Decentralized clinical trials (DCTs) have the potential to advance the conduct of clinical trials, but raise several ethical issues, including obtaining valid informed consent. The debate on the ethical issues resulting from digitalization is predominantly focused on direct risks relating to for example data protection, safety, and data quality. We submit however, that a broader view on ethical aspects of DCTs is needed to touch upon the new challenges that come with the DCT practice. Digitalization has impacts that go beyond (...) its direct purposes, by shaping behaviors, experiences, social relations, and values. We examine four elements of the informed consent procedure that are affected by DCTs, while taking these soft impacts of technologies into account: (i) informing participants and testing understanding, (ii) freedoms in relation to responsibilities and burdens, (iii) trust in participant-researcher relations, and (iv) impacts on the concept of privacy. Our analysis reveals that a broad view is key for optimal conduct of DCTs. In addition, it provides insight into the ethical impacts of DCTs on informed consent. Technologies such as DCTs potentially have profound impacts which are not immediately addressed by the existing regulatory frameworks, but nonetheless important to recognize. These findings can guide future practices of DCTs to foster the important values of clinical research in this novel approach for conducting clinical trials. (shrink)

Research ethics committees (RECs) evaluate whether the risk-benefit ratio of a study is acceptable. Decentralized clinical trials (DCTs) are a novel approach for conducting clinical trials that potentially bring important benefits for research, including several collateral benefits. The position of collateral benefits in risk-benefit assessments is currently unclear. DCTs raise therefore questions about how these benefits should be assessed. This paper aims to reconsider the different types of research benefits, and their position in risk-benefit assessments. We first propose a categorization (...) of research benefits, based on the types of benefits that can be distinguished from the literature and ethical guidelines. Secondly, we will reconsider the position of collateral benefits. We argue that these benefits are not fundamentally different from other benefits of research and can therefore be included in risk-benefit assessments of DCTs. (shrink)

In the Netherlands, in 2002, euthanasia became a legitimate medical act, only allowed when the due care criteria and procedural requirements are met. Legally, an Advanced Euthanasia Directive can replace direct communication if a patient can no longer express his own wishes. In the past decade, an exponential number of persons with dementia share a euthanasia request with their physician. The impact this on physicians, and the consequent support needs, remained unknown. Our objective was to gain more insight into the (...) experiences and needs of Dutch general practitioners and elderly care physicians when handling a euthanasia request from a person with dementia. We performed a qualitative interview study. Participants were recruited via purposive sampling. The interviews were transcribed verbatim, and analyzed using the conventional thematic content analysis. Eleven general practitioners and elderly care physicians with a variety of experience and different attitudes towards euthanasia for PWD were included. Euthanasia requests appeared to have a major impact on physicians. Difficulties they experienced were related to timing, workload, pressure from and expectations of relatives, society’s negative view of dementia in combination with the ‘right to die’ view, the interpretation of the law and AEDs, ethical considerations, and communication with PWD and relatives. To deal with these difficulties, participants need support from colleagues and other professionals. Although elderly care physicians appreciated moral deliberation and support by chaplains, this was hardly mentioned by GPs. Euthanasia requests in dementia seem to place an ethically and emotionally heavy burden on Dutch GPs and elderly care physicians. The awareness of, and access to, existing and new support mechanisms needs further exploration. (shrink)

Drawing on Dutch mortgage orientation consultations, the present study uncovers how mortgage advisors communicate information packages to laypersons. These information packages are jointly constructed by advisors and customers as a distinct activity within a professional advisory setting. We name this activity ‘explicative telling’. Through a systematic analysis of 57 of such explicative tellings we will demonstrate that this explicative telling activity consists of doing preliminary work; a body in which general, official information about a specific mortgage topic is given and (...) information is applied to the customer’s situation; and closing sequences. Essential to the explicative telling activity is the recipient orientation of mortgage information, and also the advisors’ display of accountability for providing eligible information. This is supported by the irreversibility of the preliminary phase and by the presence of news deliverer upshot formulations during the body of the telling. (shrink)

