This paper traces the unspoken, implicit white racial logic of the brain disease model of addiction, which is based on seemingly universal, disembodied brains devoid of social or environmental influences. In the United States, this implicit white logic led to “context-free” neuroscience that made the social hierarchies of addiction and its consequences invisible to, and thus exacerbated by, national policies on opioids. The brain disease model of addiction was selectively deployed among the white middle-class population that had long accessed narcotics (...) and pharmaceutical treatments for narcotics disorders from biomedical clinics, as opposed to from illegal sources subject to law enforcement. In turn, new treatments for opioid addiction were racially marketed to the same white clientele to which newly patented opioid analgesics were marketed, tapping into a circumscribed but highly lucrative consumer base that has long benefited from a legally protected, racially segregated safe space for white narcotics consumption. The connecting thread for the contemporary white opioid “crisis,” therefore, is white race as a ghost variable in addiction neuroscience and in its pharmaceutical and biotechnological translation. (shrink)

Volume 12, Issue 1, January 2012, Page 1-3.

Across Europe, national leaders and ordinary citizens alike face the problems and opportunities raised by increasing economic and political interdependence. Interdependence between nations creates new dilemmas in every sphere of activity. In The Netherlands: Negotiating Sovereignty in an Interdependent World, Thomas Rochon offers a comparative focus and a strong conceptualization of small-state issues applied to present the Netherlands experience.Although all countries face issues of sovereignty and adjustment to international forces, the Dutch have addressed these issues more explicitly and (...) over a longer span of time. How have the Dutch gone about the transformation from global power to small state? What lessons have they learned along the way that might be applied elsewhere in Europe, not to mention the United States? Rochon addresses these issues and provides background information on the people, culture, government, and economy of the country. In the final chapter, he summarizes the Dutch experience and explains that what unites the Netherlands with other industrial nations is how the country copes with change. (shrink)

In a comprehensive assessment of the penetration of Rawls's ideas in the Netherlands since 1971 five debates are discerned in which different aspects are highlighted or play a role. Some of these debates are more or less ongoing ones, some overlap with each other, and some can be pinpointed more precisely in time. In the first 15 years following the publication of A Theory of Justice, attention was focused on the distributive implications of `justice as fairness'. Next, the `liberalism-communitarianism (...) debate' came to the fore. More recently, Kantian aspects of Rawls's theory have been discussed. A fourth, also more recent debate relates to problems of multiculturalism. Finally, in recent years, and more or less in conjunction with the debate on multiculturalism, the current situation of the Dutch welfare state has been discussed. Here we get back to the core of Rawlsian theory, its distributive implications. But now it is argued that this theory focuses too much on equality at the expense of responsibility and incentives. (shrink)

Health care policy in the Netherlands has long been guided by the values of solidarity and equality. As a result of several forces, particularly the scarcity of resources, the retreat of the Welfare State and the introduction of market forces in health care, both values are increasingly under strain. Next to solidarity and equality, freedom of choice and financial responsibility are playing an important role in Dutch health care. Consequently, there is a growing division in Dutch heaith care between (...) two tiers, one basic tier giving access to a basic package of services and a luxury tier giving access to a higher quality of care and to services not included in the basic package. The main thesis of the article is that a two-tier system is morally justified on the condition that the basic tier is universally accessible and is based on the value of humanitarian solidarity. (shrink)

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)

Widespread enthusiasm for establishing scientific codes of conduct notwithstanding, the utility of such codes in influencing scientific practice is not self-evident. It largely depends on the implementation phase following their establishment—a phase which often receives little attention. The aim of this paper is to provide recommendations for guiding effective implementation through an assessment of one particular code of conduct in one particular institute. Based on a series of interviews held with researchers at the Department of Biotechnology of Delft University of (...) Technology, this paper evaluates how the Netherlands Code of Conduct for Scientific Practice is received by those it is supposed to govern. While respondents agreed that discussion of the guiding principles of scientific conduct is called for, they did not consider the code as such to be a useful instrument. As a tool for the individual scientific practitioner, the code leaves a number of important questions unanswered in relation to visibility, enforcement, integration with daily practice and the distribution of responsibility. Recommendations are provided on the basis of these questions. There is more at stake than merely holding scientific practitioners to a proper exercise of their duties; implementation of scientific society codes of conduct also concerns the further motives and value commitments that gave rise to their establishment in the first place. (shrink)

