ObjectiveInformed consent is a prerequisite for caesarean section, the commonest surgical procedure in low- and middle-income settings, but not always acquired to an appropriate extent. Exploring perceptions of health care workers may aid in improving clinical practice around informed consent. We aim to explore health workers’ beliefs and experiences related to principles and practice of informed consent.MethodsQualitative study conducted between January and June 2018 in a rural 150-bed mission hospital in Southern Malawi. Clinical observations, semi-structured interviews and a focus group (...) discussion were used to collect data. Participants were 22 clinical officers, nurse-midwives and midwifery students involved in maternity care. Data were analysed to identify themes and construct an analytical framework.ResultsDefinition and purpose of informed consent revolved around providing information, respecting women’s autonomy and achieving legal protection. Due to fear of blame and litigation, health workers preferred written consent. Written consent requires active participation by the consenting individual and was perceived to transfer liability to that person. A woman’s refusal to provide written informed consent may pose a dilemma for the health worker between doing good and respecting autonomy. To prevent such refusal, health workers said to only partially disclose surgical risks in order to minimize women's anxiety. Commonly perceived barriers to obtain a fully informed consent were labour pains, language barriers, women’s lack of education and their dependency on others to make decisions.ConclusionsHealth workers are familiar with the principles around informed consent and aware of its advantages, but fear of blame and litigation, partial disclosure of risks and barriers to communication hamper the process of obtaining informed consent. Findings can be used to develop interventions to improve the informed consent process. (shrink)

At times we are told that our habitual way of thinking has become obsolete given the new challenge we are facing. Some of the conceptual resources at our disposal are no longer capable of addressing the challenge at hand. Therefore, they lose their appeal and are rejected. But only in contrast to these intellectual resources does the challenge appear as a challenge. So it seems that we are confronted with a paradox: we need the intellectual resources for their uselessness. For (...) a proper understanding of this paradox and to unravel it, I will distinguish between de dicto and de re readings of philosophical texts. This distinction is borrowed from the neo-pragmatist Robert Brandom. A de dicto reading of a text is concerned with what its author says. A de re reading of a text is concerned with what its author talks about. Unpacking this distinction allows us to evaluate the method of engaging with our stock of conceptual resources as part of scholarly argument. (shrink)

Prenatal expectations about what children will be like after birth may provide a context for how parents perceive their infant's actual temperament. We examined how these expectations and perceptions are associated and together predict early parenting behavior, with parenting behavior in turn predicting changes in temperament. Reports of 125 families about their expectations of their unborn child's temperament, their infant's temperament at 4 and 12 months post-partum, and their hostile, responsive, warm, and overprotective parenting were included. We also included data (...) from an independent sample of 168 mothers, with the same measures, except that mothers reported on Big Five personality traits at T1. Results indicated that in both samples, parents' expectations were positively associated with perceptions of infant temperament. Prenatal expectations and newborn temperament independently predicted parenting behavior, and maternal and paternal parenting in turn predicted infant temperament at T3, controlling for infant temperament at T2. Although overall findings indicated associations between a more difficult temperament and more negative/less positive parenting, significant combinations of specific traits and parenting behaviors were sample-specific—indicating that more research is necessary to draw a conclusion about specific links. Both maternal and paternal expectations about their unborn child's temperament appear to carry over into the postpartum reality and provide a context for shaping early interactions between caregivers and their children, which may further shape the developing temperament of the child. (shrink)

This essay takes Arthur Danto’s end-of-art thesis as a case in point of a substantive philosophy of history. Such philosophy explains the direction that art has taken and why that direction could not have been different. Danto never scrutinized the philosophy of history that his end-of-art thesis presumes. I aim to do that by drawing a distinction between what I refer to as the common view of history and the philosophical view of history, and by arguing that we need the (...) latter if we want to properly assess the plausibility of the end-of-art thesis. (shrink)

