In this article, an ethical analysis of an educational programme on renal replacement therapy options for patients and their social network is presented. The two main spearheads of this approach are: (1) offering an educational programme on all renal replacement therapy options ahead of treatment requirement and (2) a home-based approach involving the family and friends of the patient. Arguments are offered for the ethical justification of this approach by considering the viewpoint of the various stakeholders involved. Finally, reflecting on (...) these ethical considerations, essential conditions for carrying out such a programme are outlined. The goal is to develop an ethically justified and responsible educational programme. (shrink)

This study aims to examine the development of diversity and inclusion (D&I) literature and identify its prominent themes and blind spots. The research was conducted using bibliometric analysis on the Web of Science database and included 2510 publications. Results showed that the development of D&I literature had increased exponentially since the 1960s, mainly due to different political and societal events. The geographic development showed that research was primarily conducted in developed countries where quotas and other legislation are implemented. The thematic (...) development revealed a stable but narrow focus on diversity management, board diversity, and team diversity, with little attention to inclusion. The keyword analysis strongly emphasized surface-level diversity, such as gender, race, and cultural diversity, while deep-level diversity received less attention. This study concludes that previous D&I literature has mainly focused on the financial effects of D&I and neglected other elements, such as the effects on social performance, its ethical implications, and the relationship between diversity and inclusion. The study recommends future research to expand the interpretation of diversity, examine the relationship between diversity and inclusion, and explore the effects of diversity on non-financial outcomes such as social performance and ethics. This study provides a valuable contribution to the field of business ethics by highlighting the blind spots in D&I literature and encouraging future research to consider the ethical implications of diversity in the workplace. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kinship:The Relationship Between Johnstone's Ideas about Philosophical Argument and the Pragma-Dialectical Theory of ArgumentationFrans H. van Eemeren and Peter Houtlosser1. Johnstone on the Nature of Philosophical ArgumentAs he himself declared in Validity and Rhetoric in Philosophical Argument (1978, 1), the late philosopher Henry W. Johnstone Jr. devoted a long period of his professional life to clarifying the nature of philosophical argument. His well-known view was that philosophical arguments are (...) sui generis, i.e., not to be judged by the standards of argumentation in science or everyday discourse. Philosophical arguments are not ad rem, but are based on premises that are expressed or implied commitments of a party in dialogue. This is why philosophical argumentation is, according to Johnstone, always ad hominem. In philosophical argumentation, every ad rem argument begs the question.Usually, ad hominem argumentation is dismissed as invalid. Johnstone, however, maintains that making use of argumentum ad hominem is the only way to establish a philosophical conclusion. In an argumentum ad hominem, inferences are drawn from propositions stated or implied by the other party and critical questions are raised about the conclusions that were drawn, so that it can be used to refute a philosophical position by showing that this position is inconsistent. As Walton (2001) rightly observes, this type of ad hominem argumentation boils down to arguing from commitments of the other party, i.e., ex concessis.The use of ad hominem argumentation as the criticism of a position in terms of its own presuppositions is, in Johnstone's view, the only valid argument in philosophy, if any philosophical argument is indeed valid. All philosophical polemic is in this perspective in fact addressed ad hominem. This applies not only to philosophical argumentation that concerns self-referential refutation but also to other ad hominem types of philosophical argumentation, including the tu quoque argument (1978, 11–12).According to Johnstone, there is no objective criterion for determining the validity of ad hominem argumentation. Validity must, says Johnstone in the [End Page 51] epilogue of his collected essays on philosophical argument, be viewed as "a regulative ideal" (135). Much earlier, Johnstone had already come to the conclusion that "the valid argument is the one that maintains philosophical discussion" (38). It is this self-perpetuating feature that is the distinctive rationality of philosophy. By forcing the interlocutor to elaborate his philosophical position rather than just repeat it, the gap between the interlocutors is bridged.In order to distinguish between constructive persuasive argumentation and mere repetition or other forms of paralyzing the discourse, the line must be drawn between responsible and irresponsible persuasion. This is a problem for Johnstone. Where the Ancients solved the problem by insisting that the persuader be virtuous, Johnstone proposed to base the distinction between responsible and irresponsible persuasion on the attitude of the philosopher and his interest in maintaining the philosophical enterprise. The philosopher is a critic who criticizes con amore. His intention to do so, however, is revealed "only in the way he goes about his work" (84).A more down to earth criterion for responsible persuasion that Johnstone proposed is that the discourse should not tend to degenerate. Logic, as the discipline concerned with reason, serves to prevent the discussion from degenerating, but it can do so only if the parties concerned have jointly committed themselves to certain logical principles. If in philosophical argument a defendant is under no obligation to acknowledge an inconsistency when the other party points out an inconsistency in his position, then the other party's criticism cannot count as valid. According to Johnstone, however, it will depend on the parties' presuppositions whether or not they consider two statements as being inconsistent. In other words, what is inconsistent for the one party may not be inconsistent for the other party.Few obligations are imposed on everyone; most obligations arise from commitments made by specific individuals or groups of individuals. As Johnstone says, "Even the cogent philosophical argument is not, of course, absolutely cogent; it is cogent only relatively to interlocutors who maintain the premises on which it depends" (27). Once we abandon the search for objective conditions under which philosophical arguments can be valid, according... (shrink)

