This article gives an overview of the moral problems experienced and described by nurses working in a dialysis unit in the Netherlands. The nurses raised a wide variety of issues that they considered were moral problems, which were grouped into seven topics. A selection of cases are described, one of which is analysed using the Nijmegen method of ethical case deliberation. This method facilitates practical approaches to the different types of moral problems encountered. The argument is made that, owing to (...) their specific moral position and responsibility, nurses' contribution to ethical reflection in ward discussions should be valued more. All caregivers involved are indispensable in developing a basis for well-reasoned decisions when deliberating about moral problems. (shrink)

This chapter contains sections titled: Background Concepts for Examining LTS Dynamics Societal Implications of LTS References and Further Reading.

The Iliad opens with the image of abandoned corpses, left as prey to the wild beasts. It closes with the hard-won and respectful funeral of Hector, during which his maimed body is finally laid to rest. In-between these passages, death and the fate of dead bodies are often part of the epic's subject matter. The audience is treated to a wide selection of images concerning the fallen and their remains, ranging from those taken gently away from the battlefield to be (...) buried to those who are posthumously mutilated where they lie. Instances of corpse mutilation are rare elsewhere in Greek historical and literary writing, but occur in the Iliad at a regular rate. The gruesomeness of these acts makes for shocking and violent scenes, and represents a radical departure from the normal funeral ritual with lasting repercussions for the relatives of the deceased and the fate of the dead person in the afterlife. (shrink)

Background: Self-determination is an important factor in improving the quality of life of people with moderate intellectual disabilities. A focus on self-determination implies that restraints on the freedom of people with intellectual disabilities should be decreased. In addition, according to the Dutch Care and Coercion bill, regular restraints of freedom, such as restrictions on choice of food or whom to visit, should be discouraged. Such restraints are only allowed if there is the threat of serious harm for the clients or (...) their surroundings. Research question: What do support staff consider as restraints on freedom and how do they justify these restraints? Research design: In this study, data were collected by semi-structured interviews. Participants and research context: Fifteen support staff working with clients with moderate intellectual disabilities were interviewed. All participants work within the same organisation for people with intellectual disabilities in the Eastern part of the Netherlands. Ethical considerations: The study was conducted according to good scientific inquiry guidelines and ethical approval was obtained from a university ethics committee. Findings: Most restraints of freedom were found to be centred around the basic elements in the life of the client, such as eating, drinking and sleeping. In justifying these restraints, support staff said that it was necessary to give clarity in what clients are supposed to do, to structure their life and to keep them from danger. Discussion: In the justification of restraints of freedom two ethical viewpoints, a principle-guided approach and an ethics of care approach, are opposing one other. Here, the self-determination theory can be helpful, while it combines the autonomy of the client, relatedness to others and the client’s competence. Conclusion: Despite the reasonable grounds support staff gave for restraining, it raises the question whether restraints of freedom are always in the interest of the client. (shrink)

We invite systematic consideration of the metaphors of cycles and circulation as a long-term theme in the history of the life and environmental sciences and medicine. Ubiquitous in ancient religious and philosophical traditions, especially in representing the seasons and the motions of celestial bodies, circles once symbolized perfection. Over the centuries cyclic images in western medicine, natural philosophy, natural history and eventually biology gained independence from cosmology and theology and came to depend less on strictly circular forms. As potent ‘canonical (...) icons’, cycles also interacted with representations of linear and irreversible change, including arrows, arcs, scales, series and trees, as in theories of the Earth and of evolution. In modern times life cycles and reproductive cycles have often been held to characterize life, in some cases especially female life, while human efforts selectively to foster and disrupt these cycles have harnessed their productivity in medicine and agriculture. But strong cyclic metaphors have continued to link physiology and climatology, medicine and economics, and biology and manufacturing, notably through the relations between land, food and population. From the grand nineteenth-century transformations of matter to systems ecology, the circulation of molecules through organic and inorganic compartments has posed the problem of maintaining identity in the face of flux and highlights the seductive ability of cyclic schemes to imply closure where no original state was in fact restored. More concerted attention to cycles and circulation will enrich analyses of the power of metaphors to naturalize understandings of life and their shaping by practical interests and political imaginations. (shrink)

