The establishment of cooperative links on a voluntary basis did not seem to be adequate for the administration in large urban agglomerations. These links are often lacking in actual administrative power, and they can be reduced to the sum of the municipal interests. Large-scale amalgamation of municipalities does not seem to be a solution when one considers the developments and prevailing attitudes in a few Western European countries. Because of the lack of an integral framework, legally based agglomeration administrations have (...) been created in a number of these countries.They are extra, often complicating administrative levels. The existing administrative levels can often suffice with a balanced redistribution of administrative tasks. Territorial adjustments must be based primarily on functional considerations, but must also be translated in terms of the other administrative levels. A functional redistribution of tasks is, therefore, a condition for a specific solution of the total administrative problem. (shrink)

Episodic representations can be entertained either as “remembered” or “imagined”—as outcomes of experience or as simulations of such experience. Here, we argue that this feature is the product of a dedicated cognitive function: the metacognitive capacity to determine the mnemicity of mental event simulations. We argue that mnemicity attribution should be distinguished from other metacognitive operations (such as reality monitoring) and propose that this attribution is a “cognitive gadget”—a distinctively human ability made possible by cultural learning. Cultural learning is a (...) type of social learning in which traits are inherited through social interaction. In the case of mnemicity, one culturally learns to discriminate metacognitive “feelings of remembering” from other perceptual, emotional, action-related, and metacognitive feelings; to interpret feelings of remembering as indicators of memory rather than imagination; and to broadcast the interpreted feelings in culture- and context-specific ways, such as “I was there” or “I witnessed it myself.” We review evidence from the literature on memory development and scaffolding, metacognitive learning and teaching, as well as cross-cultural psychology in support of this view before pointing out various open questions about the nature and development of mnemicity highlighted by our account. (shrink)

Introduction and Prologue 489 lines Part I. Officials and their ado. total: 6.214 lines Bk. 1. Curial occupations: 1.309 lines a) starting-point 3 ch.: 70 l. b) games 5 ch.: 820 l. c) varieties of magic 5 ch.: 419 l. Bk. 2. The truth of signs: prol.: 14 1. 3.116 lines a) true and false signs 3 ch.: 142 1. b) exc.: Jerusalem A.D. 70 6 ch.: 385 1. c) sequel: signs 5 ch.: 127 l. d) dreams 3 ch.: 386 (...) l. e) a problem 9 ch.: 1.272 l. f) prognostications 3 ch.: 790 l. Bk. 3. The falsehood of flattery: prol.: 26 l. 1.789 lines a) introduction 3 ch.: 194 1. b) flattery 4 ch.: 373 1. c) the theatre of life 2 ch.: 266 1. d) applications 6 ch.: 930 1. Part II. Public functions. total: 6.099 lines Bk. 4. The true sovereign: prol.: 21 1. 1.296 lines a) royal ethics 3 ch.: 258 l. b) a royal mirror from the O.T. 8 ch.: 926 l. c) conclusion I ch.: 91 1. Bk. 5. The body according to Plutarch (1): prol.: 20 l. 2.448 lines a) the comparison with the body 2 ch.: 74 1. b) the soul of the body 3 ch.: 389 1. c) the head of the body 3 ch.: 584 l. d) heart and bowels 1 ch.: 126 l. e) the flanks of the body 1 ch.: 218 l. f) eyes, ears and tongue 7 ch.: 1.037 l. Bk. 6. The body according to Plutarch (2): prol.: 34 1. 2.355 lines a) the hands of the body 19 ch.: 1.482 l. b) the feet of the body 1 ch.: 36 1. c) the commonwealth 4 ch.: 356 1. d) about lese-majesty 4 ch.: 372 1. e) general conclusion 2 ch.: 75 1. Part III. Philosophical reflections. total: 9.319 lines Bk. 7. Philosophy and ethics: prol.: 104 l. 3.716 lines a) which philosophy? 8 ch.: 786 1. b) how to attain a good philosophy? 7 ch.: 979 1. c) money and craving for power 5 ch.: 893 l. d) hypocrisy 3 ch.: 510 l. e) jealousy 2 ch.: 444 1. Bk. 8. Ethics, tyranny, and felicity: prol.: 45 1. 5.603 lines a) thirst for glory 5 ch.: 619 l. b) the five sense-organs 8 ch.: 2.225 l. c) true glory 3 ch.: 468 l. d) tyrannology 7 ch.: 1.858 l. e) conclusion 2 ch.: 388 1. Total: 166 chapters 22.121 lines. (shrink)