The review system on research with human participants in the Netherlands is characterised as a decentralised controlled and integrated peer review system. It consists of an independent governmental body, the Central Committee on Research Involving Human Subjects (or Central Committee), which regulates the review of research proposals by accredited Medical Research Ethics Committees (MRECs). The legal basis was founded in 1999 with the Medical Research Involving Human Subjects Act. The review system is a decentralised arrangement since most research proposal (...) are reviewed by the 30 accredited MRECs in the country. It is a controlled system in which the Central Committee is responsible for the accreditation and oversight of the MRECs and can make legally binding directives for these committees. The assessment of research proposals is an integrated peer review process in which all documents of the research file are reviewed by experts in one committee only. A small number of research proposals are assessed by the Central Committee and not by accredited MRECs. These proposals are on specific research categories such as gene therapy, cell therapy and embryo research. The review of research with surplus human embryos is regulated separately in the Embryos Act. The Central Committee provides support to the accredited MRECs and to researchers and sponsors. It is currently developing an internet portal to reduce the bureaucracy and make the review process more efficient and transparent. The Central Committee stimulates confidence on medical research in society by providing a public trial registry with core data on reviewed research proposals. (shrink)

ABSTRACTResearch Objective: This study focuses on ADs in the Netherlands and introduces a cross‐cultural perspective by comparing it with other countries.Methods: A questionnaire was sent to a panel comprising 1621 people representative of the Dutch population. The response was 86%.Results: 95% of the respondents didn't have an AD, and 24% of these were not familiar with the idea of drawing up an AD. Most of those familiar with ADs knew about the Advanced Euthanasia Directive . Both low education and (...) the presence of a religious conviction that plays an important role in one's life increase the chance of not wanting to draw up an AD. Also not having experienced a request for euthanasia from someone else, and the inconceivability of asking for euthanasia yourself, increase the chance of not wanting to draw up an AD.Discussion: This study shows that the subjects of palliative care and end‐of‐life‐decision‐making were very much dominated by the issue of euthanasia in the Netherlands. The AED was the best known AD; and factors that can be linked to euthanasia play an important role in whether or not people choose to draw up an AD. This differentiates the Netherlands from other countries and, when it comes to ADs, the global differences between countries and cultures are still so large that the highest possible goals, at this moment in time, are observing and possibly learning from other cultural settings. (shrink)

Health care policy in the Netherlands has long been guided by the values of solidarity and equality. As a result of several forces, particularly the scarcity of resources, the retreat of the Welfare State and the introduction of market forces in health care, both values are increasingly under strain. Next to solidarity and equality, freedom of choice and financial responsibility are playing an important role in Dutch health care. Consequently, there is a growing division in Dutch heaith care between (...) two tiers, one basic tier giving access to a basic package of services and a luxury tier giving access to a higher quality of care and to services not included in the basic package. The main thesis of the article is that a two-tier system is morally justified on the condition that the basic tier is universally accessible and is based on the value of humanitarian solidarity. Keywords: access to health care, health insurance, resource allocation, solidarity CiteULike Connotea Del.icio.us What's this? (shrink)