The issue of trust has increasingly attracted attention in the business ethics literature. Our aim is to contribute further to this literature by examining how the use of the carbon copy function in email communication influences felt trust. We develop the argument that the use of cc enhances transparency—representing an important characteristic of workplace ethics—and hence promotes trust. We further argue that a downside of the cc option may be that it can also be experienced as a control mechanism, which (...) may therefore negatively affect trust. The results of our first study showed that the use of cc indeed enhances perceived transparency, but at the same time also leads to the experience of increased control. Building upon this insight, the findings of five subsequent studies consistently revealed that the use of cc negatively influences felt trust. More precisely, employees felt trusted the least when the supervisor was always included in cc. This effect on felt trust also negatively influenced how trustworthy the organizational climate was perceived. We further replicated these results in two field surveys, which showed that the negative effect of cc on felt trust lowered perceptions of psychological safety and contributed to a culture of fear. Taken together, our findings suggest that when transparency in email communications is experienced as a control mechanism, its use is perceived as unethical, rather than as ethical. Implications and recommendations for future business ethics research are discussed. (shrink)

Amsterdam University Press is a leading publisher of academic books, journals and textbooks in the Humanities and Social Sciences. Our aim is to make current research available to scholars, students, innovators, and the general public. AUP stands for scholarly excellence, global presence, and engagement with the international academic community.

Children accrue experiences with buoyancy on a daily basis, yet research paints a mixed picture of children’s buoyancy knowledge. Whereas children’s predictions and explanations of the floating and the sinking of common objects are often based on a single feature (e.g., mass or facts), children’s predictions of novel cubes reveal solution strategies based on mass and volume integrations. Correspondingly, category learning theory suggests that categories (e.g., floaters vs. sinkers) are easier to identify when items mainly vary from one another in (...) the relevant defining features. For example, a set of cubes only varies in mass and volume and hence density, thereby being able to highlight the deterministic role of density when placed in water. Here we asked how item variation during hands-on exploration affects children’s subsequent predictions and explanations of buoyancy. Kindergarteners and first-, second-, and third-grade children individually explored either a set of 10 systematically varied cubes (i.e., systematic condition; n = 95) or a set of 10 common objects (i.e., non-systematic condition; n = 96) in a water basin. Next, the children predicted the buoyancy of five new cubes and five new common objects one at a time. Subsequently, the children explained their predictions one subset at a time. The children in the systematic condition were more accurate in their predictions of the test cubes than the children in the non-systematic condition. Latent class regression analyses identified three cube prediction solution strategies. The children in the systematic condition were more likely to use a strategy in which buoyancy decisions were made based on an accurate integration of mass and volume, while the children in the non-systematic condition were more likely to use a strategy in which mass was given more predictive load than volume. A third strategy was characterized by guessing. Latent class analyses of the children’s explanations revealed different explanation strategies, each appealing to several features, but as hypothesized, no clear condition differences were found. The findings indicate that even 5 min of exploration with systematically varied cubes can already help children use an advanced buoyancy prediction strategy. This provides evidence in favor of using category learning theory to inform early science education design. (shrink)

Different institutional tasks are accomplished in the Dutch police interrogation: from filling in required paperwork, to getting the confession on paper, to editing the text of the written statement. All these different phases have different goals and go hand in hand with different typing practices. The intertwining of these activities in the various phases of the police interrogation is of interest because it demonstrates that these two activities and the way they influence and structure each other in interaction are related (...) to the institutional goal of that phase. Subsequently, this may have an effect on the product that is being constructed – the police record. (shrink)

In spatial sequence synaesthesia ordinal stimuli are perceived as arranged in peripersonal space. Using fMRI, we examined the neural bases of SSS and colour synaesthesia for spoken words in a late-blind synaesthete, JF. He reported days of the week and months of the year as both coloured and spatially ordered in peripersonal space; parts of the days and festivities of the year were spatially ordered but uncoloured. Words that denote time-units and triggered no concurrents were used in a control condition. (...) Both conditions inducing SSS activated the occipito-parietal, infero-frontal and insular cortex. The colour area hOC4v was engaged when the synaesthetic experience included colour. These results confirm the continued recruitment of visual colour cortex in this late-blind synaesthetes. Synaesthesia also involved activation in inferior frontal cortex, which may be related to spatial memory and detection, and in the insula, which might contribute to audiovisual integration related to the processing of inducers and concurrents. (shrink)

This article explains how social norms can help to distinguish and understand a range of different kinds of social inequality and social hierarchy. My aim is to show how the literature on social norms can provide crucial resources to relational egalitarianism, which has made social equality and inequality into a central topic of contemporary normative political theorizing. The hope is that a more discriminating and detailed picture of different kinds of social inequality will help relational egalitarians move beyond a discussion (...) of the justice or injustice of social equality as a single general category. (shrink)

Keuze van artikelen uit het werk van de Vlaamse filosoof over wetenschap, milieu, en medische en biologische ethiek.

