This paper provides a Christian philosophical and theological response to the moral imperative of human advancement through multiplanetarism as emerging from the Great Filter theory. First, it explains the Fermi paradox that underlies the Great Filter theory. Next, it explores this theory itself and its motivational power in driving advancement toward multiplanetarism. In particular, we explore two motives behind the multiplanetary efforts that are (in part) guided by the Great Filter theory, analyzing the relevant statements of SpaceX founder and chief (...) engineer Elon Musk. Finally, we assess these motivations (and the accompanying normative assumptions) behind space exploration and multiplanetarism from the perspective of Reformational philosophy, using Herman Dooyeweerd’s theory of ground motives as a lens. Thus, the paper’s leading research question is this: How can we assess the current attempts at securing a multiplanetary existence for humankind in the light of Dooyeweerd’s theory of ground motives? (shrink)

An important and supposedly impactful form of clinical ethics support is moral case deliberation. Empirical evidence, however, is limited with regard to its actual impact. With this literature review, we aim to investigate the empirical evidence of MCD, thereby a) informing the practice, and b) providing a focus for further research on and development of MCD in healthcare settings. A systematic literature search was conducted in the electronic databases PubMed, CINAHL and Web of Science. Both the data collection and the (...) qualitative data analysis followed a stepwise approach, including continuous peer review and careful documentation of our decisions. The qualitative analysis was supported by ATLAS.ti. Based on a qualitative analysis of 25 empirical papers, we identified four clusters of themes: 1) facilitators and barriers in the preparation and context of MCD, i.e., a safe and open atmosphere created by a facilitator, a concrete case, commitment of participants, a focus on the moral dimension, and a supportive organization; 2) changes that are brought about on a personal and inter-professional level, with regard to professional’s feelings of relief, relatedness and confidence; understanding of the perspectives of colleagues, one’s own perspective and the moral issue at stake; and awareness of the moral dimension of one’s work and awareness of the importance of reflection; 3) changes that are brought about in caring for patients and families; and 4) changes that are brought about on an organizational level. This review shows that MCD brings about changes in practice, mostly for the professional in inter-professional interactions. Most reported changes are considered positive, although challenges, frustrations and absence of change were also reported. Empirical evidence of a concrete impact on the quality of patient care is limited and is mostly based on self-reports. With patient-focused and methodologically sound qualitative research, the practice and the value of MCD in healthcare settings can be better understood, thus making a stronger case for this kind of ethics support. (shrink)

The aim of this article is to investigate the concept of care in contemporary medical practice and medical ethics. Although care has been hailed throughout the centuries as a crucial ideal in medical practice and as an honourable virtue to be observed in codes of medical ethics, I argue that contemporary medicine and medical ethics suffer from the lack of a theoretically sustainable concept of care and then discuss possible reasons that may help to explain this absence. I draw on (...) the empirical studies of Carol Gilligan on care and connectedness as ontologically situated realities in human life. Based on a philosophical elaboration of her findings on the ethics of care emphasizing relationality, I try to show how the notion of ‘relational ontology’ originating from this stream of thought may be of help in developing a medical ethics that acknowledges care as a perspective to be observed in all interactions between physicians and patients. (shrink)

Many healthy volunteers choose to take part in Alzheimer’s disease prevention studies because they want to know whether they will develop dementia—and what they can do to reduce their risk—and are therefore interested in learning the results of AD biomarker tests. Proponents of AD biomarker disclosure often refer to the personal utility of AD biomarkers, claiming that research participants will be able to use AD biomarker information for personal purposes, such as planning ahead or making important life decisions. In this (...) paper, the claim that AD biomarkers have personal utility for asymptomatic individuals is critically assessed. It demonstrates that in the absence of clinical validity, AD biomarkers cannot have personal utility and do not serve research participants’ autonomy. Over the next few years, many research groups will be confronted with participants’ preferences to learn the results of AD biomarker tests. When researchers choose to make results available upon explicit request, they should ensure adequate information provision and education, notably on the uncertain clinical significance of AD biomarker information. Routine disclosure of AD biomarkers to cognitively unimpaired individuals in research settings cannot be justified with an appeal to the personal utility of AD biomarker information. (shrink)

