The advent of new genetic and genomic technologies may cause friction with the principle of respect for autonomy and demands a rethinking of traditional interpretations of the concept of informed consent. Technologies such as whole‐genome sequencing and micro‐array based analysis enable genome‐wide testing for many heterogeneous abnormalities and predispositions simultaneously. This may challenge the feasibility of providing adequate pre‐test information and achieving autonomous decision‐making. At a symposium held at the 11th World Congress of Bioethics in June 2012 (Rotterdam), organized by (...) the International Association of Bioethics, these challenges were presented for three different areas in which these so‐called ‘new genetics’ technologies are increasingly being applied: newborn screening, prenatal screening strategies and commercial personal genome testing. In this article, we build upon the existing ethical framework for a responsible set‐up of testing and screening offers and reinterpret some of its criteria in the light of the new genetics. As we will argue, the scope of a responsible testing or screening offer should align with the purpose(s) of testing and with the principle of respect for autonomy for all stakeholders involved, including (future) children. Informed consent is a prerequisite but requires a new approach. We present preliminary and general directions for an individualized or differentiated set‐up of the testing offer and for the informed consent process. With this article we wish to contribute to the formation of new ideas on how to tackle the issues of autonomy and informed consent for (public) healthcare and direct‐to‐consumer applications of the new genetics. (shrink)

Introducing and implementing corporate sustainability poses many challenges to business organizations. In this longitudinal, inductive study, we focus on how such challenges are handled in a Dutch bank that is developing its sustainability policies. We examine why there is such a high degree of tension and conflict within the organization and identify how the development of these policies is affected by the interplay between subcultures and institutional logics. We show how different subcultures affect the enactment of logics by infusing the (...) rational and mindful behavior coming from logics with (sub)cultural values, beliefs, and assumptions. In turn, conflicting logics amplify subcultural characteristics between groups by shaping different behavior and practices. Together, this leads to a magnification of subcultural differences while, at the same time, logics are increasingly being perceived as incompatible. (shrink)

In the light of partial (mis)understanding, we examine the thesis that concepts are individuated in terms of possession conditions and show that adherents face a fatal dilemma: Either concept‐individuating possession conditions include cases of partially (mis)understood concepts or not. If yes, possession conditions do not individuate concepts. If no, the thesis is too restricted and lacks a minimally satisfactory level of generalization.

In recent years, functional connectivity in the developmental science received increasing attention. Although it has been reported that the anatomical connectivity in the preterm brain develops dramatically during the last months of pregnancy, little is known about how functional and effective connectivity change with maturation. The present study investigated how effective connectivity in premature infants evolves. To assess it, we use EEG measurements and graph-theory methodologies. We recorded data from 25 preterm babies, who underwent long-EEG monitoring at least twice during (...) their stay in the NICU. The recordings took place from 27 weeks postmenstrual age until 42 weeks PMA. Results showed that the EEG-connectivity, assessed using graph-theory indices, moved from a small-world network to a random one, since the clustering coefficient increases and the path length decreases. This shift can be due to the development of the thalamocortical connections and long-range cortical connections. Based on the network indices, we developed different age-prediction models. The best result showed that it is possible to predict the age of the infant with a root mean-squared error equal to 2.11 weeks. These results are similar to the ones reported in the literature for age prediction in preterm babies. (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)

Anna Smajdor’s proposal of whole body gestational donation (WBGD) states that female patients diagnosed as brain-dead should be considered for use as gestational donors. In this response, Smajdor’s proposal is rejected on four different accounts: (a) the debated acceptability of surrogacy despite women's autonomy, (b) the harm to dead women ́s interests, (c) the interests of the descendants, and (d) the symbolic value of the body and interests of relatives. The first part argues that WBGD rests on a particular conception (...) of the instrumentalization of bodies that cannot be circumvented simply by the patient’s consent and relinquished autonomy. The second part argues the importance of avoiding any harm to dead women’s interests. The third part identifies the importance of the interest of the foetus in the light of Procreative-Beneficence principle that Smajdor overlooks. And finally, the fourth part considers the symbolic value of the human body and the interest of relatives. The main goal of this commentary is not to show that WBGD cannot be implemented; rather, it is to show that there are not any good arguments in favour of doing so. (shrink)

We studied the role of social dynamics in moral decision-making and behavior by investigating how physical sensations of dirtiness versus cleanliness influence moral behavior in leader–subordinate relationships, and whether a leader’s self-interest functions as a boundary condition to this effect. A pilot study revealed that when participants imagined rewarding unethical behavior of a subordinate, they felt more dirty. Our main experiment showed that directly manipulating dirtiness by allowing leaders to touch a dirty object led to more positive evaluations of, and (...) higher bonuses for, unethical subordinates than touching a clean object. This effect, however, only emerged when the subordinate’s unethical behavior did not serve the leader’s own interest. Hence, subtle cues such as bodily sensations can shape moral decision-making and behavior in leader–subordinate relationships, but self-interest, as a core characteristic of interdependence, can override the influence of such cues on the leader’s moral behavior. (shrink)