It is crucial for engineers to anticipate the socio-ethical impacts of emerging technologies. Such acts of anticipation are thoroughly normative and should be cultivated in engineering ethics education. In this paper we ask: ‘ how do we anticipate the socio-ethical implications of emerging technologies responsibly? ’ And ‘ how can such responsible anticipation be taught? ’ We o ff er a conceptual answer, building upon the framework of Responsible Innovation and its four core practices: anticipation, reflexivity, inclusion, and responsiveness. We (...) forge a more explicit link between the practices of anticipation, reflexivity, and inclusion, while also enriching them with insights from disability studies, STS, design theory, and philosophy. On this basis we present responsible anticipation as an activity of reflective problem framing grounded in epistemic humility. Via the RI-practice of responsiveness we present responsible anticipation as a creative approach to engineering ethics, offering engineering students a critical yet productive perspective on how ethics may inform innovation. (shrink)

Background The COVID-19 pandemic causes moral challenges and moral distress for healthcare professionals and, due to an increased work load, reduces time and opportunities for clinical ethics support services. Nevertheless, healthcare professionals could also identify essential elements to maintain or change in the future, as moral distress and moral challenges can indicate opportunities to strengthen moral resilience of healthcare professionals and organisations. This study describes 1) the experienced moral distress, challenges and ethical climate concerning end-of-life care of Intensive Care Unit (...) staff during the first wave of the COVID-19 pandemic and 2) their positive experiences and lessons learned, which function as directions for future forms of ethics support. Methods A cross-sectional survey combining quantitative and qualitative elements was sent to all healthcare professionals who worked at the Intensive Care Unit of the Amsterdam UMC - Location AMC during the first wave of the COVID-19 pandemic. The survey consisted of 36 items about moral distress (concerning quality of care and emotional stress), team cooperation, ethical climate and (ways of dealing with) end-of-life decisions, and two open questions about positive experiences and suggestions for work improvement. Results All 178 respondents (response rate: 25–32%) showed signs of moral distress, and experienced moral dilemmas in end-of-life decisions, whereas they experienced a relatively positive ethical climate. Nurses scored significantly higher than physicians on most items. Positive experiences were mostly related to ‘team cooperation’, ‘team solidarity’ and ‘work ethic’. Lessons learned were mostly related to ‘quality of care’ and ‘professional qualities’. Conclusions Despite the crisis, positive experiences related to ethical climate, team members and overall work ethic were reported by Intensive Care Unit staff and quality and organisation of care lessons were learned. Ethics support services can be tailored to reflect on morally challenging situations, restore moral resilience, create space for self-care and strengthen team spirit. This can improve healthcare professionals’ dealing of inherent moral challenges and moral distress in order to strengthen both individual and organisational moral resilience. Trial registration The trial was registered on The Netherlands Trial Register, number NL9177. (shrink)

Bohr’s work in quantum mechanics posed a challenge to philosophers of science, who struggled with the question of whether and to what degree his theories and methods could be considered rational. This paper focuses on Popper, Feyerabend, Lakatos and Kuhn, all of whom recognized some irrational, dogmatic, paradoxical or even inconsistent features in Bohr’s work. Popper, Feyerabend, and Lakatos expressed strong criticism of Bohr’s approach to quantum physics, while Kuhn argued that such criticism was unlikely to be fruitful: progress in (...) science is generally not made through philosophical reflection. Feyerabend’s criticism of Bohr gradually weakened, as he gained a more detailed understanding of the development of Bohr’s views on quantum mechanics, and this went together with an increasingly critical view of normative philosophy of science and was instrumental to his conversion to ‘anarchism’. This paper aims to show that quantum mechanics played a central role in their debates and disagreements on the rationality of science and the possibility of a normative philosophy of science. (shrink)