Treating physicians have key roles to play in expanded access to investigational drugs, by identifying investigational treatment options, assessing the balance of risks and potential benefits, informing their patients, and applying to the regulatory authorities. This study is the first to explore physicians’ experiences and moral views, with the aim of understanding the conditions under which doctors decide to pursue expanded access for their patients and the obstacles and facilitators they encounter in the Netherlands. In this mixed-methods study, semi-structured interviews (...) and a questionnaire were conducted with medical specialists across the country and analysed thematically. Typically, our respondents pursue expanded access in “back against the wall” situations and broadly support its classic requirements. They indicate practical hurdles related to reimbursement, the amount of time and effort required for the application, and unfamiliarity with the regulatory process. Some physicians are morally opposed to expanded access, with an appeal to safety risks, lack of evidence, and “false hope.” Some of these moral concerns and practical obstacles may be essential targets for change, if expanded access to unapproved drugs is to become available for wider groups of patients for whom standard treatment options are not—or no longer—available, on a more consistent and equal basis. (shrink)

This article gives an overview of the moral problems experienced and described by nurses working in a dialysis unit in the Netherlands. The nurses raised a wide variety of issues that they considered were moral problems, which were grouped into seven topics. A selection of cases are described, one of which is analysed using the Nijmegen method of ethical case deliberation. This method facilitates practical approaches to the different types of moral problems encountered. The argument is made that, owing to (...) their specific moral position and responsibility, nurses' contribution to ethical reflection in ward discussions should be valued more. All caregivers involved are indispensable in developing a basis for well-reasoned decisions when deliberating about moral problems. (shrink)

The aim of this study is to explore how nurses perceive patient participations of patients over 75 years old undergoing hemodialysis treatment in dialysis units, and of their next of kin. Ten nurses told stories about what happened in the dialysis units. These stories were analyzed with critical discourse analysis. Three discursive practices are found: (1) the nurses’ power and control; (2) sharing power with the patient; and (3) transferring power to the next of kin. The first and the predominant (...) discursive practice can be explained with an ideology of paternalism, in which the nurses used biomedical explanations and the ethical principle of benefice to justify their actions. The second can be explained with an ideology of participation, in which the nurses used ethical narratives as a way to let the patients participate in the treatment. The third seemed to involve autonomous decision-making and the ethical principle of autonomy for the next of kin in the difficult end-of-life decisions. (shrink)

The advent of new genetic and genomic technologies may cause friction with the principle of respect for autonomy and demands a rethinking of traditional interpretations of the concept of informed consent. Technologies such as whole‐genome sequencing and micro‐array based analysis enable genome‐wide testing for many heterogeneous abnormalities and predispositions simultaneously. This may challenge the feasibility of providing adequate pre‐test information and achieving autonomous decision‐making. At a symposium held at the 11th World Congress of Bioethics in June 2012 (Rotterdam), organized by (...) the International Association of Bioethics, these challenges were presented for three different areas in which these so‐called ‘new genetics’ technologies are increasingly being applied: newborn screening, prenatal screening strategies and commercial personal genome testing. In this article, we build upon the existing ethical framework for a responsible set‐up of testing and screening offers and reinterpret some of its criteria in the light of the new genetics. As we will argue, the scope of a responsible testing or screening offer should align with the purpose(s) of testing and with the principle of respect for autonomy for all stakeholders involved, including (future) children. Informed consent is a prerequisite but requires a new approach. We present preliminary and general directions for an individualized or differentiated set‐up of the testing offer and for the informed consent process. With this article we wish to contribute to the formation of new ideas on how to tackle the issues of autonomy and informed consent for (public) healthcare and direct‐to‐consumer applications of the new genetics. (shrink)