The problem how to ascertain the truth about the past is as old as history itself. But until the work of Louis Mink, no clear distinction was made between questions concerning the truth of statements on the past and questions concerning the truth of historical narratives as a whole. A narrative, Mink argues, is not simply a conjunction of statements on the past. Therefore its truth cannot be a function of the truth of its individual statements. The problem of narrative (...) truth is according to him thus: although each statement asserting a relation between events is subject to confirmation and disconfirmation, the combination of interrelations as established by the historical narrative is not, even though such combination of interrelations represents a real combination in past reality and is claimed to be true. As if to further complicate the problem, Mink maintains that history shares its form with fiction. Three and a half decades after Mink formulated the problem of narrative truth, it has not been dealt with in a satisfying manner. Mink does not solve nor dissolve the problem he posed. That task is taken up in this essay. It will move us away from the vocabulary of literary theory towards a pragmatist account of narrative truth. (shrink)

This comprehensive book covers the research, theory, policy and practice context of unusual reproduction using third parties. Olga Van den Akker details the psychological adaptation required to continuing changes in public opinion, advances in technologies and new legislations in surrogate motherhood and discusses their impact at an individual, societal and global level. She describes the competing interests and interactions between legal, organisational, personal, social, psychological and cultural issues in relation to biological and genetic surrogate and commissioning parenthood. This book (...) is intended for professionals, practitioners, academics and students interested in the complexities of unusual reproduction using multidisciplinary perspectives. (shrink)

An important artistic topic of Italian Renaissance painting was the rendering of the human figure. As leading actors in a painted narrative, figures had to convince beholders of the reality of the matter depicted with appropriated attitudes and gestures. This article is about two ways of drawing or rather constructing the human figure artists developed to achieve this goal. The first was only an adaptation to an old method: because of the rather simple and coarse elements used, constructions often resulted (...) in faulty pictures and were for that matter often criticized. As this article will show, the second method involved a new and very successful drawing skill, which not just required a different kind of knowledge of visual forms but of procedures of moving the hand, too. (shrink)

The “exemplification theory of history” is proposed to account for the relationship between the past and historical narratives. The theory states that what belongs to the past according to some narrative does so in order to exemplify the historical thesis of that narrative. As such the theory explains how the past receives its meaning. This implies that the past has no intrinsic historical meaning itself. Moreover, it follows that historical narratives possess an autonomy of their own with regard to the (...) past. It is argued that the exemplification theory of history goes to the heart of narrativist philosophy of history. This claim is supported by the key arguments of three narrativist philosophers: Arthur Danto, Louis Mink and Frank Ankersmit. The distinction between the history of social individuals and the identification of such individuals turns out to be fundamental in this respect. The article concludes by distinguishing between a Platonic and an Aristotelian view on narrative and by explaining why we ought to prefer the former to the latter. (shrink)

In his famous 1936 essay “The Work of Art in the Age of Mechanical Reproduction” Walter Benjamin tells us that in his time art became valued for its exhibition value instead of what he refers to as its secularised ritual or cult value. This essay makes this bold claim plausible by arguing that it means that a historicising gaze no longer has a function in the reception of art. Although this argument is supported by Benjamin’s use of the concepts of (...) authenticity and aura, it is somehow missed by Benjamin’s many readers. His essay, as it turns out, presents an end of history thesis, which foreshadows the condition of the image in contemporary media. (shrink)

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

Formulating how biomimicry relates to nature has been crucial to ‘deepening’ its theory. Currently, an autopoietic model of nature dominates the literature. However, advances in the natural and human sciences have demonstrated that autopoiesis does not adequately explain complex, dynamic, responsive, and situated systems. This article draws on Beth Dempster’s (1998) characterisation of ecosystems as sympoietic, that is as homeorhetic, evolutionary, distributively controlled, unpredictable, and adaptive, and on Donna Jeanne Haraway’s (2016) critique that entities do not pre-exist their relationships. We (...) argue that using sympoietic processes of becoming as our model, measure, and mentor impacts biomimicry’s practice and relation to sustainability. Taking John Todd’s Living Machines as a case study, we explicate how sympoiesis unfurls autopoiesis. By integrating advances in the natural and human sciences into the philosophy of biomimicry, we address the limitations of the autopoietic model and provide a more comprehensive and adequate model of ‘nature.’. (shrink)