In the empirical literature on legal education, law schools are often portrayed as rather elitist and competitive environments, dominated by authoritative law teachers, that promote a dogmatic approach to the law in which the moral and other contextual aspects of legal problems are being marginalised. We refer to legal socialisation that is marked by such characteristics as adaptive law school socialisation. This type of socialisation demands a great deal of adaptation from students whose identities do not fit well in the (...) traditional mould of the legal profession. In this article, we argue that law school socialisation may take a different form. Reflective law school socialisation, as we term this alternative type of law school socialisation, fosters a collaborative learning environment with supportive teachers that promote contextual reflection on law and its ethical and social ramifications. We use a case study of socialisation in a law school in the Netherlands to show how various elements of reflective law school socialisation can be identified in reality, and to demonstrate the analytical function of the distinction between adaptive and reflective law school socialisation. (shrink)

Book Reviews in this Article: Rationing America's Medical Care: The Oregon Plan and Beyond, edited by Martin A. Strosberg, Joshua M. Wiener, Robert Baker and I. Alan Fein. Bad Medicine: The Prescription Drug Industry in the Third World, by Milton Silverman, Mia Lydecker and Philip R. Lee. Stanford Feminist Perspectives in Medical Ethics, edited by Helen Bequaert Holmes and Laura M. Purdy, Bloomington and Indianapolis: Indiana Choices in Health Care: A Report by the Government Committee on Choices in Health Care, (...) The Netherlands, 1992. (shrink)

In serial verb constructions (SVCs), multiple independent lexical verbs are combined in a mono-clausal construction. SVCs express a range of grammatical meanings and are attested in numerous spoken languages all around the world. Yet, to date only few studies have investigated the existence and functions of SVCs in sign languages. For the most part, these studies—including a previous study on Sign Language of the Netherlands (NGT)—relied on elicited data. In this article, we offer a cross-modal typological contribution to the (...) study of SVCs by investigating the phenomenon based on naturalistic corpus data from NGT. A search of the Corpus NGT yielded 41 mono-clausal utterances in which one of a closed set of verbs—namely go, give, take, and call —combines with another lexical verb. While the combinations we found are in important respects reminiscent of SVCs described for spoken languages, our data also confirm the previous finding that the fixed verb in the SVC serves to express agreement (by means of spatial modulation) when the other verb cannot do so. In addition, we identified some novel uses of the verbs go and give: (i) go functioning as a future tense marker and (ii) give functioning as a light verb. We will also discuss aspects of the grammaticalization of SVCs in NGT: from lexical verb to light verb to auxiliary, again offering some comparison to grammaticalization paths described for spoken languages. (shrink)

Research Objective: This study focuses on ADs in the Netherlands and introduces a cross-cultural perspective by comparing it with other countries. Methods: A questionnaire was sent to a panel comprising 1621 people representative of the Dutch population. The response was 86%. Results: 95% of the respondents didn't have an AD, and 24% of these were not familiar with the idea of drawing up an AD. Most of those familiar with ADs knew about the Advanced Euthanasia Directive (AED, 64%). Both (...) low education and the presence of a religious conviction that plays an important role in one's life increase the chance of not wanting to draw up an AD. Also not having experienced a request for euthanasia from someone else, and the inconceivability of asking for euthanasia yourself, increase the chance of not wanting to draw up an AD. Discussion: This study shows that the subjects of palliative care and end-of-life-decision-making were very much dominated by the issue of euthanasia in the Netherlands. The AED was the best known AD; and factors that can be linked to euthanasia play an important role in whether or not people choose to draw up an AD. This differentiates the Netherlands from other countries and, when it comes to ADs, the global differences between countries and cultures are still so large that the highest possible goals, at this moment in time, are observing and possibly learning from other cultural settings. (shrink)

