This article concerns itself with the reception of Rous’ 1911 discovery of what later came to be known as the Rous Sarcoma Virus. Rous made his discovery at the Rockefeller Institute for Medical Research which had been primarily established to conduct research into infectious diseases. Rous’ chance discovery of a chicken tumor led him to a series of conjectures about cancer causation and about whether cancer could have an extrinsic cause. Rous’ finding was received with some scepticism by the scientific (...) community that held that cancer was not infectious and favored explanations which located the origins of cancer in the inner mechanism of the cell. After 4 years of unsuccessful effort to isolate and further determine the virus Rous felt compelled to discontinue his work on cancer viruses. When 55 years later, the significance of Rous’s discovery was attested by the award of the Nobel Prize, it opened up debates about the issues of delayed recognition and scientific reputation. This article also considers why Rous’ hypothesis of a viral origin of cancer could not be incorporated into the existing body of knowledge about cancer before the 1950s. (shrink)

To find more information about Rowman and Littlefield titles, please visit www.rowmanlittlefield.com.

On 11 September 2019, the verdict was read in the first prosecution of a doctor for euthanasia since the Termination of Life on Request and Assisted Suicide (Review Procedures) Act of 2002 was installed in the Netherlands. The case concerned euthanasia on the basis of an advance euthanasia directive (AED) for a patient with severe dementia. In this paper we describe the review process for euthanasia cases in the Netherlands. Then we describe the case in detail, the judgement of the (...) Regional Review Committees for Termination of Life on Request and Euthanasia (RTE) and the judgement of the medical disciplinary court. Both the review committees and the disciplinary court came to the conclusion there were concerns with this case, which mainly hinged on the wording of the AED. They also addressed the lack of communication with the patient, the absence of oral confirmation of the wish to die and the fact that the euthanasia was performed without the patient being aware of this. However, the doctor was acquitted by the criminal court as the court found she had in fact met all due care criteria laid down in the act. We then describe what this judgement means for euthanasia in the Netherlands. It clarifies the power and reach of AEDs, it allows taking conversations with physicians and the testimony of the family into account when interpreting the AED. However, as a practical consequence the prosecution of this physician has led to fear among doctors about prosecution after euthanasia. (shrink)

Science is fundamentally devoted to generating original knowledge, and therefore concepts of scientific originality are keys to understanding its very essence. Scientific originality has long been thought of as discovery, but new studies of the humanities and social sciences have shown that other, discipline-specific concepts of originality are used in these fields of study. Does this finding also hold for disciplines in the natural science, medicine, and engineering? Are concepts of originality scientifically grounded or do they instead reflect extrascientific modes (...) of originality? These questions lie at the heart of research proposals responding to an initiative explicitly calling for original scientific projects. The proposals undergo a two-step analysis based on grounded theory[Per style, reference citation is not allowed in abstract section. Hence, we have deleted Charmaz, 2006. Please approve.]. First, three empirically identified modes of scientific originality are described: temporal, partially different, and revolutionary. The three modes of originality are consistent with extrascientific ones such as those in art and fashion. Second, six disciplines—two each in the natural science, medical, and engineering—are analyzed for ways the three modes of originality are used and for their associated disciplinary characteristics in order to identify discipline-specific concepts of originality. (shrink)

BackgroundResearch using data from medical care promises to advance medical science and improve healthcare. Academia is not the only sector that expects such research to be of great benefit. The research-based health industry is also interested in so-called ‘real-world’ health data to develop new drugs, medical technologies or data-based health applications. While access to medical data is handled very differently in different countries, and some empirical data suggest people are uncomfortable with the idea of companies accessing health information, this paper (...) aims to advance the ethical debate about secondary use of medical data generated in the public healthcare sector by for-profit companies for medical research (ReuseForPro).MethodsWe first clarify some basic concepts and our ethical-normative approach, then discuss and ethically evaluate potential claims and interests of relevant stakeholders: patients as data subjects in the public healthcare system, for-profit companies, the public, and physicians and their healthcare institutions. Finally, we address the tensions between legitimate claims of different stakeholders in order to suggest conditions that might ensure ethically sound ReuseForPro.ResultsWe conclude that there are good reasons to grant for-profit companies access to medical data if they meet certain conditions: among others they need to respect patients’ informational rights and their actions need to be compatible with the public’s interest in health benefit from ReuseForPro. (shrink)