BackgroundFor many decades, the debate on children’s competence to give informed consent in medical settings concentrated on ethical and legal aspects, with little empirical underpinnings. Recently, data from empirical research became available to advance the discussion. It was shown that children’s competence to consent to clinical research could be accurately assessed by the modified MacArthur Competence Assessment Tool for Clinical Research. Age limits for children to be deemed competent to decide on research participation have been studied: generally children of 11.2 (...) years and above were decision-making competent, while children of 9.6 years and younger were not. Age was pointed out to be the key determining factor in children’s competence. In this article we reflect on policy implications of these findings, considering legal, ethical, developmental and clinical perspectives.DiscussionAlthough assessment of children’s competence has a normative character, ethics, law and clinical practice can benefit from research data. The findings may help to do justice to the capacities children possess and challenges they may face when deciding about treatment and research options. We discuss advantages and drawbacks of standardized competence assessment in children on a case-by-case basis compared to application of a fixed age limit, and conclude that a selective implementation of case-by-case competence assessment in specific populations is preferable. We recommend the implementation of age limits based on empirical evidence. Furthermore, we elaborate on a suitable model for informed consent involving children and parents that would do justice to developmental aspects of children and the specific characteristics of the parent-child dyad.SummaryPrevious research outcomes showed that children’s medical decision-making capacities could be operationalized into a standardized assessment instrument. Recommendations for policies include a dual consent procedure, including both child as well as parents, for children from the age of 12 until they reach majority. For children between 10 and 12 years of age, and in case of children older than 12 years in special research populations of mentally compromised patients, we suggest a case-by-case assessment of children’s competence to consent. Since such a dual consent procedure is fundamentally different from a procedure of parental permission and child assent, and would imply a considerable shift regarding some current legislations, practical implications are elaborated. (shrink)

Society’s relationship with modern animal farming is an ambivalent one: on the one hand there is rising criticism about modern animal farming; on the other hand people appreciate certain aspects of it, such as increased food safety and low food prices. This ambivalence reflects the two faces of modernity: the negative (exploitation of nature and loss of traditions) and the positive (progress, convenience, and efficiency). This article draws on a national survey carried out in the Netherlands that aimed at gaining (...) a deeper understanding about the acceptance of modern dairy farming in Dutch society. People take two dimensions into account when evaluating different aspects of modern dairy farming: (1) the way living beings are used for production and (2) the way a dairy farm functions as a business. In both these dimensions people appeared to adopt cautious opinions: most people preferred relatively traditional and natural farms and were concerned about the use of nature and treatment of animals in modern production—although this did not imply an outright rejection of modern animal farming. The study also looked for (and sought to explain) differences of opinion between social groups. Besides socio-demographic factors such as age and gender, farming experience and value-orientation (such as socially minded and professional) appeared to be important variables. The values and convictions within modern society can help to explain why some people are greatly concerned about animal welfare while some show less concern. This diversity also helps to explain why general information campaigns are quite ineffective in allaying concerns about modern animal farming. (shrink)

Human adults possess the extraordinary ability to produce mental imagery about a wide variety of non-occurrent events. We can, for example, simulate the perception of different places, different times, different possibilities, or others’ perspectives. Findings from cognitive psychology, neuropsychology, and cognitive neuroscience suggest that all of these capacities rely on the same neuro-cognitive mechanism: episodic simulation. This ability produces mental imagery by constructively recombining elements of past experiences to simulate event representations. However, if episodic simulation indeed produces mental imagery, it (...) remains unclear how the non-imagistic aspects of its outputs become cognitively determined. In this article, I argue that there are (at least) four such non-imagistic ‘dimensions’ of episodic simulation: specificity, temporal orientation, subjectivity, and factuality. Further, I propose an account of the mechanisms which might be responsible for determining where a given output of episodic simulation falls within this dimensional space. According to this view, episodic simulation relies on propositional ‘scope-operators’ either deployed as inputs to the simulation process itself or produced by post-hoc monitoring processes operating over its outputs. This view has consequences for how we should view the operation, development, and evolution of episodic simulation. (shrink)

Episodic memory has been analyzed in a number of different ways in both philosophy and psychology, and most controversy has centered on its self-referential, autonoetic character. Here, we offer a comprehensive characterization of episodic memory in representational terms and propose a novel functional account on this basis. We argue that episodic memory should be understood as a distinctive epistemic attitude taken toward an event simulation. In this view, episodic memory has a metarepresentational format and should not be equated with beliefs (...) about the past. Instead, empirical findings suggest that the contents of human episodic memory are often constructed in the service of the explicit justification of such beliefs. Existing accounts of episodic memory function that have focused on explaining its constructive character through its role in future-oriented mental time travel do justice neither to its capacity to ground veridical beliefs about the past nor to its representational format. We provide an account of the metarepresentational structure of episodic memory in terms of its role in communicative interaction. The generative nature of recollection allows us to represent and communicate the reasons why we hold certain beliefs about the past. In this process, autonoesis corresponds to the capacity to determine when and how to assert epistemic authority in making claims about the past. A domain where such claims are indispensable are human social engagements. Such engagements commonly require the justification of entitlements and obligations, which is often possible only by explicit reference to specific past events. (shrink)

The past is undeniably special for human beings. To a large extent, both individuals and collectives define themselves through history. Moreover, humans seem to have a special way of cognitively representing the past: episodic memory. As opposed to other ways of representing knowledge, remembering the past in episodic memory brings with it the ability to become a witness. Episodic memory allows us to determine what of our knowledge about the past comes from our own experience and thereby what parts of (...) the past we can give testimony about. In this article, we aim to give an account of the special status of the past by asking why humans have developed the ability to give testimony about it. We argue that the past is special for human beings because it is regularly, and often principally, the only thing that can determine present social realities such as commitments, entitlements, and obligations. Because the social effects of the past often do not leave physical traces behind, remembering the past and the ability to bear testimony it brings is necessary for coordinating social realities with other individuals. (shrink)