This article analyses how faith-based civil society organisations have advocated the value-add of faith to governmental and non-governmental development actors in the highly secularised context of the Netherlands. Its social value lies in the space for reflexivity it opens up on how the religious and the secular are entangled in the field of development through shifting the gaze towards secularised Europe. Its academic value lies in how it combines the study of faith and development, with a critical analysis of (...) the secular formations in which much of the thinking around faith and development is shaped. The article builds on an academic study of and long-term engagement with the Dutch non-governmental organisation (NGO)-based Knowledge Centre Religion and Development (KCRD), offering a critical overview of the KCRD’s work between 2006 and 2016. Data were gathered through interviews, document analysis and participant observation as part of the academic research, as well as informal observations and analysis through professional engagement. The KCRD, because of its institutional setting, had to adopt an instrumental approach towards the role of religion in development, which prevented it from challenging the reigning secular paradigm in development and its biases towards faith-based actors. The article will recommend that future initiatives on faith and development more consciously anchor their approach to faith in their institutional practices and mainstream discussions on the European continent. (shrink)

This article takes direction from the transnational feminist lesbian encounter that took place between the Dutch collective Sister Outsider and Audre Lorde in the 1980s to reflect on the role of archives within transnational feminist research. Drawing on archival materials from the International Archive for the Women’s Movement (IAV) at Atria (Institute on Gender Equality and Women’s History) in Amsterdam in the Netherlands, and the Audre Lorde Papers at Spelman College in Atlanta, Georgia in the United States, I consider (...) how fragmented archives offer stories on kinship, intimacy and loss. Taking into account the ‘absences’ and ‘presences’ (Lewis, 2017) produced in this archival research project, I propose an archival research methodology that is rooted in a practice of ‘orientation’ (Ahmed, 2006a, 2006b), ‘listening’ (Campt, 2017) and ‘intervention’ (Appadurai, 2003). (shrink)

This article contains an outline of the development of the classic wind mill with some additional attention to developments in the Netherlands.

Is it remarkable that the Royal Dutch Medical Association as a medical professional organization has the point of view that in particular circumstances euthanasia is an acceptable act for a physician. Seen from the viewpoints in the international community, we might say that it is highly remarkable. Frankly put: the RDMA has met strong international disapproval of its standpoint on euthanasia during the last 10 years or so. For instance, the World Medical Association still condemns physicians performing euthanasia as “unethical.” (...) So far the RDMA is the only professional medical organization that holds the view that in particular cases euthanasia is morally acceptable. However, viewed within the context of Dutch society, the Dutch system of healthcare, and the sociocultural approach to moral questions in The Netherlands, the RDMA point of view ceases to be reprehensible. (shrink)

Comparing the degree of openness of the economy of Poland and the Netherlands, we can say the following. The Netherlands is more dependent on foreign trade than Poland. The Netherlands export quota reaches almost 50%, unlike 41,37% in Poland in 2016. However, Poland has become more import-dependent. Poland, in contrast to the Netherlands, is continuing to increase the indicators of "economic globalization". To date, the Netherlands has been pursuing more moderate foreign trade policy and trying (...) to protect itself from external risks by focusing on an internal market with high purchasing power. On the contrary, Polish politics tries to focus on the new markets for its products in order to increase the prosperity and well-being of its citizens. Poland as a country and an economic entity has made a qualitative leap in its development. The economy of this country has become more open and integrated into the world economy. (shrink)

In this paper, the approaches of a sample of small firms to environmental issues in the UK and the Netherlands are compared.The study makes a contribution by addressing the lack of research on small firms and the environment, as well as offering insights intothe influence that cultural. institutional, and political frameworks can have on small firm owner-managers' attitudes to external issues. The environment is considered here as an ethical issue, drawing on work on the environmental responsibility of business by (...) both Bowie (1990) and Hoffman (1991). It is argued that the approaches to the environment identified in this study by Dutch and UK small firm owner-managers do not fit in with the positions of either Bowie or Hoffman. The concept of stakeholder cooperation is proposed as a more realistic alternative. (shrink)

