens. His logical writings were based around discussion of the “Old Logic”: Porphyry's Isagoge, aristotle'S Categories and (...) On Interpretation and boethius'S textbook on topical inference. They comprise a freestanding Dialectica (“Logic”; probably c.1116), a set of commentaries (known as the Logica [Ingredientibus], c. 1119) and a later (c. 1125) commentary on the Isagoge (Logica Nostrorum Petititoni Sociorum or Glossulae). In a work Abelard called his Theologia, issued in three main versions (between 1120 and c.1134), he attempted a logical analysis of trinitarian relations and explored the philosophical problems surrounding God's claims to omnipotence and omniscience. The Collationes (“Debates,” also known as “Dialogue between a Christian, a Philosopher and a Jew”; probably c.1130) present a rational investigation into the nature of the highest good, in which the Christian and the Philosopher (who seems to be modeled on a philosopher of pagan antiquity) are remarkably in agreement. The unfinished Scito teipsum (“Know thyself,” also known as the “Ethics”; c.1138) analyses moral action. (shrink)

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BackgroundPregnant people have been overlooked or excluded from clinical research, resulting in a lack of scientific knowledge on medication safety and efficacy during pregnancy. Thus far, both the opportunities to generate evidence-based knowledge beyond clinical trials and the role of pregnant people in changing their status quo have not been discussed. Some scholars have argued that for rare disease patients, for whom, just like pregnant people, a poor evidence base exists regarding treatments, solidarity has played an important role in addressing (...) the evidence gap. This paper explores whether and how the enactment of solidarity among pregnant people can be stimulated to help address the poor evidence base on medications used during pregnancy.MethodWe use the concept of solidarity formulated by Prainsack and Buyx and enrich their concept by providing an account for stimulating the enactment of solidarity. Then we apply this account to the case of pregnant people who use medication.ResultsSolidarity means enacted commitment on the part of an individual to assisting others with whom the person recognizes a similarity in a relevant respect. Although solidarity cannot be imposed, we argue that the empowerment of people is a crucial concept in understanding how solidarity can be stimulated. Empowerment in the context of pregnant people means creating awareness about their status quo, explaining how scientific research can help close the knowledge gap, and how pregnant people can themselves contribute. In particular, how pregnant people can contribute to the collection of health data to strengthen the evidence base for medications used during pregnancy.ConclusionsWe conclude that acting in solidarity can help change the status quo for pregnant people. Furthermore, we argue that the empowerment of pregnant people and other relevant stakeholders is a way to stimulate the enactment of solidarity. The process of empowerment starts by raising awareness about the lack of evidence on medications used during prengnacy and by explaining to pregnant people how they can contribute to changing the way knowledge is being generated by, for example, sharing data on the health effects of medications. (shrink)

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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.

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relative to the actual world) of a propositional theory are defined. A theory is ‘closer to the truth’ the logically stronger its positive content and the logically weaker its negative content. This proposal delivers the same verisimilar preordering of theories that has been defined by Brink and Heidema as a ‘power ordering’. The preordering may be collapsed to a partial ordering and then embedded into a complete distributive lattice. The preordering may also be refined to a partial ordering by employing (...) the ‘convex content’ and the ‘non-convex content’ of each theory. Philosophical implications and historical relations are discussed. (shrink)

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BackgroundIn research ethics, the most basic question would always be, “which is an ethical issue, which is not?” Interestingly, depending on which ethics guideline we consult, we may have various answers to this question. Though we already have several international ethics guidelines for biomedical research involving human participants, ironically, we do not have a harmonized document which tells us what these various guidelines say and shows us the areas of consensus. In this manuscript, we attempted to do just that.MethodsWe extracted (...) the imperatives from five internationally-known ethics guidelines and took note where the imperatives came from. In doing so, we gathered data on how many guidelines support a specific imperative.ResultsWe found that there is no consensus on the majority of the imperatives and that in only 8.2 % of the imperatives were there at least moderate consensus. Of the 12 clusters, Informed Consent has the highest level of consensus and Research Collaboration and Regulatory Sanctions have the least.ConclusionThere was a lack of consensus in the majority of imperatives from the five internationally-known ethics guidelines. This may be partly explained by the differences among the guidelines in terms of their levels of specification as well as conceptual/ideological differences. (shrink)