This paper examines the support for diversity from a moral perspective. Combining business ethics theory with a lens of critical discourse analysis, it reconstructs the debates on the ethicality of three disability inclusion practices—positive discrimination, job adaptations, and voluntary disclosure—drawn from multi-stakeholder interviews in disability-friendly organizations. Discursive resistance to disability inclusion practices, otherwise known to work, arises out of moral beliefs characteristic of an ethic of justice, whereas support is more often informed by an ethic of care. This study contributes (...) to the literature by laying bare how ethics fuel ‘resistance to’ rather than ‘support for’ diversity and inclusion. Like prior studies, it links such resistance to the myth of individual merit, noting that some re-appropriation of an ethic of justice becomes possible when legal awareness around issues of disability is raised in the context of work. In addition, it identifies an ethic of care as holding the greatest potential for fostering workplace inclusion yet cautions for two adverse side effects that may arise when promoting corporate care: the potential of paternalism and the inclination to individualise inherent to wellbeing initiatives. (shrink)

This paper considers the meaning and use of the English particle man. It is shown that the particle does quite different things when it appears in sentence-initial and sentence-final position; the first use involves expression of an emotional attitude as well as, on a particular intonation, intensification; this use is analyzed using a semantics for degree predicates along with a separate dimension for the expressive aspect. Further restrictions on modification with the sentence-initial particle involving monotonicity and evidence are introduced and (...) analyzed. The sentence-final use can be viewed as strengthening the action performed by the sentence. A formal semantics is given by making use of dynamic techniques and, in a sense, dynamically simulating the modification of certain speech acts. Some empirical and theoretical extensions of the analyses are proposed and some consequences discussed. (shrink)

The advent of new genetic and genomic technologies may cause friction with the principle of respect for autonomy and demands a rethinking of traditional interpretations of the concept of informed consent. Technologies such as whole-genome sequencing and micro-array based analysis enable genome-wide testing for many heterogeneous abnormalities and predispositions simultaneously. This may challenge the feasibility of providing adequate pre-test information and achieving autonomous decision-making. At a symposium held at the 11th World Congress of Bioethics in June 2012 (Rotterdam), organized by (...) the International Association of Bioethics, these challenges were presented for three different areas in which these so-called ‘new genetics’ technologies are increasingly being applied: newborn screening, prenatal screening strategies and commercial personal genome testing. In this article, we build upon the existing ethical framework for a responsible set-up of testing and screening offers and reinterpret some of its criteria in the light of the new genetics. As we will argue, the scope of a responsible testing or screening offer should align with the purpose(s) of testing and with the principle of respect for autonomy for all stakeholders involved, including (future) children. Informed consent is a prerequisite but requires a new approach. We present preliminary and general directions for an individualized or differentiated set-up of the testing offer and for the informed consent process. With this article we wish to contribute to the formation of new ideas on how to tackle the issues of autonomy and informed consent for (public) healthcare and direct-to-consumer applications of the new genetics. (shrink)

Västvärldens åldrande befolkning anses ofta ställa krav på nya former av vård och omsorg. Olika typer av informations- och kommunikationstekniskt baserat vårdstöd framhålls ofta som en lösning. Tekniken medger en rad olika fördelar, exempelvis tätare tillsyn, kontinuerliga mätningar av vitala funktioner, med möjlighet att kontinuerligt ställa diagnos, och snabb respons på larm, men de tekniska lösningarna får också etiska implikationer. I den här artikeln beskrivs och exemplifieras IKT-baserad vård och omsorg och teknikens påverkan på centrala värden som personlig integritet, autonomi, (...) frivillighet och informerat samtycke diskuteras. Interaktiv etisk teknikvärdering föreslås för att bättre inkorporera alla berörda parters behov av och synpunkter på den här typen av vårdstöd.Nyckelord: autonomi, etik, frivillighet, informerat samtycke, interaktiv etisk teknikvärdering, IKT-baserat vårdstöd, hemvård, personlig integritet, robotteknik, sensorteknik, säkerhet, trygghet, valfrihetEnglish summary: When health care moves in – the ethics of mobile health careAn ageing population in the Western world is typically taken to require novel forms of health care. Different types of Information and Communication based services and functions are presented as a solution. Even if such technology imply benefits in terms of more frequent attendance, continuous monitoring and diagnoses of vital signs and quick response to alarms, the technology also gives raise to ethical concerns. This article describes and exemplifies ICT-based health care and discusses implications on central values like privacy, autonomy, freedom of choice and informed consent. Interactive ethical technology assessment is suggested as a means to better incorporate the needs of all concerned parties and their perspectives on this type of support. (shrink)