Most research in environmental psychology is conducted in individualistic countries and focuses on factors pertaining to individuals. It is yet unclear whether these findings also apply to more collectivistic countries, in which group factors might play a prominent role. In the current paper, we test the individual-focused value–identity–behaviour pathway, in which personal biospheric values relate to pro-environmental actions via environmental self-identity, in an individualistic and a collectivistic country. Furthermore, we test in both countries whether a new group-focused pathway also exists, (...) in which group values relate to pro-environmental behaviour via environmental group identity, particularly in collectivistic countries. Questionnaire studies were conducted among Dutch and Chinese students. Our results indicated that personal biospheric values, mostly via environmental self-identity, predict pro-environmental behaviour in both countries. We also found initial support for our newly proposed value–identity–behaviour pathway at the group level, particularly in China. Yet, in both countries, the association between group-level variables and pro-environmental behaviour was weaker than for personal-level variables, and partly overlapped with personal-level variables. Our findings show the relevance of personal- and group-level factors in understanding pro-environmental behaviour in both individualistic and collectivistic countries, which has strong theoretical and practical implications, particularly for developing international strategies to promote pro-environmental actions across the world. (shrink)

In the interview in this article, Randall Collins discusses various aspects of his oeuvre. First, he considers why interaction rituals (IRs) in religion are special emotional transformers. This is followed by a discussion of IRs in the digital age and the symbolic and economic power that is required to orchestrate IRs in politics and revolutions. Then comes a discussion of social scientific research into violence, in the past and more recently. The interview continues with a reflection on the notion of (...) attention space, a concept which Collins has applied in analyses of violent interactions and the intellectual struggles between philosophers. Finally, the article considers the state of the art of sociology and its future prospects, evaluating its potential for rapid discovery and its position on the abstraction-reflexivity continuum. As the interview demonstrates Collins’s insightful sociological craftsmanship, it provides social scientists with a strong and optimistic lead in how to do social theory. (shrink)

Questions the dominant biological approach of explaining animal development as entirely genetic by exploring the explanatory value of investigating environmental influences.

Fabi and Goldberg have helpfully shed some light on the wrongs perpetuated by the current funding architecture on research, sponsorship, and career development in the field of bioethics. The...

An unresolved issue in the occupational health literature that is of both theoretical and practical importance is whether interpersonal conflicts, aggression and bullying at work are distinct or overlapping phenomena for exposed workers. In this study, we addressed this question empirically by employing a Latent Class (LC) analysis using cross-industry data from 6,175 Belgian workers. We found that a two-factor solution with a conflict-aggression factor and a bullying factor had the best fit. Employees with low exposure to workplace conflicts-aggression and (...) bullying perceived the phenomena as mostly overlapping. Reversely, employees who were exposed more frequently to the phenomena perceived them as more distinct - especially so for workplace bullying. Conflicts-aggression and bullying seem to be perceived as separate phenomena given their distinctive relationships with criterion variables in the domain of well-being and strain. These findings entail that a simple unifying approach or a single label for the three phenomena is not appropriate, at least from a measurement point of view and from the different perspectives of those exposed. Our results have important implications for the theoretical understanding of the concepts of interpersonal conflicts, aggression and bullying, and for practitioners who have to assist those involved with how to handle these problems and who have to develop legal as well as internal policies for the prevention and management of these issues at the workplace. (shrink)