In the present article we argue that emotional interactions are not appropriately captured in present emotion research and theorizing. Emotional stimuli or antecedents are dynamic and change over time because they often interact and have a specific relationship with the subject. Earlier emotional interactions may, for example, intensify later emotional reactions to a specific person, or our anger reactions towards powerful or powerless others may differ considerably. Thus, we suggest that such social factors not only affect the intensity, but also (...) the nature of emotional experiences and expressions, and specifically the nature of the social movement (e.g., moving towards, away, or against). We discuss different processes that are implicated in the relation between the social environment and our emotions, describe how emotional expressions shape social behavior, and provide suggestions for incorporating the social dimension of emotion in future research. (shrink)

Despite the reported limited success of conventional treatments and growing evidence of the effectiveness of adult bariatric surgery, weight loss operations for (morbidly) obese children and adolescents are still considered to be controversial by health care professionals and lay people alike. This paper describes an explorative, qualitative study involving obesity specialists, morbidly obese adolescents, and parents and identifies attitudes and normative beliefs regarding pediatric bariatric surgery. Views on the etiology of obesity—whether it should be considered primarily a medical condition or (...) more a psychosocial problem—seem to affect the specialists’ normative opinions concerning the acceptability of bariatric procedures as a treatment option, the parents’ feelings regarding both being able to influence their child’s health and their child being able to control their own condition, and the adolescents’ sense of competence and motivation for treatment. Moreover, parents and adolescents who saw obesity as something that they could influence themselves were more in favor of non-surgical treatment and vice versa. Conflicting attitudes and normative views—e.g., with regard to concepts of disease, personal influence on health, motivation, and the possibility of a careful informed consent procedure—play an important role in the acceptability of bariatric surgery for childhood obesity. (shrink)

Previous research has yielded inconsistent findings concerning the relationship between envy and schadenfreude. Three studies examined whether the distinction between benign and malicious envy can resolve this inconsistency. We found that malicious envy is related to schadenfreude, while benign envy is not. This result held both in the Netherlands where benign and malicious envy are indicated by separate words (Study 1: Sample A, N = 139; Sample B, N = 150), and in the USA where a single word is used (...) to denote both types (Study 2, N = 180; Study 3, N = 349). Moreover, the effect of malicious envy on schadenfreude was independent of other antecedents of schadenfreude (such as feelings of inferiority, disliking the target person, anger, and perceived deservedness). These findings improve our understanding of the antecedents of schadenfreude and help reconcile seemingly contradictory findings on the relationship between envy and schadenfreude. (shrink)