Background Self-binding directives (SBDs) are psychiatric advance directives that include the possibility for service users to consent in advance to compulsory care in future mental health crises. Legal provisions for SBDs exist in the Netherlands since 2008 and were updated in 2020. While ethicists and legal scholars have identified several benefits and risks of SBDs, few data on stakeholder perspectives on SBDs are available. Aims The aim of the study was to identify opportunities and challenges of SBDs perceived by stakeholders (...) who have personal or professional experience with legally enforceable SBDs. Methods Data collection was carried out in the Netherlands from February 2020 to October 2021 by means of semi-structured interviews. Participants were selected through purposive sampling and snowball methods. Interviews were conducted with mental health service users (n = 7), professionals (n = 13), and an expert on SBD policy (n = 1), resulting in a total number of 21 interviews. The data were analyzed thematically. Results Perceived benefits of SBDs included increased autonomy, improvement of the therapeutic relationship, possibility of early intervention and prevention of harm, prevention of compulsory care, reduction of the duration of compulsory care and recovery, mitigation of negative experiences around compulsory care, and guidance for professionals in providing compulsory care. Perceived risks included infeasibility of SBD instructions, difficulty in decision-making around SBD activation, limited accessibility of SBDs, disappointment of service users due to non-compliance with SBDs, and limited evaluation and updating of SBD content. Barriers to SBD completion included lack of knowledge of SBDs among professionals, lack of motivation or insight among service users, and lack of professional support for SBD completion. Facilitators of SBD completion and activation included support for SBD completion, involvement of relatives and peer experts, specification of SBD content, and evaluation of compulsory care and SBD content. The new legal framework was regarded as having both positive and negative effects on SBD implementation. Conclusions Stakeholders who have personal or professional experience with legally enforceable SBDs perceive SBDs as having important benefits and tend not to articulate the fundamental ethical concerns about SBDs which can be found in the ethics and legal literature. Instead, they perceive ethical and practical challenges that can be addressed through the implementation of suitable safeguards. (shrink)

Eco-anxiety increasingly weighs on (young) people’s mental health and impacts their life choices. This commentary zooms in on socio-ecological reproductive concerns with the aim to provide room for collective doubts on this individual choice, and to normalize emotions of anxiety, fear, grief, guilt, and regret, among many others, because of it.

The guiding premise of this chapter is that we, as teachers in higher education, must consider how the content and form of our teaching can foster inclusivity through a responsiveness to neurodiverse learning styles. A narrow pedagogical focus on lectures, textual engagement, and essay-writing threatens to exclude neurodivergent students whose ways of learning and making sense of the world may not be best supported through these traditional forms of pedagogy. As we discuss in this chapter, we, as engineering ethics educators, (...) designed and implemented a new engineering ethics exercise with which we aimed to promote inclusivity at the levels of form and content. At the content level, students were invited to critically engage with inclusivity-undermining ableist assumptions in technology development. This took shape, at the formal level, through a hands-on ‘material tinkering’ workshop in which students collaboratively and creatively altered (or ‘hacked’) artifacts used in contexts of disability and healthcare, so as to operationalize values of inclusivity and accessibility. Our hunch was that this hands-on tinkering workshop would simultaneously encourage a meaningful way of engagement with these ethical issues and values, while also enacting a more inclusive learning environment by enriching the range of pedagogical activities and learning formats available to our students. As we aim to show in this chapter, we believe this hunch largely panned out - though there are clear areas for future improvement pertaining to the pilot exercise itself and the research we conducted on the exercise. We begin by offering a description of our tinkering exercise. We discuss the exercise’s source of inspiration (2.1) and its implementation (2.2), which is visually captured via photographic documentation. We then discuss (3) how we utilized a triangulated research method to assess the pedagogical value of the exercise. After we discuss our findings, we conclude by identifying areas for future improvement (4). (shrink)

Filosofische analyse van de verhouding tussen lichaam en geest en overzicht van eerdere opvattingen.

Beknopte weergave van de voornaamste kenmerken van het werk van een aantal filosofen en theologen, afkomstig uit China, India, Israël, Perzië en Griekenland.