Throughout the longstanding debate on privacy, the concept has been framed in various ways. Most often it has been discussed as an area within which individuals rightfully may expect to be left alone and in terms of certain data that they should be entitled to control. The sphere in which individuals should be granted freedom from intrusion has typically been equated with the indisputably private domestic sphere. Privacy claims in the semi-public area of work have not been sufficiently investigated. In (...) this article, the case is made that employees have reasonable expectations on privacy at work. Firstly, in a descriptive analysis, employees’ need for workspace privacy is spelt out. Secondly, a normative analysis explicates the reasons why privacy should be protected. The main thrust is to provide a more inclusive privacy concept and hence, a more adequate basis for privacy protection legislation and codes in the area of work. Contrary to prevailing workplace privacy protection, employees’ need for local privacy should be accommodated as well as informational privacy. (shrink)

Based on conversation analysis, this study investigates central practices in what is defined as a caring interview, in the context of welfare administration. Caring refers to a helpful interviewing in reformulations of questions, taking interviewees’ difficulties to answer into consideration; a caring attitude in the framing of questions, showing understanding of clients’ circumstances and professional’s enactment of expertise in assessments of clients’ disabilities and care needs. Data include a corpus of 43 recorded interviews in which officials at the Swedish Social (...) Insurance Agency interview clients who have applied for benefits. The study adds to research on interactional sensitivity, polar questions and epistemic stance in institutional interaction. The study shows how the interviewer prioritizes confirming polar questions, takes responsibilities of knowing into account and reduces the epistemic gap to the interviewee in practices of a caring interview. This makes the interviewing markedly different from standardized and bureaucratic interviewing. (shrink)

The introduction of non-invasive prenatal testing in healthcare systems around the world offers an opportunity to reconsider funding policies for prenatal screening. In some countries with universal access healthcare systems, pregnant women and their partners are asked to pay for NIPT. In this paper, we discuss two important rationales for charging women for NIPT: to prevent increased uptake of NIPT and to promote informed choice. First, given the aim of prenatal screening, high or low uptake rates are not intrinsically desirable (...) or undesirable. Using funding policies to negatively affect uptake, however, is at odds with the aim of screening. Furthermore, copayment disproportionally affects those of lower socioeconomic status, which conflicts with justice requirements and impedes equal access to prenatal screening. Second, we argue that although payment models may influence pregnant women’s choice behaviours and perceptions of the relevance of NIPT, the copayment requirement does not necessarily lead to better-informed choices. On the contrary, external influences on women’s personal choices for or against prenatal screening should ideally be avoided. To improve informed decision-making, healthcare systems should instead invest in adequate non-directive, value-focused pretest counselling. This paper concludes that requiring copayments for NIPT in universal access healthcare systems fails to promote reproductive autonomy and is unfair. (shrink)

Clarifying and analysing moral problems arising in the practice of palliative care was the objective of participatory observations in five palliative care settings. The results of these observations will be described in this contribution. The moral problems palliative caregivers have to deal with in their daily routines will be explained by comparison with the findings of a previously performed literature study. The specific differences in the manifestation of moral problems in the different palliative care settings will be highlighted as well.

In the last two decades, stem cell-based brain organoids have been developed to study disease mechanisms in various neurological, psychiatric, and developmental disorders. Simultaneously, there hav...