Do any nonhuman animals have hedonically valenced experiences not directly caused by stimuli in their current environment? Do they, like us humans, experience anticipated or previously experienced pains and pleasures as respectively painful and pleasurable? We review evidence from comparative neuroscience about hippocampus-dependent simulation in relation to this question. Hippocampal sharp-wave ripples and theta oscillations have been found to instantiate previous and anticipated experiences. These hippocampal activations coordinate with neural reward and fear centers as well as sensory and cortical areas (...) in ways that are associated with conscious episodic mental imagery in humans. Moreover, such hippocampal “re- and preplay” has been found to contribute to instrumental decision making, the learning of value representations, and the delay of rewards in rats. The functional and structural features of hippocampal simulation are highly conserved across mammals. This evidence makes it reasonable to assume that internally triggered experiences of hedonic valence (IHVs) are pervasive across (at least) all mammals. This conclusion has important welfare implications. Most prominently, IHVs act as a kind of “welfare multiplier” through which the welfare impacts of any given experience of pain or pleasure are increased through each future retrieval. However, IHVs also have practical implications for welfare assessment and cause prioritization. (shrink)

In everyday conversation, messages are often communicated indirectly, implicitly. Why do we seem to communicate so inefficiently? How speakers choose to express a message (modulating confidence, using less explicit formulations) has been proposed to impact how committed they will appear to be to its content. This commitment can be assessed in terms of accountability – is the speaker held accountable for what they communicated? – and deniability – can the speaker plausibly deny they intended to communicate it? We investigated two (...) factors that may influence commitment to implicitly conveyed messages. In a preregistered online study, we tested the hypothesis that the degree of meaning strength (strongly or weakly communicated) and the level of meaning used by the speaker (an enrichment or a conversational implicature) modulate accountability and plausible deniability. Our results show that both meaning strength and level of meaning influence speaker accountability and plausible deniability. Participants perceived enrichments to be harder to deny than conversational implicatures, and strongly implied content as more difficult to deny than weakly implied content. Furthermore, participants held the speaker more accountable to content conveyed via an enrichment than to content conveyed via an implicature. These results corroborate previously found differences between levels of meaning (enrichment vs. implicature). They also highlight the largely understudied role of meaning strength as a cue to speaker commitment in communication. (shrink)

Intuitive theories are sets of integrated concepts and causal laws that people adopt to comprehend, explain, and predict certain phenomena they encounter in the world. These theories are ‘intuitive’ because they are thought to drive our intuitions about how the physical and biological world, the mental life of people, and the society we live in work, without meeting the standards of explicit scientific theorizing. The proposal that people adopt such theories has been around at least since the 1970s. However, how (...) psychologists think about intuitive theories has been changing since they have been first proposed. In this chapter, we provide a short overview of the approaches to the function of intuitive theories and belief-forming systems more generally. While early characterization of intuitive theories emphasized their epistemic function, later attempts took an evolutionary view, claiming that they serve adaptive functions that are not always aligned with the goal of accurately tracking environmental states. A recent twist in this story is the proposal that shared intuitive theories may also serve social functions by providing a ‘theoretical common ground’ on which people interpret unobservable entities, such as memories, character traits, entitlements, and obligations. Such shared theories might be essential for social coordination via communication. (shrink)

Book Reviews in this Article: Rationing America's Medical Care: The Oregon Plan and Beyond, edited by Martin A. Strosberg, Joshua M. Wiener, Robert Baker and I. Alan Fein. Bad Medicine: The Prescription Drug Industry in the Third World, by Milton Silverman, Mia Lydecker and Philip R. Lee. Stanford Feminist Perspectives in Medical Ethics, edited by Helen Bequaert Holmes and Laura M. Purdy, Bloomington and Indianapolis: Indiana Choices in Health Care: A Report by the Government Committee on Choices in Health Care, (...) The Netherlands, 1992. (shrink)

We propose that episodic thought (i.e., episodic memory and imagination) is a domain where the language-of-thought hypothesis (LoTH) could be fruitfully applied. On the one hand, LoTH could explain the structure of what is encoded into and retrieved from long-term memory. On the other, LoTH can help make sense of how episodic contents come to play such a large variety of different cognitive roles after they have been retrieved.

A large share of the available literature on television and ageing depicts old age as a life stage characterized by losses in which people use television as a substitute for decreased activities. The aim of the present study is to investigate how television viewing is part of both selection and compensation strategies. Based on a qualitative interview study among a diverse sample of older adults, we found three ways in which television viewing is part of selection strategies and three ways (...) in which it is part of compensation strategies. In contrast to the focus on compensation in previous research, we found that selection strategies appear to provide a better characterization of older people’s television viewing than compensation strategies. Moreover, particular television viewing behavior does not automatically signal whether television viewing is part of selection or compensation strategies. (shrink)

Large-scale linkage of international clinical datasets could lead to unique insights into disease aetiology and facilitate treatment evaluation and drug development. Hereto, multi-stakeholder consortia are currently designing several disease-specific translational research platforms to enable international health data sharing. Despite the recent adoption of the EU General Data Protection Regulation, the procedures for how to govern responsible data sharing in such projects are not at all spelled out yet. In search of a first, basic outline of an ethical governance framework, we (...) set out to explore relevant ethical principles and norms. We performed a systematic review of literature and ethical guidelines for principles and norms pertaining to data sharing for international health research. We observed an abundance of principles and norms with considerable convergence at the aggregate level of four overarching themes: societal benefits and value; distribution of risks, benefits and burdens; respect for individuals and groups; and public trust and engagement. However, at the level of principles and norms we identified substantial variation in the phrasing and level of detail, the number and content of norms considered necessary to protect a principle, and the contextual approaches in which principles and norms are used. While providing some helpful leads for further work on a coherent governance framework for data sharing, the current collection of principles and norms prompts important questions about how to streamline terminology regarding de-identification and how to harmonise the identified principles and norms into a coherent governance framework that promotes data sharing while securing public trust. (shrink)

