Blood service organizations employ various ways to ensure transfusion blood safety, including the testing of all donations for transfusion-transmissible infections (TTI) and the exclusion of donors who are at increased risk of a recent infection. As some TTIs are more common among men who have sex with men (MSM), many jurisdictions (temporarily) defer the donation of blood by sexually active MSM. This boils down to a categorical exclusion of a large group solely on the basis of their sexual orientation, which (...) is seen as unduly discriminatory and stigmatizing. Blood service organizations in the U.K. and the Netherlands have recently changed their deferral policies for MSM. The problem of the MSM deferral involves a conflict between fundamental rights: the right of MSM to equal treatment and the right to health of the recipients of blood and blood products. We distinguish and discuss three broad alternative options to the current categorical deferral of MSM donations: (1) completely abandoning donor selection on the basis of sexual behavior, (2) individual risk assessment of the sexual activities of each potential donor, and (3) individual risk assessment of the sexual activities of MSM only. The new U.K. policy falls within the second category, and the new Dutch policy is in the third category. We argue that each approach comes with moral costs but that the most reasonable option is different from the policies of both the U.K. and the Netherlands. (shrink)

Dynamical systems theory (DST) is gaining popularity in cognitive science and philosophy of mind. Recently several authors (e.g. J.A.S. Kelso, 1995; A. Juarrero, 1999; F. Varela and E. Thompson, 2001) offered a DST approach to mental causation as an alternative for models of mental causation in the line of Jaegwon Kim (e.g. 1998). They claim that some dynamical systems exhibit a form of global to local determination or downward causation in that the large-scale, global activity of the system governs or (...) constrains local interactions. This form of downward causation is the key to the DST model of mental causation. In this paper I evaluate the DST approach to mental causation. I will argue that the main problem for current DST approaches to mental causation is that they lack a clear metaphysics. I propose one metaphysical framework (Gillett, 2002a/b/c) that might deal with this deficiency. (shrink)

We study original position arguments in the context of social choice under ignorance. First, we present a general formal framework for such arguments. Next, we provide an axiomatic characterization of social choice rules that can be supported by original position arguments. We illustrate this characterization in terms of various well-known social choice rules, some of which do and some of which do not satisfy the axioms in question. Depending on the perspective one takes, our results can be used to argue (...) against certain rules, against Rawlsian theories of procedural fairness, or in support of richer, multidimensional models of individual choice. (shrink)

Pleidooi vooor eerherstel van de politiek, door de PvdA-fractieleider.

Is het niet vreemd om te zeggen dat een verhaal uit de achtste eeuw voor Christus ons iets kan vertellen over onze hedendaagse westerse cultuur? Hoe kan de beschrijving van een wereld die geregeerd wordt door goden, heksen, nimfen en allerlei mythische gedrochten bijdragen aan ons zelfbegrip? Dat is minder vreemd dan het lijkt. Juist omdat Homeros helemaal aan het begin van onze beschaving stond, kunnen wij in retrospectief herkennen wat de nieuwe wereld scheidde van de oude. De homerische epen (...) vormen een eerste definitie van de westerse cultuur, zij geven de contouren aan van een manier van denken en handelen die de wereld tot op de dag van vandaag beheerst. (shrink)

In order to contain public care expenditure, policymakers in the Netherlands have over the last decades formulated in ever more stringent ways what ought to be expected from spouses, partners, and family members with regard to care for dependent relatives. The current Dutch coalition cabinet plans to shift the principal responsibility for nonmedical care, including demanding forms of care such as long-term personal care, to individuals and families. I argue that these policy developments imply cost redistribution rather than cost containment (...) and that this redistribution is disadvantageous for women. (shrink)

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)

