Interactive technology assessment (iTA) provides an answer to the ethical problem of normative bias in evaluation research. This normative bias develops when relevant perspectives on the evaluand (the thing being evaluated) are neglected. In iTA this bias is overcome by incorporating different perspectives into the assessment. As a consequence, justification of decisions based on the assessment is provided by stakeholders having achieved agreement. In this article, agreement is identified with wide reflective equilibrium to show that it indeed has the potential (...) of justifying decisions. We work out several conditions for this agreement to be achievable and just. (shrink)

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 In the Utrecht Universiteitsmuseum there is an unpublished letter of Amp`ere to van Beek, which is published at the end of this article.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

Patients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Yet these patients have shown to survive sometimes for decades. The role of the families is thought to be important. The aim of this study was to make an inventory of the professional perspective on conflicts in long-term (...) care of patients in VS/UWS. A qualitative study of transcripts on 2 Moral Deliberations (MD’s) in 2 cases of patients in VS/UWS in long-term care facilities. Six themes emerged: 1) Vision on VS/UWS; 2) Treatment and care plan; 3) Impact on relationships; 4) Feelings/attitude; 5) Communication; 6) Organizational aspects. These themes are related to professionals and to what families had expressed to the professionals. We found conflicts as well as contradictory feelings and thoughts to be a general feature in 4 of these themes, both in professionals and families. Conflicts were found in several actors: within families concerning all 6 themes, in nurse teams concerning the theme treatment and care plan, and between physicians concerning all 6 themes. Different visions, different expectations and hope on recovery, deviating goals and contradictory feelings/thoughts in families and professionals can lead to conflicts over a patient with VS/UWS. Key factors to prevent or solve such conflicts are a carefully established diagnosis, clarity upon visions, uniformity in treatment goals and plans, an open and empathic communication, expertise and understanding the importance of contradictory feelings/thoughts. Management should bridge conflicts and support their staff, by developing expertise, by creating stability and by facilitating medical ethical discourses. Shared compassion for the patient might be a key to gain trust and bridge the differences from non-shared to shared decision making. (shrink)

The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia.

We assessed how synchronous speech listening and lipreading affects speech recognition in acoustic noise. In simple audiovisual perceptual tasks, inverse effectiveness is often observed, which holds that the weaker the unimodal stimuli, or the poorer their signal-to-noise ratio, the stronger the audiovisual benefit. So far, however, inverse effectiveness has not been demonstrated for complex audiovisual speech stimuli. Here we assess whether this multisensory integration effect can also be observed for the recognizability of spoken words. To that end, we presented audiovisual (...) sentences to 18 native-Dutch normal-hearing participants, who had to identify the spoken words from a finite list. Speech-recognition performance was determined for auditory-only, visual-only (lipreading) and auditory-visual conditions. To modulate acoustic task difficulty, we systematically varied the auditory signal-to-noise ratio. In line with a commonly-observed multisensory enhancement on speech recognition, audiovisual words were more easily recognized than auditory-only words (recognition thresholds of -15 dB and -12 dB, respectively). We here show that the difficulty of recognizing a particular word, either acoustically or visually, determines the occurrence of inverse effectiveness in audiovisual word integration. Thus, words that are better heard or recognized through lipreading, benefit less from bimodal presentation. Audiovisual performance at the lowest acoustic signal-to-noise ratios (45%) fell below the visual recognition rates (60%), reflecting an actual deterioration of lipreading in the presence of excessive acoustic noise. This suggests that the brain may adopt a strategy in which attention has to be divided between listening and lipreading. (shrink)

Thanks to the exchange of arguments, groups outperform individuals on some tasks, such as solving logical problems. However, these results stem from experiments conducted among Westerners and they could be due to cultural particularities such as tolerance of contradiction and approval of public debate. Other cultures, collectivistic cultures in particular, are said to frown on argumentation. Moreover, some influential intellectual movements, such as Confucianism, disapprove of argumentation. In two experiments, the hypothesis that Easterners might not share the benefits of argumentation (...) was tested. In Experiment 1, Japanese participants had to solve a standard logical problem individually and then in groups. They performed significantly better in groups. In Experiment 2, Japanese participants had to estimate the weight of various animals. They did so individually, then after learning of another participant's estimates, then after discussing these estimates with the other participant, and then indi.. (shrink)

After Jacobus Henricus van't Hoff had passed away on 1 March 1911, his pupil Charles Marinus van Deventer wrote a very personal ‘in memoriam’ in the Dutch literary periodical De Gids, pointing out that van't Hoff had merely been interested in scientific facts, not in the people discovering these facts. Van't Hoff considered the study of the history of chemistry, although by no means uncongenial, a matter of little importance. He once even said: ‘To me historical research appears to be (...) appropriate for a chemist in the decline of life, when he no longer creates professional ideas, and when the laboratory has become a burden to him’. Although van Deventer had studied physical chemistry at van't Hoff's Amsterdam laboratory and had been his assistant from 1885 until 1893, he disagreed with this verdict. Van Deventer was not only a capable physical chemist, he was also an active member of the Tachtigers, a circle of Dutch poets who around 1880 brought about a renewal in Dutch literature. He took a special interest in Greek philosophy. He did not graduate with van't Hoff, but with his colleague Jan Willem Gunning . His thesis was not based on physical-chemical, but on historical research: Schetsen uit de Geschiedenis van de Scheikunde . From 1922 to 1923 he lectured on the history of chemistry at Utrecht University. His fascinating lectures were published as Grepen uit de Historie der Chemie . This work reveals his particular interest in the development of chemical concepts. (shrink)