ABSTRACT Over the past few decades the concept of (human) dignity has deeply pervaded medical ethics. Appeals to dignity, however, are often unclear. As a result some prefer to eliminate the concept from medical ethics, whereas others try to render it useful in this context. We think that appeals to dignity in medical ethics can be clarified by considering the concept from an historical perspective. Firstly, on the basis of historical texts we propose a framework for defining the concept in (...) medical debates. The framework shows that dignity can occur in a relational, an unconditional, a subjective and a Kantian form. Interestingly, all forms relate to one concept since they have four features in common: dignity refers, in a restricted sense, to the ‘special status of human beings’; it is based on essential human characteristics; the subject of dignity should live up to it; and it is a vulnerable concept, it can be lost or violated. We argue that being explicit about the meaning of dignity will prevent dignity from becoming a conversation‐stopper in moral debate. Secondly, an historical perspective on dignity shows that it is not yet time to dispose of dignity in medical ethics. At least Kantian and relational dignity can be made useful in medical ethics. (shrink)

During the past decennium, one of the main issues discussed in research ethics has been focused on the care that should be provided to the control group in a clinical trial. This discussion is also called the standard of care debate . Current international research ethics guidelines contain a wide variety of standards for the standard of care—including the provision of the highest attainable, the best available, the best current, a proven , and an established effective treatment. In this article, (...) we systematically review the currently used standards and argue that none of the current standards is adequate to serve as a universal standard for the standard of care. Alex London has made a substantial proposal for a universal standard, but universally adopting his standard is problematic. In this article, we propose a revised version of London's standard. (shrink)

John Calvin (1509–1564) started his career as a thoroughly trained humanist who possessed, in addition, a thorough knowledge of the Fathers of the Church. This article provides an overview of this particular knowledge. It also focuses on the use Calvin made of the patristic argument in both his instructive and apologetic writings. Some evident cases of Calvin’s misuse of the patres are discussed as well. It is concluded that Calvin’s special patristic knowledge gave his theology its special hallmark and still (...) links authentic Calvinism with the church’s catholic tradition through the ages. (shrink)

As early as 2002, CIOMS stated that pregnant women should be presumed eligible for participation in research. Despite this position and calls of other well‐recognized organizations, the health needs of pregnant women in research remain grossly under‐researched. Although the presumption of eligibility remains unchanged, the revision of the 2002 CIOMS International ethical guidelines for biomedical research involving human subjects involved a substantive rewrite of the guidance on research with pregnant women and related guidelines, such as those on fair inclusion and (...) vulnerability. However, close reading of the guidelines reveals morally relevant different approaches to fair inclusion of pregnant women and other under‐represented groups, such as children and incompetents. Where CIOMS sets out that children and adolescents must be included unless a good scientific reason justifies their exclusion, no such claim of having to justify exclusion appears in the guideline on pregnant women. Instead, CIOMS claims that research relevant to pregnant women’s health needs must be promoted. This paper analyses how and to what extent the guideline on pregnant women differs from other guidance on fair inclusion in the document. Accordingly, the paper evaluates to what extent the current phrasing may contribute to fair inclusion of pregnant women in research. We will conclude that a system change towards a learning health system is essential to break down the status quo of knowledge generation in the field of medication use during pregnancy and argue that the CIOMS guidelines allow for this system change. (shrink)

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)

The article aims to give an overall overview of Saint Augustine’s attitude towards the Gnostic Christians Manichaeans. First a historical overview mainly based on his Confessions outlines Augustine’s acquaintance with the members of the manichaean church and his familiarity with their writings. Second the place of the Manichaeans in a considerable number of Augustine’s works is discussed. It is in particular in his many anti-Manichaean writings that the Church father displays his intimate knowledge of their myth and their doctrines. Third, (...) a summary is given of the research on the impact of the Manichaeans on Augustine. It is concluded that from his early years onwards to the very end of his life, the Manichaean Christians were a real and powerful force to him. (shrink)

The Remmelink Committee published its report on medical decisions at the end of life in the Netherlands in September 1991. As a result, the Dutch debate about physician aid‐in‐dying has been broadened to include life‐terminating acts that have not been explicitly requested by the patient.

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 this article ethical issues are discussed which play a role in pharmacogenetics. Developments in pharmacogenetics have a large impact on many different practices such as clinical trials, the practice of medicine and society at large. In clinical trials, questions rise regarding the exclusion of genetic subgroups that may be non- or poor-responders to the experimental drug. Also, the question is asked how pharmaceutical companies should deal with their growing knowledge about the relations between genetic variation and adverse effects. Moreover, (...) pharmacogenetics may provide disease-specific predictive information which may have a significant impact on the relations between physicians, patients and their relatives in the practice of medicine. Here, issues also arise regarding responsibility of patients and physicians for health and disease. In the society at large, the high costs of new pharmacogenetic possibilities lead to questions concerning solidarity and fair distribution on a national as well as an international level. It is concluded that in the near future, ethical research should be focused on the themes responsibility, inclusion and exclusion and global justice. (shrink)