On 17 November 1820 there appeared a Dutch translation of Oersted's pamphlet concerning the discovery of the effect of an electric current on a magnetic needle suspended in the earth's magnetic field . In the Netherlands a number of physicists were immediately interested in the electromagnetic and electrodynamic discoveries made by Oersted and the French physicists. They repeated and extended the experiments, and constructed new modifications of the galvanic battery for better results. They made no fundamental discoveries in this (...) field of physics, but the fact that their work was important follows from the experiments of van Beek, which confirmed Amp`ere's theory of molecular magnetic currents. Van Beek as well as Speyert van der Eyk corresponded with Amp`ere about electromagnetic and electrodynamic phenomena. In the Utrecht Universiteitsmuseum there is an unpublished letter of Amp`ere to van Beek, which is published at the end of this article. (shrink)

The Dutch experience has influenced the debate on euthanasia and death with dignity around the globe, especially with regard to whether physician-assisted suicide and euthanasia should be legitimized or legalized. Review of the literature reveals complex and often contradictory views about the Dutch experience. Some claim that the Netherlands offers a model for the world to follow; others believe that the Netherlands represents danger, rather than promise, and that the Dutch experience is the definitive answer regarding why we (...) should not make active euthanasia and physician-assisted suicide part of our lives.Having investigated the Dutch experience for a number of years, in the summer of 1999 I went to the Netherlands to visit the major centers of medical ethics as well as some research hospitals, and to speak with leading figures in euthanasia policy and practice. This essay commences by providing some background information on the practice of euthanasia and on the legal framework, and then reports the main answers to my first question: Why the Netherlands? (shrink)

In the Netherlands the incidence of methicillin resistant Staphylococcus aureus infections in hospitals is surprisingly low when compared to that of neighbouring countries. It is believed that this favourable condition is caused by stringent precautionary measures such as complete isolation of the patients. In one case the nurse taking care of such patients was herself MRSA positive. This condition changed and she became MRSA negative after removal of her tonsils. The question is raised how far one should go to (...) protect patients when the preventive measures taken may endanger the health of those who take care of them. (shrink)

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)

Studies have shown that students may feel emotional discomfort when they are asked to identify ethical problems which they have encountered during their training. Teachers in medical ethics, however, more often focus on the cognitive and rational ethical aspects and not much on students’ emotions. The purpose of this qualitative study was to explore students’ feelings and emotions when dealing with ethical problems during their clinical training and explore differences between two countries: Indonesia and the Netherlands. We observed a (...) total of eighteen ethics group discussions and interviewed fifteen medical students at two medical schools. Data were interpreted and analyzed using content analysis. We categorized students’ negative emotions based on their objects of reflection and came up with three categories: emotions concerning their own performance, emotions when witnessing unethical behaviors, and emotions related to barriers and limitations of their working environment. Our study suggests that addressing emotional responses in a culturally sensitive way is important to develop students’ self-awareness. Teachers should be able to guide students to reflect on and be critical of their own thoughts and emotions, to understand their own moral values, especially when confronted with other individuals. (shrink)

Background: Debates over legalisation of physician-assisted suicide or euthanasia often warn of a “slippery slope”, predicting abuse of people in vulnerable groups. To assess this concern, the authors examined data from Oregon and the Netherlands, the two principal jurisdictions in which physician-assisted dying is legal and data have been collected over a substantial period.Methods: The data from Oregon comprised all annual and cumulative Department of Human Services reports 1998–2006 and three independent studies; the data from the Netherlands comprised (...) all four government-commissioned nationwide studies of end-of-life decision making and specialised studies. Evidence of any disproportionate impact on 10 groups of potentially vulnerable patients was sought.Results: Rates of assisted dying in Oregon and in the Netherlands showed no evidence of heightened risk for the elderly, women, the uninsured , people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations. The only group with a heightened risk was people with AIDS. While extralegal cases were not the focus of this study, none have been uncovered in Oregon; among extralegal cases in the Netherlands, there was no evidence of higher rates in vulnerable groups.Conclusions: Where assisted dying is already legal, there is no current evidence for the claim that legalised PAS or euthanasia will have disproportionate impact on patients in vulnerable groups. Those who received physician-assisted dying in the jurisdictions studied appeared to enjoy comparative social, economic, educational, professional and other privileges. (shrink)