Despite their status as high-income food producing nations, children and their caregivers, both in the United States (U.S.) and Australia can experience food insecurity. Nutrition researchers formed a joint U.S.-Australia collaboration to help advance food security for households with young children aged 0–5 years. This study investigated food insecurity from the perspective of caregivers, especially their perceptions of the impact of food insecurity on their own childhood, their current life, and for the children in their care. Semi-structured interviews were conducted (...) from July to September 2020 during the COVID-19 pandemic. Participants were recruited in Omaha, Nebraska, U.S. (_n_ = 19) and Melbourne, Victoria, Australia (_n_ = 22), during periods of stay-at-home public health orders. These two case study sites enabled an exploration of some universal, and some context-specific, social, economic, and health conditions that buffer, or exacerbate, food insecurity for families in these neo-liberal political settings. An inductive thematic analysis was conducted and established six themes:_growing up poor_, _lessons learned_,_ feeding a family amidst a pandemic_,_ caregiver coping strategies_, _food security in the early years_ and _protecting (young) children_. Perspectives on local anti-hunger strategies were organized to outline participant’s preferred solutions. Household food insecurity is conceptualized in public policy in the U.S. and Australia as a short-term crisis for people, justifying austere, time-limited and patchwork solutions. A narrative of caregivers’ lived experience of food insecurity suggests that it is inter-generational, and exacerbated by a food system shock (i.e., COVID-19). These findings from two varying cities and nations offer a different conceptualization of the timespan and nature of the phenomenon of food insecurity, challenging a dominant policy narrative and highlighting the inadequacy of current so-called solutions. (shrink)

To prevent ordinary people from being harmed by natural language processing (NLP) technology, finding ways to measure the extent to which a language model is biased (e.g., regarding gender) has become an active area of research. One popular class of NLP bias measures are bias benchmark datasets—collections of test items that are meant to assess a language model’s preference for stereotypical versus non-stereotypical language. In this paper, we argue that such bias benchmarks should be assessed with models from the psychometric (...) framework of item response theory (IRT). Specifically, we tie an introduction to basic IRT concepts and models with a discussion of how they could be relevant to the evaluation, interpretation and improvement of bias benchmark datasets. Regarding evaluation, IRT provides us with methodological tools for assessing the quality of both individual test items (e.g., the extent to which an item can differentiate highly biased from less biased language models) as well as benchmarks as a whole (e.g., the extent to which the benchmark allows us to assess not only severe but also subtle levels of model bias). Through such diagnostic tools, the quality of benchmark datasets could be improved, for example by deleting or reworking poorly performing items. Finally, in regards to interpretation, we argue that IRT models’ estimates for language model bias are conceptually superior to traditional accuracy-based evaluation metrics, as the former take into account more information than just whether or not a language model provided a biased response. (shrink)

PurposeTo explore the mindfulness practice, its long-term effects, facilitators and barriers, in clinical clerkship students 2 years after participation in an 8-week mindfulness-based stress reduction training.MethodA qualitative study was performed by semi-structured in-depth interviews with 16 clinical clerkship students selected by purposive sampling. Students had participated in a MBSR training 2 years before and were asked about their current mindfulness practice, and the long-term effects of the MBSR training. Thematic analysis was conducted using the constant comparison method. Data saturation was (...) reached after 16 interviews.ResultsMost interviewees were still engaged in regular, predominantly informal, mindfulness practice, although some discontinued mindfulness practice and reported an “unchanged lifestyle.” Three main themes came forward; “focused attention and open awareness” during daily activities as core elements of long-term mindfulness practice; “changes in behavior and coping” that resulted from taking a pause, reflecting, recognizing automatic behavioral patterns and making space for a conscious response; “integration in personal and professional life” by enhanced enjoyment of daily activities, improved work-life-balance and making different career choices. Barriers and facilitators in starting and maintaining mindfulness practice were understanding and intention as “pre-conditions”; practical, personal, and professional factors of students in maintaining practice.ConclusionTwo years after participation in a MBSR training, many interviewees were still engaged in mindfulness practice contributing to both personal and professional changes. In light of the high clerkship demands, MBSR training could be a valuable addition to medical curricula, supporting medical students in developing necessary competencies to become well-balanced professionals. (shrink)