Protagoras of Abdera, Socrates’ older contemporary, is regarded as one of the most prominent representatives of the so-called sophistic movement. Instead of simply accepting the biased reports given by Plato and Aristotle about this sophist, the contributors to this volume review the complicated doxographical situation and make a case for Protagoras as a philosopher in his own right. Two major themes of this volume are Protagoras’ relativism and his case for a moral and political ideal, both of which are contrasted (...) with the metaphysical idealism of his future opponents in the Academy and the mundane conventionalism typically associated with the sophists. It turns out that rather than a parasitic force of intellectual subversion, Protagoras may have been a prolific and original thinker aiming at a coherent and comprehensive view of man’s place in the world. (shrink)

This article aims to analyse all the passages in Augustine’s City of God in which he either explicitly or implicitly makes mention of Manichaeism and its doctrines. It turns out that, even in his later years, Manichaean doctrines were at the forefront of Augustine’s mind, although essential elements of his own doctrines have a clearly anti-Manichaean background. A close reading of all those anti-Manichaean passages further discloses some fairly unique particulars, such as, for example, the Manichaeans’ use and interpretation of (...) John 8:44 and 1 John 3:8. (shrink)

The earliest Christians – all of whom were Jews – spoke of the Holy Spirit as a feminine figure. The present article discusses the main proof texts, ranging from the ‘Gospel according to the Hebrews’ to a number of testimonies from the second century. The ancient tradition was, in particular, kept alive in East and West Syria, up to and including the fourth century Makarios and/or Symeon, who even influenced ‘modern’ Protestants such as John Wesley and the Moravian leader Count (...) von Zinzendorf. It is concluded that, in the image of the Holy Spirit as woman and mother, one may attain a better appreciation of the fullness of the Divine. (shrink)

Academics and/or scholars increasingly feel that their academic voice (combined or individual) has been squelched by the demands of performativity in its various guises, and resultantly, that they have been caught up in a process of steady disempowerment. Rather, it should be their right to be free to use their positions in the pursuit of scholarship as their conscience and their expert knowledge of their subject dictate. Academics should be free to question for themselves the boundaries of their limitations, and (...) not have these i mposedon them by the state or government bureaucracy. In order to help empower academics to regain their academic voice and identity, this article transposes six of the philosophical ideas of Belgian philosopher Rudi Visker to the world of academia. It explores the possibilities of using these ideas as instruments for the promotion and maintenance of academic freedom. Key concepts: academic freedom, managerialism, institutions of higher learning, Rudi Visker. (shrink)

The ground-state dispersion energy of a pair of axially symmetric molecules is calculated, to arbitrary order in the inverse intermolecular separation, on the basis of London's anisotropic oscillator model.

After discussing the so-called Ham myth in South Africa, my focus is on the African church father Augustine (354–430). All texts from his immense oeuvre in which he mentions biblical Ham are reviewed in chronological order. In Against Faustus, the story of Noah and his sons is mainly explained as being Christological: Ham figures as a type of the unbelieving Jews who consented to the murder of Christ, but he is also a type of the Jews because he is ‘the (...) slave of his brothers’ carrying the books by which the Christians may be instructed. Later Augustine corrects his confusion of Ham with the slave Canaan. The story of Ham (and Canaan) is most extensively discussed in the City of God. Neither here nor in the Expositions on the Psalms, Ham is described as being black or a slave. The same goes for a number of his other writings. In Augustine’s late works Against Julian and Unfinished Work against Julian, he thoroughly goes into the question of why (although Ham sinned) ‘vengeance was brought upon Canaan’. Augustine perceives God’s prophecy: from Canaan stems the cursed seed [ semen maledictum ] of the Canaanites. Nowhere, however, he claims that Ham or his descendants would have been cursed to be black or that all of his offspring were condemned to slavery. Contribution: This article demonstrates that the Ham myth does not occur in Augustine. It argues that the ‘ mestizo ’ African Augustine might have been extra sensitive to questions of race and colour. (shrink)

Current challenges to sustaining public support for health data research have directed attention to the governance of data-intensive health research networks. Accountability is hailed as an important element of trustworthy governance frameworks for data-intensive health research networks. Yet the extent to which adequate accountability regimes in data-intensive health research networks are currently realized is questionable. Current governance of data-intensive health research networks is dominated by the limitations of a drawing board approach. As a way forward, we propose a stronger focus (...) on accountability as learning to achieve accountable governance. As an important step in that direction, we provide two pathways: (1) developing an integrated structure for decision-making and (2) establishing a dialogue in ongoing deliberative processes. Suitable places for learning accountability to thrive are dedicated governing bodies as well as specialized committees, panels or boards which bear and guide the development of governance in data-intensive health research networks. A continuous accountability process which comprises learning and interaction accommodates the diversity of expectations, responsibilities and tasks in data-intensive health research networks to achieve responsible and effective governance. (shrink)

The starting point of the present study is to investigate which environmental factors play a role in the media behavior of ethnic minority youth. To what extent do socio-demographic characteristics influence ownership and use of the media? We also address the role of religion, cultural origin and the cultural distance between ethnic minority youth and indigenous Dutch youth. Three numerically important groups of ethnic minority youth are discussed: Turks, Moroccans and Surinamese. In a survey conducted among Turkish, Moroccan and Surinamese (...) youth aged between 12 and 19, residing in the Netherlands, we investigated which environmental factors play a role in the media behavior of ethnic minority youth. A control group of indigenous Dutch youth was established and likewise exposed to the variables under study. (shrink)

A study is made of the dominant terms of an earlier model-based formula describing the dispersion energy of axially symmetric interacting molecules. The existence of mixed-pole eighth-order terms is noted.