It often appears that leading politicians in Belgium consider the results of the municipal elections in the light of national polities. They stick to the thesis that the municipal poll-results, at least in the bigger towns, are more and more influenced by the constellation of the nation's politics.Is it really so that the municipal elections indicate the hearings of the national political situation? Can one draw conclusions from the results of these elections as if they were national ones? And can (...) one,any how, compare municipal to parliamentary elections? By comparison of the results of municipal elections 1964 and of parliamentary elections 1965 it was checked which shifts in party-choice havehappened during this short period of eight months. If no oscillations, or only a few, were detected between both elections, one could conclude that the municipal elections 1964 indicated indeed the hearings of the parliamentary elections 1965.Successively, the national and provincial results of these elections were compared and the party-shifts on national and provincial level were calculated.To make a relevant comparison between the election-results on a lower level, a comparable basic unity had to be found. As there were no municipal data available at parliamentary elections on one side, andonly municipal results at the municipal elections on the other side, the least possible unity for which parliamentary election-results are known, the electoral canton namely, was chosen as a comparison-basis. For that purpose however the results per party had to be additioned in all municipalities belonging to one canton.Part of the electoral cantons was unfit for use as comparison-material for two reasons : the highly varied and often strongly local-coloured political party-structure on one hand, the big number of municipalitieswithout elections on the other hand. So we were bound to make a choice out of 212 electoral cantons. Finally the cantons with a maximum of 4 municipalities were chosen, which limited the number of cantons to 28. These cantons were classified by degree of urbanisation according to the typology of W. Van Waelvelde and H. Van der Haegen.In that classification the percentages of votes in favour of the political parties, at the occasion of these elections, were tabulated and compared.The participating parties and lists were grouped as much as possible around the traditional parties to which they were most related. So we distinguish in Flanders : CVP, BSP, PVV, VU, CPB and other parties ;in the Walloon region: PSC, PSB, PLP PCB, French-speaking lists and other parties.For this analysis we also thought it was relevant to control separately the shifts of the electoral corps in the Flemish, the Walloon and the Brussels cantons. These shifts were then specified according to thedegree of urbanisation.To measure the size of the party-shifts for these elections, the external election-shift standard was calculated for the chosen Flemish, Walloon and Brussels cantons, with a special attention for the degree of urbanisation. Finally we examined which attitude was assumed by the government, the governmental and the opposition parties, in relation to the results of the municipal 1964 elections.It appeared that some notable party-shifts had been realized during the short period between the municipal elections of 1964 and the legislative elections of 1965. In general, a certain polarization has taken place due to a centrifugal vote-shift to the left and still more to the right. The direction of vote-shifts, which had shown at the municipal elections of 1964, was affirmed at the legislative elections of 1965 and for some parties, CVP and PVV namely, it was even accentuated. The parallelism between both elections in relation to the direction of the vote-shifts did not mean however that the size of these shifts was the same everywhere. The image of the shifts was different according to linguistic region and degree of urbanisation.The analysis of the urbanisation-degree showed that the level of oscillations grew higher as the urbanisation-degree grew lower. Seen per linguistic region, the largest shifts had taken place in the Walloon cantons. According to the calculations of the electoral shift standards during the period 1964-1965, the lowest oscillations were noted in the Flemish and Brussels cantons, i.e. the voting-behaviour of the big agglomerations during the municipal elections of 1964 were the closest to the national electoral pattern. Seen that way they were, up to a certain degree, a value-measure for the general policy.Finally the remark should be made that the limitation to the two above-mentioned elections does not allow any generalization of the obtained conclusions. The short period between those elections was itself an exceptional situation which may have been of influence on the results of the comparisons. (shrink)

Samenvatting van de grote wijsgerige systemen van Plato tot en met Hegel, gevolgd door een kritische analyse van de metafysica als uitingsvorm van westers intellectualisme.