Moral (or ethical) sensitivity is widely viewed as a foundational learning goal in engineering ethics education. We have argued in this paper is that this view of moral sensitivity cannot be readily transported from the nursing context to the engineering context on the basis of a care-analogy. The particularized care characteristic of the nursing context is decisively different from the generalized and universalized forms of care characteristic of the engineering context. Through a focus on care and maintenance, the engineering student’s (...) moral sensitivity can be refined, opening up a perceptual awakening and affectivity towards the complex nature of the engineer’s Other. This awakening is in part promoted through an understanding of the ideology of neutrality as a moment in the history engineering. Becoming aware of this ideology as an ideology can then be seen as an activity of dividing loyalties that allows for a reflexive and critical view of the biases and presuppositions inherited within the world of engineering. This process of deepening the engineering student’s moral sensitivity is perhaps as much a process of the student becoming aware of her professional world, how it shapes her understanding of herself, and what it means to be a good engineer. (shrink)

According to Locke, scripture says nothing about the resurrection of the same body. We will be resurrected. But in what sense can resurrected Jane be the “same” as living Jane? Throughout his thinking, Locke holds that sameness of body and/or sameness of soul are not required for the resurrection of “the same Jane.” Sameness of person is required. Locke’s theory of personal identity was ground-breaking in the seventeenth and eighteenth centuries. It was provoking and resulted in a wave of critical (...) responses. His distinction between “man” and “person” is important for his account of personal identity, but the distinction was hard for his contemporaries to understand. The correspondence between Locke and Edward Stillingfleet, for example, shows that for Stillingfleet the distinction between “man” and “person” is artificial. Having read this correspondence, Winch Holdsworth attacks Locke in a sermon in 1719 arguing that Locke denied the resurrection altogether. Catharine Trotter Cockburn tries to defend Locke in her Vindication. Despite her clear understanding of the distinctions applied by Locke, she too struggles with what to make of a person. (shrink)

There are two notions of intentionality: the first contains the thesis that our acts of thinking, judging and loving have a content; the second that our mental acts are about something external to the act. Brentano uses the term ‘intentionality’ only in relation to the first notion; for him, intentionality does not function as a bridge between the mind and the external world. Is it possible for a phenomenologist like Brentano to give an account of the second notion of intentionality? (...) It is argued that this is possible, but not without introducing the notion of judgement. A comparison with Mill’s distinction between connotation and denotation, and with Frege’s distinction between sense and reference shows how original Brentano’s theory is. (shrink)

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

This article provides ethical guidance on using race in health research as a variable or in defining the study population. To this end, a plain, non-exhaustive checklist is provided for researchers and research ethics committees, preceded by a brief introduction on the need for justification when using race as a variable or in defining a study population, the problem of exoticism, that distinctions pertain between race, ethnicity and ancestry, the problematic naming of races, and that race does not serve well (...) as a presumed biological construct in genetic research. (shrink)

One important question to ask when either writing or reviewing is: what is the ideal audience for this book? I would not recommend Tao Jiang’s Origins of Moral-.

When the language-dialect dichotomy first emerged in the early modern period, several scholars devised terminological alternatives, particularly for the subordinate lower half of the dichotomy. This article examines a series of terminological alternatives in their social and linguistic contexts, considering terms from the Romance, Germanic, and Slavic linguistic zones. Our case studies suggest that there were two main reasons for coining neologisms, or for devising new meanings for existing words. Some scholars sought terms with stronger pejorative connotations, others acted from (...) language purism. Pejorative neologisms generally proved unsuccessful, but several purist neologisms endured. (shrink)

Social media are increasingly important in the news menu of media users. Differences in news production processes between traditional and social media may lead to differences in how political and social issues are depicted, and this may, eventually, have consequences for the information that reaches citizens about an issue. Against this background, this study compares content across the two media types to examine whether and how the framing of a sociopolitical issue differs between newspaper articles and posts on social media. (...) The empirical analyses are based on a content analysis of newspaper articles (n = 414) and social media messages (n = 2,771) conducted in the context of the socially contested issue of raising the retirement age in the Netherlands. Findings suggest that different content production processes can still lead to similar outcomes as both media types emphasize problems with (instead of solutions to) the retirement age issue. Our findings also confirm differences across traditional and social media, although these differences are substantially relatively small. While traditional news media emphasize conflict-related frames more often than social media, social media present more frame diversity in solutions. (shrink)