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown (...) that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life. (shrink)

The display of artefacts always implies an external mediation that influences, and often codifies, the reception of the exhibits. Objects are manipulated, restored, appropriated, staged, in short displayed, through various representational strategies that include pedestals, labels, and showcases. These elements, that we could define as parerga, are often ignored because of their utilitarian function. Yet, they play an important role in the history of the artefacts and define the setting in which the objects can exert their agency. They not only (...) shape their meaning, but also determine the effect that these artefacts have on their viewers. Framing devices create the conditions for interactions between the individual and the object to take place. This publication aims to explore the relation between artefacts and viewers as they are manifested in framing devices, and to develop a new theoretical framework for thinking about the power of objects on display. (shrink)

Recent developments in biotechnology allow for the generation of increasingly complex products out of human tissues, for example, human stem cell lines, synthetic embryo-like structures and organoids. These developments are coupled with growing commercial interests. Although commercialisation can spark the scientific and clinical promises, profit-making out of human tissues is ethically contentious and known to raise public concern. The traditional bioethical frames of gift versus market are inapt to capture the resulting practical and ethical complexities. Therefore, we propose an alternative (...) approach to identify, evaluate and deal with the ethical challenges that are raised by the increasing commercialisation of the exchange of sophisticated human tissue products. We use organoid technology, a cutting-edge stem cell technology that enables the cultivation of ‘mini-organs’ in a dish, as an example. First, we examine the moral value of organoids and recognise them as hybrids that relate to persons and their bodies as well as to technologies and markets in ambiguous ways. Second, we show that commercialisation of organoids is legitimised by a detachment of the instrumental and commercial value of organoids from their associations with persons and their bodies. This detachment is enacted in steps of disentanglement, among which consent and commodification. Third, we contend that far-reaching disentanglement is ethically challenging: (1) Societal interests could be put under pressure, because the rationale for commercialising organoid technology, that is, to stimulate biomedical innovation for the good of society, may not be fulfilled; (2) The interests of donors are made subordinate to those of third parties and the relational moral value of organoids may be insufficiently recognised. Fourth, we propose a ‘consent for governance’ model that contributes to responsible innovation and clinical translation in this exciting field. (shrink)

In this paper, we explore the extent to which issues of simulation model validation take on novel characteristics when the models in question become particularly complex. Our central claim is that complex simulation models in general, and global models of climate in particular, face a form of confirmation holism. This holism, moreover, makes analytic understanding of complex models of climate either extremely difficult or even impossible. We argue that this supports a position we call convergence skepticism: the belief that the (...) existence of a plurality of different models making a plurality of different forecasts of future climate is likely to be a persistent feature of global climate science. (shrink)

Pragmatic trials aim to directly inform health care decision-making through the collection of so-called ‘real world data’ from observations of comparative treatment effects in clinical practice. In order to ensure the applicability and feasibility of a pragmatic trial, design features may be necessary that deviate from standard research ethics requirements. Examples are traditional requirements to seek written informed consent and to perform extensive data and safety monitoring. Proposals for deviations from standard research ethics practice have resulted in controversy about their (...) ethical acceptability. One of the justifications for altered procedures is the allegedly high social value of pragmatic trials. In order to properly operationalize the concept in the ethical assessment of pragmatic trial designs, specification is warranted. We identified three determinants from common claims about a pragmatic trial's social value: the extent to which the research question has real world relevance, the trial design's ability to generate a real world answer and the probability of direct uptake of the results by decision-makers in practice. Subsequently, we discuss how these determinants should be applied to the practice of pragmatic trials, and to what extent they might be applicable to explanatory trials. (shrink)

Julian of Norwich (1342–ca.1416) as a post-scholastic theologian. This article positions the ‘first female English writer from the Middle Ages’, Julian of Norwich (1342–ca.1416), within the context of ‘post-scholasticism’, the very last period in late Medieval Philosophy, of which one feature was the final separation of theology and philosophy in the late Medieval index. Julian should in terms of this placing be engaged as a theologian proper, distinguished from the six other prominent female thinkers from the Medieval Latin West (Héloïse, (...) Hildegard, Mechtild, Hadewijch, Marguerite and Catherine), who were all philosopher-theologians. However, Julian’s epistemology and metaphysics were intertwined with her theology, as presented in her Book of Showings, to such an extent that it is impossible to isolate it from her theological output. She is within the socio-historical context of the third wave of the Black Plague in Norwich in 1369 henceforth profiled as a ‘post-scholastic theologian’ and presented on the basis of prominent theological features in Showings, including its immanent-mystical character (being a presentation of convent theology rather than scholastic theology), its vernacular (Middle English) originality and profound pastoral appeal, its maternal-Christological imagery (Moder Jhesu), its Trinitarian orientation (for the trinitie is god, god is the trinitie) and its deeply eschatological, open-ended engagement with a world devastated by the Plague (alle shalle be wele). Contribution: As a millennium-long discourse, Medieval philosophy functions in a Venn diagrammatical relationship with Medieval history, Church history, patristics and philosophy of religion. Whenever ‘mainstream’ or ‘canonised’ Medieval philosophy is impacted from specialist research, it may well have implications that these closely related disciplines could take note of. Such is the case in this reappraisal of Julian of Norwich’ theological and pastoral legacy from its original context of the Black Plague in the 14th century – and indeed within the context of the Covid-19 pandemic in 2020. (shrink)