Many researchers studying subjective wellbeing (SWB) understand SWB as a concept that is close to Bentham’s notion of happiness. This conception of happiness is philosophically controversial, because it treats pleasure as a homogenous experience. I analyze an important deviation from Bentham in John Stuart Mill’s Utilitarianism and its relevance for SWB research: qualitative differences in pleasurable experiences. I argue that in cases where lives involving qualitatively different experiences are compared, Mill’s qualitative perspective is incompatible with an important assumption in the (...) SWB literature: that happiness can be meaningfully rated by people on a scale. I illustrate the problem by means of the question of whether becoming a parent makes people happier. I analyze whether the problem can be avoided on alternative views of happiness, but argue that on all plausible accounts of happiness, the problem persists. I conclude that the problem it poses for self-reported happiness is genuine and should be acknowledged by SWB researchers. I end by discussing the ways in which this conclusion can help the study of happiness move forward. (shrink)

Objective—Consultation of another physician is an important method of review of the practice of euthanasia. For the project “support and consultation in euthanasia in Amsterdam” which is aimed at professionalising consultation, a protocol for consultation was developed to support the general practitioners who were going to work as consultants and to ensure uniformity. Participants—Ten experts (including general practitioners who were experienced in euthanasia and consultation, a psychiatrist, a social geriatrician, a professor in health law and a public prosecutor) and the (...) general practitioners who were going to use the protocol. Evidence—There is limited literature on consultation: discursive articles and empirical studies describing the practice of euthanasia. Consensus—An initial draft on the basis of the literature was commented on by the experts and general practitioners in two rounds. Finally, the protocol was amended after it had been used during the training of consultants. Conclusions—The protocol differentiates between steps that are necessary in a consultation and steps that are recommended. Guidelines about four important aspects of consultation were given: independence, expertise, tasks and judgment of the consultant. In 97% of 109 consultations in which the protocol was used the consultant considered the protocol to be useful to a greater or lesser extent. Although this protocol was developed locally, it also employs universal principles. Therefore it can be of use in the development of consultation elsewhere. (shrink)

Background: Although genetic research into Alzheimer disease (AD) is increasing, the ethical aspects of this kind of research and the differences between ethical issues related to genetic and non-genetic research into AD have not yet received much attention. Objectives: (1) To identify and compare the five ethical issues considered most important by surveyed expert panellists in non-genetic and genetic AD research and (2) to compare our empirical findings with ethical issues in genetic research in general as described in the literature. (...) Method: A modified Delphi study in two rounds Results: Genetic and non-genetic research into AD generated an approximately equal number of topics with a considerable overlap. Different priorities in the ethics of both types of research were found. Genetic research raised new topics such as “confidentiality of genetic information” and “implications of research for relatives” which changes the impact and application of existing ethical topics such as “informed consent” and is judged to have more impact on both individuals and society. A difference with the results of more theoretical approaches on ethical aspects related to AD research was also found. Conclusions: Different priorities are given to ethical issues in genetic and non-genetic research. These arise partly because genetic research causes unique and new questions, mostly related to the position of family members and the status of and access to genetic information. Differences found between the results of our empirical study and the more theoretical literature, suggest an additional value for empirical research in medical ethics. (shrink)

Due to its extraordinary predictive power and the great generality of its mathematical structure, quantum theory is able, at least in principle, to describe all the microscopic and macroscopic properties of the physical world, from the subatomic to the cosmological level. Nevertheless, ever since the Copen hagen and Gottingen schools in 1927 gave it the definitive formu lation, now commonly known as the orthodox interpretation, the theory has suffered from very serious logical and epistemologi cal problems. These shortcomings were immediately (...) pointed out by some of the principal founders themselves of quantum theory, to wit, Planck, Einstein, Ehrenfest, Schrodinger, and de Broglie, and by the philosopher Karl Popper, who assumed a position of radical criticism with regard to the standard formulation of the theory. The aim of the participants in the workshop on Open Questions in Quantum Physics, which was held in Bari (Italy), in the Department of Physics of the University, during May 1983 and whose Proceedings are collected in the present volume, accord ingly was to discuss the formal, the physical and the epistemo logical difficulties of quantum theory in the light of recent crucial developments and to propose some possible resolutions of three basic conceptual dilemmas, which are posed respectively ~: (a) the physical developments of the Einstein-Podolsky-Rosen argument and Bell's theorem, i. e. (shrink)