In the Netherlands, euthanasia and assisted suicide are formally forbidden by criminal law, but, under certain strictly formulated conditions, physicians are excused for administering these to patients on the basis of necessity. These conditions are bound up with a long process of criteria development. Therefore, physicians still live in uncertainty. Future court decisions may change the criteria. Apart from that, physicians can always be prosecuted. The position of nurses, however, is perfectly clear; they are never allowed to administer euthanasia (...) or assisted suicide. Nevertheless, they should be involved in the decision-making process because they are an important source of information and have consultation skills. The openness of the discussion about these issues in the Netherlands may prevent an escalation of medical or nursing responsibility and falling victim to the ‘slippery slope’. (shrink)

Introduction: In The Netherlands, physicians have to be convinced that the patient suffers unbearably and hopelessly before granting a request for euthanasia. The extent to which general practitioners (GPs), consulted physicians and members of the euthanasia review committees judge this criterion similarly was evaluated. Methods: 300 GPs, 150 consultants and 27 members of review committees were sent a questionnaire with patient descriptions. Besides a “standard case” of a patient with physical suffering and limited life expectancy, the descriptions included cases (...) in which the request was mainly rooted in psychosocial or existential suffering, such as fear of future suffering or dependency. For each case, respondents were asked whether they recognised the case from their own practice and whether they considered the suffering to be unbearable. Results: The cases were recognisable for almost all respondents. For the “standard case” nearly all respondents were convinced that the patient suffered unbearably. For the other cases, GPs thought the suffering was unbearable less often (2–49%) than consultants (25–79%) and members of the euthanasia review committees (24–88%). In each group, the suffering of patients with early dementia and patients who were “tired of living” was least often considered to be unbearable. Conclusions: When non-physical aspects of suffering are central in a euthanasia request, there is variance between and within GPs, consultants and members of the euthanasia committees in their judgement of the patient’s suffering. Possible explanations could be differences in their roles in the decision-making process, differences in experience with evaluating a euthanasia request, or differences in views regarding the permissibility of euthanasia. (shrink)

OBJECTIVES: To identify the factors that influence the assessment of reported cases of physician-assisted death by members of the public prosecution. DESIGN/SETTING: At the beginning of 1996, during verbal interviews, 12 short case-descriptions were presented to a representative group of 47 members of the public prosecution in the Netherlands. RESULTS: Assessment varied considerably between respondents. Some respondents made more "lenient" assessments than others. Characteristics of the respondents, such as function, personal-life philosophy and age, were not related to the assessment. (...) Case characteristics, i.e. the presence of an explicit request, life expectancy and the type of suffering, strongly influenced the assessment. Of these characteristics, the presence or absence of an explicit request was the most important determinant of the decision whether or not to hold an inquest. CONCLUSIONS: Although the presence of an explicit request, life expectancy and the type of suffering each influenced the assessment, each individual assessment was dependent on the assessor. The resulting danger of legal inequality and legal uncertainty, particularly in complicated cases, should be kept to a minimum by the introduction of some form of protocol and consultation in doubtful or boundary cases. The notification procedure already promotes a certain degree of uniformity in the prosecution policy. (shrink)

Egg freezing has led to heated debates in healthcare policy and bioethics. A crucial issue in this context concerns the distinction between “medical” and “social” egg freezing —contrasting objections to bio-medicalization with claims for oversimplification. Yet such categorization remains a criterion for regulation. This paper aims to explore the “regulatory boundary-work” around the “medical”–”social” distinction in different egg freezing regulations. Based on systematic documents’ analysis we present a cross-national comparison of the way the “medical”–”social” differentiation finds expression in regulatory frameworks (...) in Austria, Germany, Israel, and the Netherlands. Findings are organized along two emerging themes: the definition of MEF and its distinctiveness—highlighting regulatory differences in the clarity of the definition and in the medical indications used for creating it ; and hierarchy of medical over social motivations reflected in usage and funding regulations. Blurred demarcation lines between “medical” and “social” are further discussed as representing a paradoxical inclusion of SEF while offering new insights into the complexity and normativity of this distinction. Finally, we draw conclusions for policymaking and the bioethical debate, also concerning the related cryopolitical aspects. (shrink)