Crises today occur in manifold variants. Cyberattacks, floods, wars, pandemics – the list of cases is ongoing. Academic literature recognizes them as “transboundary crises” (Ansell et al. 2010) or as “global polycrisis” (Homer-Dixon et al., 2022), referring to their transgressing, cascading and overlapping dynamics in both space and time. In this paper, we discuss how decisions are made at a local level in such dynamic, if not disruptive, environments. By combining DDM and crisis management literature, we illustrate how the decision-making (...) evolves when the crisis shows transboundary characteristics, that is, when cascading dynamics call for even more decisions (hence the “Hydra” metaphor referring to a monster in Greek mythology that multiplies its heads once it is being fought). The paper draws on a qualitative study on decision processes in local authorities and organizations in Germany during the Covid-19 pandemic. It can show (1) how these local actors build inter-organizational networks (e.g. task forces) in order to synchronize their decision processes against the background of changing federal requirements; (2) how, due to the duration of the pandemic, rather permanent decision systems developed; and (3) how these networks learn to sustain dynamic decision-making capacities in order to cope with crises following Covid-19, such as the effects of the war in the Ukraine or recent climate impacts. With these findings we contribute to an “integrative” conception of crisis in current crisis management literature that seeks definition in a dynamic process view rather than using either objective or subjective criteria. A DDM approach allows for a more detailed realization of this conceptual shift by representing the current “cascading disasters” as “cascading decision-making”. This understanding focuses on the active role decision-making plays as well as it reflects on the fact that decision-making in today’s crises always involves _others _making decisions, too. (shrink)

With a specific example from Norway and inspiration from Sara Ahmed’s The Promise of Happiness, this article demonstrates how today’s educational rhetoric lacks the language and will to recognise a key pedagogical dimension in education: what happens when the normative ambitions of education and students meet. At best, teaching students life skills to mitigate their mental health issues is naive. Inspired by Ahmed, such an initiative might actually work against its purpose. At a time when educational outcomes are emphasised in (...) local and international political contexts, I argue that the task of philosophy of education should be 1) to reclaim the significance of the pedagogical dimension in education and 2) to philosophise on what negative emotions such as unhappiness require of education. (shrink)

The article describes and analyses connections established between Roman Jakobson’s scholarly legacy and the topic of translation in a selection of academic reference works. The aim in doing so is twofold: first, to look beyond the conventionalised image of Jakobson as an influential scholar for several disciplines, such as translation studies, linguistics and semiotics, and to provide an overview of the actual reception of his ideas on the level of general academic knowledge as presented by scholarly reference works in these (...) fields. Another aim is to find out whether and how Jakobson’s ideas on translation are seen to relate to his other ideas concerning language and communication. It appears that — while there also exist some differences fieldwise as well as among individual reference works — the general reception of Jakobson is based predominantly on just two of his articles (out of his overall legacy of several hundred works) and to a large extent ignores the inner logic of Jakobson’s thought as it manifests in his different works (i.e. there are few connections made between his ideas expressed in his different works). (shrink)

Dutch manner of motion verbs play a prominent role in the literature on unaccusativity. As these verbs can take both hebben ‘have’ and zijn ‘be’ as their perfective auxiliaries, they are considered to show both unergative and unaccusative behavior. The general consensus is that these verbs normally take hebben, yet occur with zijn if they are ‘telicized’ by an endpoint, and that the auxiliaries are diagnostics for the syntactic status of prepositional phrases (PPs). The paper presents attested data that reveal (...) that this generalization is untenable: there are examples that take the opposite auxiliary from what the generalization predicts. To account for the full set of data, the paper takes a cognitive-grammar perspective, arguing that auxiliary choice, telicity and syntactic status of PPs are independent issues requiring their own explanations. Auxiliary choice is analyzed in terms of alternate construals of a motion event: with hebben as a type of act and with zijn as a change of location. In this manner, the paper adds to a growing body of literature that questions the usefulness of the coarse unergative–unaccusative distinction, advocating a ‘local analysis’ instead. (shrink)

Ibn al-Sāʿī, Consorts of the Caliphs: Women and the Court of Baghdad. Edited by Shawkat M. Toorawa, translated by Editors of LAL. Library of Arabic Literature. New York: New York University Press, 2015. Pp. xlv + 226. $30.