Contrary to the widespread concern about over-treatment at the end of life, today, patient preferences for palliative care at the end of life are frequently respected. However, ethically challenging situations in the current healthcare climate are, instead, situations in which a competent patient requests active treatment with the goal of life-prolongation while the physician suggests best supportive care only. The argument of futility has often been used to justify unilateral decisions made by physicians to withhold or withdraw life-sustaining treatment. However, (...) we argue that neither the concept of futility nor that of patient autonomy alone is apt for resolving situations in which physicians are confronted with patients' requests for active treatment. Instead, we integrate the relevant arguments that have been put forward in the academic discussion about ‘futile’ treatment into an ethical algorithm with five guiding questions: (1) Is there a chance that medical intervention will be effective in achieving the patient's treatment goal? (2) How does the physician evaluate the expected benefit and the potential harm of the treatment? (3) Does the patient understand his or her medical situation? (4) Does the patient prefer receiving treatment after evaluating the benefit-harm ratio and the costs? (5) Does the treatment require many resources? This algorithm shall facilitate approaching patients' requests for treatments deemed futile by the physician in a systematic way, and responding to these requests in an ethically appropriate manner. It thereby adds substantive considerations to the current procedural approaches of conflict resolution in order to improve decision making among physicians, patients and families. (shrink)

As moral decision making in financial markets incorporates moral considerations into investment decisions, some rational decision theorists argue that moral considerations would introduce inefficiency to investment decisions. However, market demand for socially responsible investment is increasing, suggesting that investment decisions are influenced by both financial and moral considerations. Several models can be applied to explain moral behavior. We test the suitability of (a) multiple attribute utility theory (MAUT), (b) theory of planned behavior, and (c) issue-contingent model of ethical decision making (...) in organizations. In an experimental setting, 141 participants traded company shares in a computerized asset market. Over 12 periods, companies varied in morality (i.e., treatment of employees) and in profitability (i.e., expected dividends per share). Participants’ bids and asks for shares were recorded. Results indicate that moral considerations influence investment decisions, controlling for profit. Differences between the three models are discussed. (shrink)

In this chapter, I clarify the notions of mental content and of concept. I present competing views on these notions and indicate my own position. I introduce content in terms of correctness conditions and distinguish several kinds of propositions, as well as non-propositional scenario content, with which perceptual content might be identified. I relate this discussion to a wide-spread commitment in philosophy of perception to respect the subject’s perceptual perspective in ascriptions of perceptual content. Then I compare views of concepts (...) as Fregean senses, as mental representations, and as cognitive abilities and investigate how they relate to the central idea that concepts are possessed by subjects. I suggest that our talk of concept possession and exercise is anchored in subjects’ abilities for re-identification and for general thought and in their inferential abilities. I clarify how possession and exercise of these three conceptual abilities relate. (shrink)

Die Entscheidung für oder gegen lebensverlängernde Behandlungsmaßnahmen geht inzwischen der Hälfte aller Todesfälle in Europa voraus. Sie wird im klinischen Alltag häufig als ethische Herausforderung wahrgenommen, zudem sind unter Klinikern juristische Unsicherheiten und Fragen der korrekten Vorgehensweise verbreitet. Die hier vorgestellte Münchner Leitlinie zu Entscheidungen am Lebensende soll rechtliche Unsicherheit reduzieren, Klinikumsmitarbeiter für die ethische Dimension von Therapieentscheidungen am Lebensende sensibilisieren und ethisch begründete Entscheidungen fördern. Aus organisationsethischer Perspektive soll mit der Leitlinie eine Reflexion und Meinungsbildung zu einem ethisch relevanten (...) Themenbereich erfolgen und ein Beitrag zur Qualitätssicherung der Patientenversorgung und damit auch zur Patientenzufriedenheit geleistet werden. Die Prozesse der Leitlinienentwicklung, -aktualisierung und -implementierung werden vorgestellt. Die wesentlichen inhaltlichen Elemente der Leitlinie mit Darstellung der Rechtslage, der Definition zentraler Begriffe und Klärung medizinischer Entscheidungskriterien werden an Hand eines Entscheidungsalgorithmus dargestellt. Inhalt und Prozess der Leitlinienentwicklung werden auf die folgenden organisationsethischen Qualitätskriterien hin überprüft: deliberativer Prozess, inhaltliche Transparenz, repräsentative Zusammensetzung der Arbeitsgruppe, Implementierung und Evaluation der Leitlinie. Institutionen, die diese Leitlinie übernehmen wollen, sollten diese von einem autorisierten Gremium überprüfen lassen und auf die spezifischen Bedürfnisse ihrer Institution adaptieren. Hierfür ist eine vorgeschaltete Bedarfserhebung hilfreich. In dem Gremium sollten all diejenigen vertreten sein, die in der Folge mit der Leitlinie arbeiten werden. (shrink)

Anonymous resume screening, as assumed, does not dissuade age discriminatory effects. Building on job market signaling theory, this study investigated whether older applicants may benefit from concealing explicitly mentioned age signals on their resumes (date of birth) or whether more implicit/subtle age cues on resumes (older-sounding names/old-fashioned extracurricular activities) may lower older applicants’ hirability ratings. An experimental study among 610 HR professionals using a mixed factorial design showed hiring discrimination of older applicants based on implicit age cues in resumes. This (...) effect was more pronounced for older raters. Concealing one’s date of birth led to overall lower ratings. Study findings add to the limited knowledge on the effects of implicit age cues on hiring discrimination in resume screening and the usefulness of anonymous resume screening in the context of age. Implications for research and practice are discussed. (shrink)