Social media (SM) influence young adults’ communication practices. Artificial Intelligence (AI) is increasingly used for making recommendations on SM. Yet, its effects on different generations of SM users are unknown. SM can use AI recommendations to sort texts and prioritize them, shaping users’ online and offline experiences. Current literature primarily addresses technological or human-user perspectives, overlooking cognitive perspectives. This research aims to propose methods for mapping users’ interactions with AI recommendations (AiRS) and analyzes how embodied interactions mediated by a digital (...) agent can lead to changes in social and cultural practices. For this, this work proposes a comparative analysis of central practices evoked by AI recommendations-mediated communication on SM among users in Italy, Estonia, and the Netherlands in the age category 18–26 years old. The data used in the comparative analysis was collected via semi-structured interviews and elaborated based on cognitive psychology and semiotics. This research highlights the contextual significance of AI recommendations as a mediator in creating new communication practices. Findings confirm that young adults often choose practices that would enhance their digital representations according to AiRS’ dominant patterns and categories. AiRS impacts individual interpretations and practices and can further affect social and cultural levels. (shrink)

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)

The Health Council of the Netherlands is an independent scientific advisory board to the Dutch government in matters of public health. In this article we argue that even for an independent body such as the Health Council there seems to be no escape from the increasing intertwinement of scientific and societal processes. In order to produce a serviceable truth for policymaking, the council needs to reflect on what goes on in its socio-political surroundings. On the other hand, how could (...) we ever come to understand the legitimacy of the council when notions of scientific objectivity dissolve in such a reflexive, inherently political stance? In a situation where science and society are thoroughly interrelated, the Health Council somehow succeeds in bringing about or re-claiming some sense of objectivity. Our central question will be how to conceptualise this notion of 'objectivity' without having to rely on idealized notions of objectivity that are criticized in philosophical, sociological and historical studies of science and society. In order to do so, we will regard the objectivity of advisory reports of the Health Council as being constructed out of heterogeneous elements and under complex circumstances. The theoretical point will be empirically underpinned with case material drawn from activities of the Health Council in the period 1985-2002 in predominantly the subject areas healthcare and medical technology. (shrink)

In this article, we shift the usual analytical attention of the GPN framework from lead firms to suppliers in the network and from production to IT services. Our focus is on how Indian IT suppliers embed in the Netherlands along the threefold characterization of societal, territorial and network embeddedness. We argue that Indian IT suppliers attempt to display societal embeddedness when they move to The Netherlands. Our findings reveal that the endeavour by Indian IT suppliers to territorially dis-embed (...) from the Dutch context is reinforced by their peripheral position in the network and their ability to offshore work in a bid to contain costs, in addition to the influence of client domination. Therefore, territorial embeddedness is considered to be secondary to societal embeddedness which is intertwined with client interest while neglecting the interest of other network members. Nonetheless, the inter-firm relationship is complex, given the tension between societal, territorial and network embeddedness. While preferring Indian IT suppliers because of their low pricing, Dutch clients also insist on compliance with the institutional context of the Netherlands especially when it comes to Dutch employees. This results in hybridization which means that Indian IT suppliers find ways to adhere to the institutional framework for Dutch nationals while simultaneously insulating Indian employees from the same. Consequently, a highly unfair segmented internal labour market develops, with Dutch nationals being treated more favourably as compared to Indian nationals. Nonetheless, to address these violations, Indian employees prefer individual strategies of resilience and rework rather than a collectivization response. (shrink)