In Belgium, as in most countries, each Minister or Secretary is assisted by a limited number of trusted collaborators who constitute the Ministerial Office.The article is an attempt to shed a light on the Chief Ministerial Officer who is the closest collaborator of the Minister.In order to show the role of the Chief Ministerial Officer, the article first describes the tasks, powers and composition of the Ministerial Office to proceed to a more extensive analysis of the functions, the appointment of (...) the Chief Ministerial Officer, and the question whether he can exercise executive power.The most important tasks of the Chief Ministerial Officer are: organization and coordination of the Office and its activities, acting as a «Liaison-Officer» with the Minister, passing on of information, exercising of a form of internal, political and administrative control.The article closes with some more personal remarks, pointing out a few guidelines which a Chief Ministerial Office, should keep in mind. (shrink)

This commentary is a response to Contextual Integrity as a General Conceptual Tool for Evaluating Technological Change by Elizabeth O’Neill (Philosophy & Technology (2022)). It argues that while contextual integrity (CI) might be an useful addition to the toolkit of approaches for ethical technology assessment, a CI approach might not be able to uncover all morally relevant impacts of technological change. Moreover, the inherent conservatism of a CI approach might be problematic in cases in which we encounter new kinds of (...) morally problematic situations, such as climate change, or when technology reinforces historically grown injustices. (shrink)

Pain and posttraumatic stress disorder frequently co-occur but underlying mechanisms are not clear. This study aimed to test the development and maintenance of pain and PTSD symptom clusters, i.e., intrusions, avoidance, and hyperarousal. The longitudinal study included 216 adults with burns. PTSD symptom clusters, indexed by the Impact of Event Scale-Revised, and pain, using a graphic numerical rating scale, were measured during hospitalization, 3 and 6 months post-burn. Cross-lagged panel analysis was used to test the relationships between pain and PTSD (...) symptom clusters. Cross-lagged results showed that in-hospital intrusions predicted pain and avoidance 3 months post-burn. In-hospital pain predicted intrusions and avoidance 3 months post-burn and a trend was found for hyperarousal. In the second wave, intrusions predicted pain and hyperarousal. Pain predicted hyperarousal. This study provides support for an entangled relationship between pain and PTSD symptoms, and particularly subscribes the role of intrusions in this bidirectional relationship. To a lesser extent, hyperarousal was unidirectionally related to pain. These results may subscribe the driving role of PTSD, particularly intrusions, which partly supports the Perpetual Avoidance Model. (shrink)

Open peer commentary on the article “Design Research as a Variety of Second-Order Cybernetic Practice” by Ben Sweeting. Upshot: I claim that the parallels between design research, second-order cybernetics and second-order science, as discussed by Sweeting in the target article, are more explicit in digital design. The discussion of SOC and SOS can point towards the creation of an epistemological foundation to digital design, where self-reflexivity and the inclusion of the observer are central questions.

Dit artikel behandelt de vraag van wat filosofie is vanuit de gelijknamige tekst van Heidegger. Het bespreekt het mogelijk onderscheid tussen continentale en analytische manieren om aan filosofie te doen, evenals het effect van de universitaire institutie op de filosofische bedrijvigheid.

This article discusses the proof theory, semantics and meta-theory of a class of adaptive logics, called hierarchic adaptive logics. Their specific characteristics are illustrated throughout the article with the use of one exemplary logic HKx, an explicans for reasoning with prioritized belief bases. A generic proof theory for these systems is defined, together with a less complex proof theory for a subclass of them. Soundness and a restricted form of completeness are established with respect to a non-redundant semantics. It is (...) shown that all hierarchic adaptive logics are reflexive, have the strong reassurance property and that a subclass of them is a fixed point for a broad class of premise sets. Finally, they are compared to a different yet related class of adaptive logics. (shrink)

Standardisation is increasingly seen as a means to insert ethics in innovation processes. We examine the institutionalisation of responsible innovation in de jure standardisation as this is an important but unexplored research area. In de jure standardisation, stakeholders collaborate in committees to develop standards. We adopt the anticipation, inclusion, reflexivity, and responsiveness responsible innovation framework as our theoretical lens. Our study suggests that responsible standardisation processes should embody forms of these four dimensions. We investigate the institutionalisation of these dimensions and (...) identify 96 factors that can motivate, hinder, or facilitate responsible standardisation. Factors were found through in-depth interviews with managers of a standard developing organisation. These are subsequently validated/rejected using surveys completed by committee representatives. The results suggest that the social desirability of standards is not self-evident. This study could pave the way for future research on responsible standardisation processes, complementing research on legitimacy, responsible innovation, and standardisation. (shrink)