The debate on abortion has tended to avoid the psychological significance of an unwanted pregnancy, dominated istead by the strong emotions the subject excites. Eva Pattis Zoja examines the thoughts that surround a woman's decision to end a pregnancy, and presents the challenging thesis that voluntary abortion can often be a violent and unconscious act of self-realisation. Treating a theme which is central to our existence, the author makes no attempt to argue for or against, or to deny the painful (...) nature of the subject which she tackles, but instead looks at the way in which a decision to abort can affect a woman's inner life. (shrink)

The children of today live in a time when the images of themselves and their childhood, their needs, interests, and skills, are discussed, researched, challenged, and changed. Childhood, education and educational settings for young children are to a great extent governed by temporality. In this paper, temporality and temporal notions in education are explored and discussed. We especially illuminate two different ways of thinking about children in education and care for younger children in the West— the predominant biased notions of (...) the child as becoming or being. The child as becoming, is manifested primarily in classical developmental psychology while the notion of the child as being, has been highlighted mainly by sociological researchers in their critique of developmental psychology. This latter notion is also visible in a totally different manner in the philosophy of Rousseau, emphasizing the free and natural child. In addition, we explore an alternative way of thinking about temporality and children. Drawing upon the philosophy of Maurice Merleau-Ponty and Gilles Deleuze, we argue for a rethinking of temporality beyond linear views on time and biased notions of children as ‘either or’. A movement towards a perspective which not only combines notions, but where the whole is more than merely the sum of the parts, is proposed. This leads to an ambiguous, intertwined and ongoing connection between the temporal notions of have been, being and becoming, described by a novel concept—a chiasmic be(com)ing. We suggest that this alternative may be a fruitful way to overcome binary approaches and expand the discussion of temporality, and temporal notions of children, in education. Such an alternative could function as a counterweight to the predominant notions of education and teachers’ work. It may also be seen as a significant foundation for an ethical education since it is built upon ongoing and intertwined relationships, which appreciate openness and unpredictability. (shrink)

Research question The secondary research use of treatment data has the potential to expand medical knowledge and improve patient care. Hospitals play an important role in systematic secondary research use: they generate large amounts of treatment data and are supposed to establish the necessary structures for their use in research. This raises the ethical question: do hospitals have a moral duty to support secondary research use of treatment data by establishing and operating the necessary resources and infrastructure? Procedure Our aim (...) is to outline a conceptual framework to discuss the question and to propose a first normative position. Building on insights from business and organizational ethics, we develop a conceptual framework in which we view hospitals as moral actors. Our normative-ethical analysis is based on a reconstructive stakeholder approach, in which we identify the following general duties of hospitals: orientation towards patient wellbeing; cost efficiency; enabling employees to act in accordance with professional ethical standards; supporting public health and research. We examine whether these general duties provide reasons for a specific duty of hospitals to support secondary research use of treatment data. We discuss potential objections to such a duty arising from other, potentially conflicting general duties of hospitals (e.g., data protection), from practice (e.g., costs/resources), or related discourses (data ownership). Conclusion Certain general duties (orientation towards patient wellbeing, cost efficiency, support of public health) justify a duty of hospitals to support secondary research use of treatment data. The duty to enable employees to act in accordance with professional ethical standards is only an indirect reason; the duty to support research applies solely to university hospitals. Potential objections apply to a certain extent but can be mitigated through targeted measures. (shrink)

This chapter explores whether a version of causalism about reasons for action can be saved by giving up Davidsonian psychologism and endorsing objectivism, so that the reasons for which we act are the normative reasons that cause our corresponding actions. We address two problems for ‘objecto-causalism’, actions for merely apparent normative reasons and actions performed in response to future normative reasons—in neither of these cases can the reason for which the agent acts cause her action. To resolve these problems, we (...) move from objecto-causalism to ‘objecto-capacitism’, which appeals to agential competences manifest-ed in acting for a reason. We briefly apply this view of reasons for action to historical action explanations. (shrink)

This essay, the last in a series, focuses on the relationship between Nietzsche’s mental illness and his philosophical art. It is predicated upon my original diagnosis of his mental condition as bipolar affective disorder, which began in early adulthood and continued throughout his creative life. The kaleidoscopic mood shifts allowed him to see things from different perspectives and may have imbued his writings with passion rarely encountered in philosophical texts. At times hovering on the verge of psychosis, Nietzsche was able (...) to gain access to unconscious images and the music of language, usually inhibited by the conscious mind. He reached many of his linguistic, psychological and philosophical insights by willing suspension of the rational. None of these, however, could have been communicated had he not tamed the subterranean psychic forces with his impressive discipline and hard work. (shrink)

(1992). Cultural goods and their positive externalities. World Futures: Vol. 33, Culture and Development: European Experiences and Challenges A Special Research Report of the European Culture Impact Research Consortium (EUROCIRCON), pp. 181-187.