Background and aim With the increasing interest in lifestyle, health and consequences of unhealthy lifestyles for the healthcare system, a new kind of solidarity is gaining importance: lifestyle solidarity. While it might not seem fair to let other people pay for the costs arising from an unhealthy lifestyle, it does not seem fair either to punish people for their lifestyle. However, it is not clear how solidarity is assessed by people, when considering disease risks or lifestyle risks. The aim of (...) this study was to investigate the degree of solidarity with lifestyle as well as with other factors that are related to health outcomes—for example, old age—and the relation between this degree of solidarity and various characteristics. Methods This cross-sectional study is part of the Dutch longitudinal SMILE study. Data on the degree of solidarity with different lifestyles and old age, and the relation between the degree of solidarity and various demographic and other variables were obtained in a questionnaire survey. Results Solidarity with smokers and overweight people was moderate, as was solidarity with older people. Respondents were ambivalent about athletes. Respondents who were younger, male and highly educated, and those with a healthy lifestyle, a small social network, high quality of life and an internal locus of control, showed low solidarity. Conclusions Solidarity with an unhealthy lifestyle and old age is moderate and the degree of solidarity varies among the different subgroups. (shrink)

Background: Clinical ethics support instruments aim to support healthcare professionals in dealing with moral challenges in clinical practice. CURA is a relatively new instrument tailored to the wishes and needs of healthcare professionals in palliative care, especially nurses. It aims to foster their moral resilience and moral competences. Aim: To investigate the effects of using CURA on healthcare professionals regarding their Moral Resilience and Moral Competences. Design: Single group pre-/post-test design with two questionnaires. Methods: Questionnaires used were the Rushton Moral (...) Resilience Scale measuring Moral Resilience and the Euro-MCD, measuring Moral Competences. Respondents mainly consisted of nurses and nurse assistants who used CURA in daily practice. Forty-seven respondents contributed to both pre- and post-test with 18 months between both tests. Analysis was done using descriptive statistics and Wilcoxon signed rank tests. This study followed the SQUIRE checklist. Ethical considerations: This study was approved by the Institutional Review Board of Amsterdam UMC. Informed consent was obtained from all respondents. Results: The total Moral Resilience score and the scores of two subscales of the RMRS, that is, Responses to Moral Adversity and Relational Integrity, increased significantly. All subscales of the Euro-MCD increased significantly at posttest. Using CURA more often did not lead to significant higher scores on most (sub) scales. Conclusion: This study indicates that CURA can be used to foster moral resilience and moral competences of healthcare professionals. CURA therefore is a promising instrument to support healthcare professionals in dealing with moral challenges in everyday practice. (shrink)

Approximately three decades ago the question was first answered whether parasitoids are able to assess the number or origin of eggs in a host for a solitary parasitoid, Leptopilina heterotoma, by fitting theoretically derived distributions to empirical ones. We extend the set of different theoretically postulated distributions of eggs among hosts by combining searching modes and abilities in assessing host quality. In the models, parasitoids search either randomly (Poisson) (1) or by vibrotaxis (Negative Binomial) (2). Parasitoids are: (a) assumed to (...) treat all hosts equally, (b) able to distinguish them in unparasitised and parasitised hosts only, (c) able to distinguish them by the number of eggs they contained, or (d) able to recognise their own eggs. Mathematically tractable combinations of searching mode (1 and 2) and abilities (a,b,c,d) result in seven different models (M1a, M1b, M1c, M1d, M2a, M2b and M2c). These models have been simulated for a varying number of searching parasitoids and various mean numbers of eggs per host. Each resulting distribution is fitted to all theoretical models. The model with the minimum Akaike's information criterion (AIC) is chosen as the best fitting for each simulated distribution. We thus investigate the power of the AIC and for each distribution with a specified mean number of eggs per host we derive a frequency distribution for classification.Firstly, we discuss the simulations of models including random search (M1a, M1b, M1c and M1d). For M1a, M1c and M1d the simulated distributions are correctly classified in at least 70% of all cases. However, in a few cases model M1b is only properly classified for intermediate mean values of eggs per host. The models including vibrotaxis as searching behaviour (M2a, M2b and M2c) cannot be distinguished from those with random search if the mean number of eggs per host is low. Among the models incorporating vibrotaxis the three abilities are detected analogously as in models with random search. (shrink)