This text elaborates an understanding of abstraction as fundamental to how we think from a closer look at relationships between abstraction, movement, materiality and lived experience. Starting from Whitehead-inspired reflections on ab­straction by Alberto Toscano and Brian Massumi, the differences between their respective readings of his work are shown to be indicative for their different conceptions of the relationships between abstraction, the concrete, and lived experience. The text then continues to elaborate how Alva Noë’s enactive approach to perception illumi­nates the (...) central role of movement and sensorimotor skills in the emergence of abstractions from the continuity of process that is reality, and could contribute to further understanding of the relationship between movement and abstraction as what Massumi describes as the incorporeal dimension of the real. Finally, this text reflects on the potential of movement practices and technology to become part of how abstraction is achieved. (shrink)

This piece lists, in an evocative way, how the author hopes that psychoanalysis may contribute to liberation.

From an interdisciplinary perspective the authors of this book, scholars in theology and religious studies, give an account of the problematic and promising aspects of biblically based monotheism, considered as a formative religious idea, belief, and practice in Western history and culture.

Inleiding in de theorie van de geschiedenis en de geschiedschrijving.

Love and War deepens our understanding and brings us one step closer to that distant day when we will lay down our sword and shield and deserve the name Homo sapiens-wise human beings. - Sam Keen, Best-selling author of Faces of the Enemy Love and War is a stunning tour de force which traces the darkest shadows of our progenitors on humankind's evolutionary journey through individual, societal, communal, and nation-state relationships. It is a compelling and wonderfully readable analysis of how (...) innate latent noble and fearsome factors in the human psyche surface in varying circumstances. In demonstrating how the latter can collectively lead to hostilities to achieve tribal or national goals, this book provides profound psychological insights as to why nations in the twenty-first century still employ war as an instrument of national policy. The authors specify what we must do, as nations and individuals, to create a global community working in concert to deal with the now-recognized universal threats to life on Earth. - Harry J. Petrequin, Jr. Retired Foreign Service Officer. (shrink)

_Suggests that a full acceptance of the finitude of existence can lead to the affirmation of God._.

In the emerging academic field of game studies, Roger Caillois’ Les Jeux et les hommes has already received the status of an obligatory reference. It is honoured as one of the few classic texts in game theory, but some also argue that it is not useful for analysing digital games. Caillois’ book is of particular interest for cultural theorists, though, because it presents a theory of games and play while also addressing the meaning of play. After analysing more closely why (...) Caillois’ theory falls short when it is applied to digital games, we suggest a slight modification of its categories. Starting from the four game dimensions outlined by Caillois - competition, chance, simulation and vertigo - and his two modes of playing, paidia and ludus, we build on his theory by distinguishing two additional game characteristics, called repens and repositio. Both deal with the internal, temporal organization of a game. Repens is a specific characteristic of games that appeals to the player’s desire to discover, explore and get to know the surprises a game has in store and to make progress by learning from these surprises. Repositio denotes complementary experiences: having to retry, return, replay and repeat a certain action while getting better at it with every try. The balance, or unbalance, between repens and repositio, as characteristic elements of many digital games, determines to a large extent their attraction. Finally, repens and repositio are not only indicators of fun in the playing of digital games; they also hint at basic elements in learning theories and social theory. The study of the interplay between repens and repositio can help in clarifying the possibilities and limitations of digital games for learning purposes. (shrink)

Swedish beef and dairy farmers are currently facing a challenging financial situation. Simultaneously, beef farming contributes significant environmental impacts. To support farmers, actors from the whole value chain are now promoting Swedish beef as particularly ‘sustainable’. The paper draws on critical discourse analysis of interviews with and documents from the largest Swedish supermarket chain ICA, Swedish farmer organisations and farmers to study how ICA and farmers articulate sustainability and their responsibility for the same. Articulations are subsequently discussed in the light (...) of actual environmental impacts of beef production and the distribution of power in the beef value chain. The findings suggest that negative environmental impacts and farmers’ struggles are largely hidden in the dominant articulation of sustainability. Furthermore, ICA does not use the power it has to steer consumers toward reduced beef consumption. We conclude with suggesting more open deliberation about current levels of beef sales and consumption and about what compromises to make when striving for ‘sustainable’ beef consumption. (shrink)