The participation of vulnerable patients in clinical research poses apparent ethical dilemmas. Depending on the nature of the vulnerability, their participation may challenge the ethical principles of autonomy, non-maleficence, or justice. On the other hand, non-participation may preclude the building of a knowledge base that is a prerequisite for defining the optimal clinical management of vulnerable patients. Such clinical uncertainty may also incur substantial economic costs. We present the participation of pre-menopausal women with atrial fibrillation in trials of novel oral (...) anticoagulant drugs as a case study. Due to their non-participation in pivotal trials, it is uncertain whether for them, the risks that are associated with these drugs are outweighed by the advantages compared with conventional treatment. We addressed the question whether research of this new class of drugs in this subgroup would be appropriate from both, an ethical as well an economic perspective. We used the method of specifying norms as a wider framework to resolve the apparent ethical dilemma, while incorporating the question whether research of oral anticoagulants in premenopausal women with atrial fibrillation can be justified on economic grounds. For the latter, the results of a value-of-information analysis were used. Further clinical research on NOACs in premenopausal women with atrial fibrillation can be justified on both, ethical and economic grounds. Addressing apparent ethical dilemmas by invoking a method such as specifying norms can improve the quality of public practical reasoning. As such, the method should also prove valuable to committees that have formally been granted the authority to review trial protocols and proposals for scientific research. (shrink)

Objectives: There are indications that institutional review board members do not find it easy to assess the risks and benefits in medical experiments, although this is their principal duty. This study examined how IRB members assessed the risk/benefit ratio of a specific phase II breast cancer clinical trial.Participants and methods: The trial was evaluated by means of a questionnaire administered to 43 members of IRBs at six academic hospitals and specialised cancer centres in the Netherlands. The questionnaire addressed: identification and (...) estimation of inconvenience, toxicity, psychosocial distress, and benefits of trial participation to patients; identification and estimation of benefits to future patients and medical science; assessment of the trial’s RBR; and assessment of its ethical acceptability.Results: Most IRB members expected trial participation to involve fairly or very serious inconvenience, fairly severe to sometimes life-threatening toxicity, and serious psychological and social consequences. Conversely, the perceived likelihood of benefits to patients was modest. Most regarded the study as important, and the balance between risks and benefits to be favourable, and believed that the protocol should be approved. The IRB members’ final judgement on the trial’s ethical acceptability was significantly correlated with their RBR assessment of the protocol.Conclusions: Because most patients who participate in clinical trials hope this will prolong their lives, it is suggested that patient information should better describe the anticipated benefits—for example, the likelihood of prolonging life. This would allow patients to make decisions regarding participation based on realistic expectations. (shrink)

Transcranial direct current stimulation over the contralateral primary motor cortex of the target muscle has been described to enhance corticospinal excitability, as measured with transcranial magnetic stimulation. Recently, tDCS targeting the brain regions functionally connected to the contralateral primary motor cortex was reported to enhance corticospinal excitability more than conventional tDCS. We compared the effects of motor network tDCS, 2 mA conventional tDCS, and sham tDCS on corticospinal excitability in 21 healthy participants in a randomized, single-blind within-subject study design. We (...) applied tDCS for 12 min and measured corticospinal excitability with TMS before tDCS and at 0, 15, 30, 45, and 60 min after tDCS. Statistical analysis showed that neither motor network tDCS nor conventional tDCS significantly increased corticospinal excitability relative to sham stimulation. Furthermore, the results did not provide evidence for superiority of motor network tDCS over conventional tDCS. Motor network tDCS seems equally susceptible to the sources of intersubject and intrasubject variability previously observed in response to conventional tDCS. (shrink)

A novel Protocol Ethics Tool Kit (‘Ethics Tool Kit’) has been developed by a multi-stakeholder group of the Multi-Regional Clinical Trials Center of Brigham and Women9s Hospital and Harvard. The purpose of the Ethics Tool Kit is to facilitate effective recognition, consideration and deliberation of critical ethical issues in clinical trial protocols. The Ethics Tool Kit may be used by investigators and sponsors to develop a dedicated Ethics Section within a protocol to improve the consistency and transparency between clinical trial (...) protocols and research ethics committee reviews. It may also streamline ethics review and may facilitate and expedite the review process by anticipating the concerns of ethics committee reviewers. Specific attention was given to issues arising in multinational settings. With the use of this Tool Kit, researchers have the opportunity to address critical research ethics issues proactively, potentially speeding the time and easing the process to final protocol approval. (shrink)

The editors welcome letters from readers, although we cannot guarantee that all will be published. To ensure timeliness, correspondents must respond to an article within seven weeks and not exceed two double‐spaced pages. Letters become the property of the editors and may be edited and shortened at our discretion.