This paper analyses the way in which discourse and argumentation may vary depending on participants’ educational level and gender. Men and women from three different educational levels (literacy, advanced level and university students) participated in discussion groups that debated about women and work, the sharing of housework and the way in which girls and boys are educated. The results showed important differences depending on participants’ educational level and gender. In general, the main differences were related to educational level, while gender (...) tended to interact with educational level, as a moderating factor. (shrink)

In this paper we consider an intuitionistic variant of the modal logic S4 (which we call IS4). The novelty of this paper is that we place particular importance on the natural deduction formulation of IS4— our formulation has several important metatheoretic properties. In addition, we study models of IS4— not in the framework of Kirpke semantics, but in the more general framework of category theory. This allows not only a more abstract definition of a whole class of models but also (...) a means of modelling proofs as well as provability. (shrink)

Until Process and Reality – An Essay in Cosmology (1929) by Alfred North Whitehead (1861-1947) was translated into Portuguese, four other works had been previously translated, proving Portuguese people had a persistent interest in the thought of a philosopher who is probably the last and most important speculative thinker of the 20th century. Yet, Processo e Realidade – Ensaio de Cosmologia hopefully stands as a turning point in Whiteheadian reception in Portugal; on the hand, it was publishe...

Problems arise when applying the current procedural conceptualization of decision-making capacity to paediatric healthcare: Its emphasis on content-neutrality and rational cognition as well as its implicit assumption that capacity is an ability that resides within a person jeopardizes children’s position in decision-making. The purpose of the paper is to challenge this dominant account of capacity and provide an alternative for how capacity should be understood in paediatric care. First, the influence of developmental psychologist Jean Piaget upon the notion of capacity (...) is discussed, followed by an examination of Vygostky’s contextualist view on children’s development, which emphasizes social interactions and learning for decision-making capacity. In drawing parallels between autonomy and capacity, substantive approaches to relational autonomy are presented that underline the importance of the content of a decision. The authors then provide a relational reconceptualization of capacity that leads the focus away from the individual to include important social others such as parents and physicians. Within this new approach, the outcome of adults’ decision-making processes is accepted as a guiding factor for a good decision for the child. If the child makes a choice that is not approved by adults, the new conceptualization emphasizes mutual exchange and engagement by both parties. (shrink)

The validity of the conclusion to the nonlocality of quantum mechanics, accepted widely today as the only reasonable solution to the EPR and Bell issues, is questioned and criticized. Arguments are presented which remove the compelling character of this conclusion and make clear that it is not the most obvious solution. Alternative solutions are developed which are free of the contradictions related with the nonlocality conclusion. Firstly, the dependence on the adopted interpretation is shown, with the conclusion that the alleged (...) nonlocality property of the quantum formalism may have been reached on the basis of an interpretation that is unnecessarily restrictive. Secondly, by extending the conventional quantum formalism along the lines of Ludwig and Davies it is shown that the Bell problem may be related to complementarity rather than to nonlocality. Finally, the dependence on counterfactual reasoning is critically examined. It appears that locality on the quantum level may still be retained provided one accepts a newly proposed principle of nonreproducibility at the individual quantum level as an alternative of quantum nonlocality. It is concluded that the locality principle can retain its general validity, in full conformity with all experimental data. (shrink)

There is an increasing interest in the possibility of using nudges to promote people's health. Following the advances in developmental biology and epigenetics, it is clear that one's health is not always the result of one's own choices. In the period surrounding pregnancy, maternal choice behaviour has a significant influence on perinatal morbidity and mortality as well as the development of chronic diseases later in life. One's health is thus a matter of one's own as well as one's maternal choices. (...) Therefore, self-regarding and other-regarding nudges should be considered as viable strategies to promote health. In this article, we introduce the concept of other-regarding nudges. We use the harm principle and the principle of beneficence to justify these other-regarding nudges. We conclude by stressing the importance of a fair assessment of expectations towards the nudgee, when determining whether a nudge is aimed at preventing harm or promoting a good. (shrink)

_Ordo II_ comprises the work that made Erasmus famous, namely the _Adagia_ (Proverbs) some of which were extended into essays. This first volume of the _Adages_ in the Amsterdam edition of the Latin texts of Erasmus gives a general introduction to the _Adages_ in German, as well as a critical edition of the Latin text of the first half of the first thousand _Adages_.