The ‘five tears’ as mystical expression in the Dialogues of the Dominican nun Catherine of Siena (1347–1380). This article explores the underestimated teaching of the ‘five tears’ as mystical expression in the text Il dialogo ( The dialogues, written in 1378) by the Dominican ( Mantellate ) nun and philosopher-theologian, Catherine of Siena (Caterina Benincasa, 1347–1380). The objective of the article is to indicate the significance of the teaching of the ‘five tears’, against the backdrop of the wider symbolic function (...) of tears and ‘holy grief’ in Late Medieval mysticism. After presenting a biographical introduction, the contemplative, communicative and secretive import of the meaning of tears in the Middle Ages are reappraised and applied to The dialogues. By synthesising the scarce references in the relevant secondary literature, the teaching of the five tears are henceforth discussed: the tears of damnation, which are the tears of ‘evil and sinful people’; the tears of fear, which are the tears of fallen humankind in the presence of God’s judgement; the tears of gratitude, cried by a ‘saved humanity’ who now ‘see and taste God’s goodness’ (implicitly referring to the eucharist); the perfect tears, cried by people in their selfless disposition toward and love for the human Other; and the sweet tears of tenderness, cried by those who love God and humankind, in a radicalisation of Jesus of Nazareth’s summary of the Law, ‘more than thyself’. Catherine’s teaching of the ‘five tears’ certainly presents unique features and its own considerations, but should, nevertheless, be interpreted as an extension of the contemplative and secretive functions of ‘holy grief’ as already presented in Scripture and reconsidered by the Eastern and Western church fathers in the second to the fifth centuries. Catherine’s contribution to Medieval mysticism is established therein that she expanded those initial contents by presenting the teaching of the five tears as a ritualised prerequisite for development in the Medieval pilgrim’s spiritual itinerary to God. Contribution: This article contributes to scholarship in Medieval philosophy by contextualising Catherine of Siena’s teaching of the ‘five tears’ within the wider symbolic realm of tears and ‘holy grief’ in late Medieval mysticism, stressing the contemplative, communicative and secretive import of tears throughout the Middle Ages. (shrink)

BackgroundAn important principle underlying the Dutch Euthanasia Act is physicians' responsibility to alleviate patients' suffering. The Dutch Act states that euthanasia and physician-assisted suicide are not punishable if the attending physician acts in accordance with criteria of due care. These criteria concern the patient's request, the patient's suffering (unbearable and hopeless), the information provided to the patient, the presence of reasonable alternatives, consultation of another physician and the applied method of ending life. To demonstrate their compliance, the Act requires physicians (...) to report euthanasia to a review committee. We studied which arguments Dutch physicians use to substantiate their adherence to the criteria and which aspects attract review committees' attention.MethodsWe examined 158 files of reported euthanasia and physician-assisted suicide cases that were approved by the review committees. We studied the physicians' reports and the verdicts of the review committees by using a checklist.ResultsPhysicians reported that the patient's request had been well-considered because the patient was clear-headed (65%) and/or had repeated the request several times (23%). Unbearable suffering was often substantiated with physical symptoms (62%), function loss (33%), dependency (28%) or deterioration (15%). In 35%, physicians reported that there had been alternatives to relieve patients' suffering which were refused by the majority. The nature of the relationship with the consultant was sometimes unclear: the consultant was reported to have been an unknown colleague (39%), a known colleague (21%), otherwise (25%), or not clearly specified in the report (24%). Review committees relatively often scrutinized the consultation (41%) and the patient's (unbearable) suffering (32%); they had few questions about possible alternatives (1%).ConclusionDutch physicians substantiate their adherence to the criteria in a variable way with an emphasis on physical symptoms. The information they provide is in most cases sufficient to enable adequate review. Review committees' control seems to focus on (unbearable) suffering and on procedural issues. (shrink)

This article, by analysing, annotating en interpreting the most recent research in all relevant departments, provides a fresh and updated overview of the Neoplatonic metaphysics of Pseudo-Dionysius (ca. 500). After providing an introduction to Dionysius’ metaphysics in terms of the contributions of Middle Platonism and Neoplatonism, the article explores his broader philosophical system. A number of traits that are uniquely Dionysic-metaphysical, are eventually isolated: the interpretation of transcendence as bound to immanence; the affirmation of God’s transcendence in the world (that (...) is, a metaphysics of ‘creation as teophany’; following E.D. Perl); the radical transcendence and simultaneous radical immanence of God (that is, God as ‘Beingness’); fundamental restrictions of language and the analogical ‘Naming’ of God; creation as a system of dialectical symbols about God; the analogical participation of the subject in creation; and unification (reditus, the ‘flowing of things back to God’). These traits are utilised to reappraise the metaphysics of Nicholas of Cusa (1401–1464) in a subsequent article. (shrink)