Rationale In Belgium, several policies regulating reimbursement of acid suppressant drugs and evidence-based recommendations for clinical practice were issued in a short period of time, creating a unique opportunity to observe their effect on prescribing. Aims and objectives To describe the evolution of prescriptions for acid suppressants and explore the interaction of policies and practice recommendations with prescribing patterns. Method Monthly claims-based data for proton pump inhibitors (PPIs) and H-2-antihistamines by general practitioners, internists and "astroenterologists were obtained from the Belgian (...) national health insurance database (1997-2005). The evolution of reimbursed defined daily doses and expenses after introduction of reimbursement regulations and dissemination of practice recommendations was explored. Results Recommendations had no impact on prescribing. All changes can be related to concomitant policies. Lifting reimbursement restrictions for cheaper products did not control growth or save costs in the Iona term. Only restricting reimbursement of all PPIs managed to curb the growth. We observed an unintended increase of non-omeprazole PPIs by gastroenterologists. Conclusions Reimbursement policies influence prescribing, but their effect can be unintended. A dialogue between policymakers and guideline developers, and evidence-based policies that are linked to clinical guidelines, could be an effective way to pursue both cost-containment and quality of care. (shrink)

PurposeTo explore the mindfulness practice, its long-term effects, facilitators and barriers, in clinical clerkship students 2 years after participation in an 8-week mindfulness-based stress reduction training.MethodA qualitative study was performed by semi-structured in-depth interviews with 16 clinical clerkship students selected by purposive sampling. Students had participated in a MBSR training 2 years before and were asked about their current mindfulness practice, and the long-term effects of the MBSR training. Thematic analysis was conducted using the constant comparison method. Data saturation was (...) reached after 16 interviews.ResultsMost interviewees were still engaged in regular, predominantly informal, mindfulness practice, although some discontinued mindfulness practice and reported an “unchanged lifestyle.” Three main themes came forward; “focused attention and open awareness” during daily activities as core elements of long-term mindfulness practice; “changes in behavior and coping” that resulted from taking a pause, reflecting, recognizing automatic behavioral patterns and making space for a conscious response; “integration in personal and professional life” by enhanced enjoyment of daily activities, improved work-life-balance and making different career choices. Barriers and facilitators in starting and maintaining mindfulness practice were understanding and intention as “pre-conditions”; practical, personal, and professional factors of students in maintaining practice.ConclusionTwo years after participation in a MBSR training, many interviewees were still engaged in mindfulness practice contributing to both personal and professional changes. In light of the high clerkship demands, MBSR training could be a valuable addition to medical curricula, supporting medical students in developing necessary competencies to become well-balanced professionals. (shrink)

Background: Although previous studies have shown an inverse relation between life meaning and eating disorder symptoms, the correlational nature of this evidence precludes causal inferences. Therefore, this study used an experimental approach to test the causal impact of life meaning on individuals' weight and shape concerns.Methods: Female students at risk for developing an eating disorder were randomly assigned to the control or the meaning condition, which involved thinking about and committing to pursue intrinsically valued life goals. A color-naming interference task (...) was used to assess the motivational salience of body-related stimuli, and self-report measures were used to assess participants' overvaluation of weight and shape.Results: The meaning manipulation was effective in activating intrinsically valued life goals. However, it did not result in lower self-reported overvaluation of weight and shape or lower color-naming interference effects of body-related stimuli, compared to the control condition. Post-hoc analyses suggested that baseline meaning in life was related to the impact of the manipulation.Conclusions: This experimental study did not provide evidence for a causal influence of life meaning on the overvaluation of weight and shape in a high-risk group. The current findings suggest that we first need to examine the relationship between life meaning and eating disorder symptoms in more detail, before implementing brief meaning manipulations in clinical practice. (shrink)

Featuring a unique systematic approach to dealing with ethical problems known as the 'ethical cycle, ' the book utilizes an abundance of real-life case studies ...