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Alexius Meinong's specific use of the term "self-presentation" had a significant influence on modern epistemology and philosophical psychology. To show that there are remarkable parallels between Meinong's account of the self-presentation of experiences and Lehrer's account of the exemplarization of experiences is one of this paper's main objectives. Another objective is to put forward some comments and critical remarks to Lehrer's approach. One of the main problems can be expressed by the following: The process of using a particular experience as (...) a sample, that is, an exemplar that we use to stand for and refer to a plurality of experiences, Lehrer calls "exemplarization". As concrete experiences are multifarious (red and round, for example), how can we single out a specific sort of experiences (the red ones) by the process of exemplarization when we use such a multifarious experience as a sample? (shrink)

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Background In the EU, clinical assessors, rapporteurs and the Committee for Medicinal Products for Human Use are obliged to assess the ethical aspects of a clinical development program and include major ethical flaws in the marketing authorization deliberation processes. To this date, we know very little about the manner that these regulators put this obligation into action. In this paper, we intend to look into the manner and the extent that ethical issues discovered during inspection have reached the deliberation processes. (...) Methods To gather data, we used the Dutch Medicines Evaluation Board database and first searched for the inspections, and their accompanying site inspection reports and integrated inspection reports, related to central marketing authorization applications of drugs submitted to the European Medicines Agency from 2011 to 2015. We then extracted inspection findings that were purely of ethical nature, i.e., those that did not affect the benefit/risk balance of the study. Only findings graded at least major by the inspectorate were included. Lastly, to identify how many of the ethically relevant findings reach the application deliberation processes, we extracted the relevant joint response assessment reports and reviewed the sections that discussed inspection findings. Results From 2011 to 2015, there were 390 processed applications, of which 65 had inspection reports and integrated inspection reports accessible via the database of the Dutch Medicines Evaluation Board. Of the 65, we found ERFs in 37. The majority of the ERFs were graded as major and half of the time it was informed-consent related. A third of these findings were related to research ethics committee processes and requirements. Of the 37 inspections with ERFs, 30 were endorsed in the integrated inspection reports as generally GCP compliant. Day 150 joint response assessment reports and Day 180 list of outstanding issues were reviewed for all 37 inspections, and none of the ERFs were carried over in any of the assessment reports or list of outstanding issues. Conclusion None of the ethically relevant findings, all of which were graded as major or critical in integrated inspection reports, were explicitly carried over to the joint assessment reports. This calls for more transparency in EMA application deliberations on how ERFs are considered, if at all, in the decision-making processes. (shrink)

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HIV/AIDS continues to constitute a serious threat to the social and physical wellbeing of African mothers and their babies. In the hardest hit countries of sub-Saharan Africa, more than 60% of all new HIV infections are occurring in women, infants and young children. Mother-to-child transmission constitutes 90% of new HIV infections among infants and young children. Most of these infections can be prevented. However, the social stigma of HIV/AIDS insidiously continues to undermine the success of prevention programs. Ironically, some attributes (...) or characteristics of prevention of mother-to-child transmission programs may in fact serve as catalysts to the stigmatization process. This paper identifies and discusses six potential initiators: Routine HIV testing, Six months exclusive breastfeeding, Incentives, Home visits, Location of PMTCT program, and PMTCT terminology. In all these areas, there are practical strategies that may be applied to reduce the chances of being stigmatized. These strategies are introduced and discussed. (shrink)

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Insurance fraud and abuse—international concerns—are inherent in the proposition of insurance and prevalent in insurer–insured interactions. While the subject of considerable industry and regulatory attention, this little-researched area of consumer behavior and consumer ethics represents persistent social policy questions and problems at multiple levels. This article addresses the issue by first defining insurance fraud and its origins in contract, as well as consumer- and insurer-management. The authors conclude by re-envisioning the problem as one of co-creation by the consumer-insured and insurer (...) personnel, proposing a framework for its study and resolution. (shrink)

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A continuing need for care for elderly, combined with looser family structures prompt the question what filial obligations are. Do adult children of elderly have a duty to care? Several theories of filial obligation are reviewed. The reciprocity argument is not sensitive to the parent–child relationship after childhood. A theory of friendship does not offer a correct parallel for the relationship between adult child and elderly parent. Arguments based on need or vulnerability run the risk of being unjust to those (...) on whom a needs-based claim is laid. To compare filial obligations with promises makes too much of parents’ expectations, however reasonable they may be. The good of being in an unchosen relationship seems the best basis for filial obligations, with an according duty to maintain the relationship when possible. We suggest this relationship should be maintained even if one of the parties is no longer capable of consciously contributing to it. We argue that this entails a duty to care about one’s parents, not for one’s parents. This implies that care for the elderly is not in the first place a task for adult children. (shrink)

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