BackgroundIn this manuscript, we argue that within the context of phase IV, physician-researchers retain their fiduciary obligation to treat the patient-participants.DiscussionWe first clarify why the perspective that research ethics ought to be differentiated from clinical ethics is not applicable in phase IV, and therefore, why therapeutic orientation is most convivial in this phase. Next, assuming that ethics guidelines may be representative of common morality, we show that ethics guidelines see physician-researchers primarily as physicians and only secondarily as researchers. We then (...) elaborate on what a fiduciary obligation is and how some of the obligations are default duties. Lastly, we look at the fiduciary obligation of the physician-researcher in phase IV interventional trials.ConclusionThe fiduciary obligation to treat is not as easily waived as in earlier trials. Assuming the entwinement of research and practice in phase IV, physician-researchers, in collaboration with other researchers, investigators, and research ethics committees, should ensure that in terms of study design, methodology, and research practice, the therapeutic value of the research to the patient-participants is not diminished. (shrink)

We begin by considering two common ways of conceiving critical metaphysics. According to the first (and polemical) conception, critical metaphysics analyzes nothing more than the form of thought and thereby misses the proper point of metaphysics, namely to investigate the form of reality. According to the second (and affirmative) conception, critical metaphysics starts from the supposed insight that the form of reality cannot be other than the form of thought and is thus not required to analyze anything but that form. (...) We argue that the first conception is too weak while the second is too strong. Then we sketch an alternative conception of critical metaphysics, a conception we find expressed both in Kant’s B-Deduction and in the way Barry Stroud has recently investigated the possibility of metaphysics. According to such a conception, a properly critical metaphysics needs to proceed in two steps: first, it needs to analyze the most general and necessary form of any thought that is about an objective reality at all; second, it needs to investigate how that form of thought relates to the reality it purports to represent. But unlike Kant, Stroud remains sceptical regarding the possibility of a satisfying transition from thought to reality in metaphysics. We argue that this dissatisfaction can be traced back to a notion of objectivity and reality in terms of complete mind-independence. Then we sketch an alternative notion of objectivity and reality in terms of distinctness from subjects and acts of thinking, and argue that it is that notion that allows Kant, with his Transcendental Idealism, to make the transition required for any satisfying metaphysics, namely that from the form of thought to reality. (shrink)

In recent years, schools and education authorities world wide have been paying increasing attention to issues surrounding diversity and religious tolerance. The term 'tolerance' is, however, clouded by considerable confusion and vagueness. This article seeks to contribute to recent scholarly attempts at understanding tolerance and the term that denotes it. After a brief semantic analysis of the term 'tolerance', arguments concerning the onticity of tolerance as phenomenon or entity are discussed. By examining its onticity we explore and explain some of (...) the essential features of tolerance. The article ends with a brief discussion of some of the implications of our examination that we foresee for education. (shrink)

The triumph of a post-scholastic mysticism over scholastic loyalism:Gerson versus Ruusbroec, 1399. This article provides an introduction to the thought of the Flemish-Brabant 14th-century mystical thinker, Jan van Ruusbroec, with special attention to the explosion in the niche research from 1981 to 2017. Ruusbroec is presented as a ‘post-scholastic’ thinker, who in an idiosyncratic way, transcended the high-scholastic aspirations of absolute clarity and certainty about God and human existence. His thought is contextualised within a polemical, posthumous context, namely the attempt (...) of the chancellor of the University of Paris at the time, John Gerson, to get Ruusbroec’s text‘, ‘Die geestelike brulocht’ declared as heresy and Ruusbroec himself as a heretic in the year 1399 AD, 18 years after Ruusbroec’s death. The attempts of Ruusbroec’s young colleagues at the modest monastery of Groenendaal, confronting and rearguing Gerson on this issue, are thoroughly explored. The fact that neither ‘Die geestelike brulocht’ nor Ruusbroec himself could eventually be effectively challenged by the high-powered Gerson, is presented as an example of the inherent potential of ‘post-scholasticism’ to contribute to the progression that eventually manifested itself as the ‘new world’, the Renaissance. No one won or lost this posthumous battle: but Gerson certainly did not win it. This is a remarkable note in, even a ‘triumph’ for, the archives of the small Augustinian monastery in Groenendaal, consisting of subtle ‘Augustinian’ monks, who had little more than a dedicated passion for Ruusbroec’s mysticism on their side. A hermeneutic interpretation of the events of 1399 is henceforth presented, to indicate that within the socio-political turmoil of European societies in the 14th century, there were still places, where people were able to find ‘rest in God’ – as there should be today. (shrink)

An increasing number of older patients have to decide on a treatment plan for advanced chronic kidney disease, involving dialysis or conservative care. Shared decision-making is recommended as the model for decision-making in such preference-sensitive decisions. The aim of SDM is to come to decisions that are consistent with the patient’s values and preferences and made by the patient and healthcare professional working together. In clinical practice, however, SDM appears to be not yet routine and needs further implementation. A shift (...) from a biomedical to a person-centered conception might help to make the process more shared. Shared should, therefore, be interpreted as two persons bringing two perspectives to the table, that both need to be explored during the decision-making process. Starting from the patient’s perspective will enable to determine the mutual goals of care first and, subsequently, determine the best way for achieving those goals. To perform such SDM, the healthcare professional needs to become a skilled companion, being part of the patient’s relational context, and start asking the right questions about what matters to the patient as person. In this article, we describe the need for a person-centered conception of SDM for the setting of older patients with advanced CKD. (shrink)