In this paper I introduce a theoretical framework on care developed by the Norwegian nurse and philosopher Kari Martinsen, and I argue that this approach has relevance not only within nursing, but also within clinical medicine. I try to substantiate this claim by analysing some of the key concepts in this approach, and I illustrate the potential clinical relevance of this approach by applying it in relation to two care scenarios. Finally, I discuss some of the concerns that have been (...) raised in relation to the aim of highlighting care in medicine. (shrink)

Simple mindfulness practices to help your child (ages 5-12) deal with anxiety, improve concentration, and handle difficult emotions—with a 60-minute audio CD of guided exercises Mindfulness—the quality of attention that combines full awareness with acceptance of each moment, just as it is—is gaining broad acceptance among mental health professionals as an adjunct to treatment. This little book is a very appealing introduction to mindfulness meditation for children and their parents. In a simple and accessible way, it describes what mindfulness is (...) and how mindfulness-based practices can help children calm down, become more focused, fall asleep more easily, alleviate worry, manage anger, and generally become more patient and aware. The book contains eleven practices that focus on just these scenarios, along with short examples and anecdotes throughout. Included with purchase is an audio CD with guided meditations, voiced by Myla Kabat-Zinn, who along with her husband, Jon Kabat-Zinn, popularized mindfulness-based stress reduction (MBSR) as a therapeutic approach. Continue your mindfulness practice with Eline Snel through her other mindfulness meditation titles, including Sitting Still Like a Frog Activity Book, which offers 75 fun mindfulness games and activities for children, and The Little Frog Awakes, which offers tools and advice for mindfully responding to younger children ages 18 months to 4 years. (shrink)

Natural language contains many expressions with underspecified emotive content. This paper proposes a way to resolve such underspecification. Nonmonotonic inference over a knowledge base is used to derive an expected interpretation for emotive expressions in a particular context. This ‘normal’ meaning is then taken to influence the hearer’s expectations about probable interpretations, and, because of these probable interpretations, the decisions of the speaker about when use of underspecified emotive terms is appropriate.

An aging population is often taken to require a profound reorganization of the prevailing health care system. In particular, a more cost-effective care system is warranted and ICT-based home care is often considered a promising alternative. Modern health care devices admit a transfer of patients with rather complex care needs from institutions to the home care setting. With care recipients set up with health monitoring technologies at home, spouses and children are likely to become involved in the caring process and (...) informal caregivers may have to assist kin-persons with advanced care needs by means of sophisticated technology. This paper investigates some of the ethical implications of a near-future shift from institutional care to technology-assisted home care and the subsequent impact on the care recipient and formal- and informal care providers. (shrink)

As thousands of healthy research participants are being included in small and large imaging studies, it is essential that dilemmas raised by the detection of incidental findings are adequately handled. Current ethical guidance indicates that pathways for dealing with incidental findings should be in place, but does not specify what such pathways should look like. Building on an interview study of researchers’ practices and perspectives, we identified key considerations for the set-up of pathways for the detection, management and communication of (...) incidental findings in imaging research. We conducted an interview study with a purposive sample of researchers at research facilities across the Netherlands. Based on a qualitative analysis of these interviews and on existing guidelines found in the literature, we developed a prototype ethical framework, which was critically assessed and fine-tuned during a two-day international expert meeting with bioethicists and representatives from large population-based imaging studies from the United Kingdom, Germany, Sweden and Belgium. Practices and policies for the handling of incidental findings vary strongly across the Netherlands, ranging from no review of research scans and limited feedback to research participants, to routine review of scans and the arrangement of clinical follow-up. Respondents felt that researchers do not have a duty to actively look for incidental findings, but they do have a duty to act on findings, when detected. The principle of reciprocity featured prominently in our interviews and expert meeting. We present an ethical framework that may guide researchers and research ethics committees in the design and/or evaluation of appropriate pathways for the handling of incidental findings in imaging studies. The framework consists of seven steps: anticipation of findings, information provision and informed consent, scan acquisition, review of scans, consultation on detected abnormalities, communication of the finding, and further clinical management and follow-up of the research participant. Each of these steps represents a key decision to be made by researchers, which should be justified not only with reference to costs and/or logistical considerations, but also with reference to researchers’ moral obligations and the principle of reciprocity. (shrink)