While many public health threats are now widely appreciated by the public, the risks from asbestos exposure remain poorly understood, even in high-risk groups. This article makes the case that asbestos exposure is an important, ongoing global health threat, and argues for greater policy efforts to raise awareness of this threat. It also proposes the extension of asbestos bans to developing countries and increased public subsidies for asbestos testing and abatement.

Voting Advice Applications (VAAs) are online tools designed to help citizens decide how to vote. They typically offer their users a representation of what is at stake in an election by matching user preferences on issues with those of parties or candidates. While the use of VAAs has boomed in recent years in both established and new democracies, this new phenomenon in the electoral landscape has received little attention from political theorists. The current academic debate is focused on epistemic aspects (...) of the question how a VAA can adequately represent electoral politics. We argue that conceptual and normative presuppositions at play in the background of the tool are at least as important. Even a well-developed VAA does not simply reflect what is at stake in the election by neutrally passing along information. Rather, it structures political information in a way that is informed by the developers’ presuppositions. Yet, these presuppositions remain hidden if we interpret the tool as a mirror that offers the user a reflection of him/herself situated within the political landscape. VAAs should therefore be understood as electoral dioramas, staged according to a contestable picture of politics. (shrink)

Lee and Schwarz interpret meta-analytic research and replication studies as providing evidence for the robustness of cleansing effects. We argue that the currently available evidence is unconvincing because publication bias and the opportunistic use of researcher degrees of freedom appear to have inflated meta-analytic effect size estimates, and preregistered replications failed to find any evidence of cleansing effects.

The rise of multi-stakeholder institutions (MIs) involving the ultra-processed food (UPF) industry has raised concerns among food and public health scholars, especially with regards to enhancing the legitimacy and influence of transnational food corporations in global food governance (GFG) spaces. However, few studies have investigated the governance composition and characteristics of MIs involving the UPF industry, nor considered the implications for organizing global responses to UPFs and other major food systems challenges. We address this gap by conducting a network analysis (...) to map global MIs involving the UPF industry, drawing data from web sources, company reports, business and market research databases, and academic and grey literature. We identified 45 such global food system MIs. Of these, executives from the UPF industry or affiliated interest groups held almost half (_n_ = 263, or 43.8%) of the total 601 board seat positions. Executives from a small number of corporations, especially Unilever (_n_ = 20), Nestlé (_n_ = 17), PepsiCo Inc (_n_ = 14), and The Coca-Cola Company (_n_ = 13) held the most board seat positions, indicating centrality to the network. Board seats of these MIs are dominated by executives from transnational corporations (_n_ = 431, or 71.7%), high-income countries (_n_ = 495, or 82.4%), and four countries (United States, Switzerland, United Kingdom, and the Netherlands) (_n_ = 350, or 58.2%) in particular. This study shows that MIs involving the UPF industry privilege the interests of corporations located near exclusively in the Global North, draw legitimacy through affiliations with multi-lateral agencies, civil society groups and research institutions, and represent diverse corporate interests involved in UPF supply chains. Corporate-anchored multi-stakeholderism, as a form of GFG governance, raises challenges for achieving food systems transformation, including the control and reduction of UPFs in human diets. (shrink)

Theoretical arguments and empirical investigations indicate that a high proportion of published findings do not replicate and are likely false. The current position paper provides a broad perspective on scientific error, which may lead to replication failures. This broad perspective focuses on reform history and on opportunities for future reform. We organize our perspective along four main themes: institutional reform, methodological reform, statistical reform and publishing reform. For each theme, we illustrate potential errors by narrating the story of a fictional (...) researcher during the research cycle. We discuss future opportunities for reform. The resulting agenda provides a resource to usher in an era that is marked by a research culture that is less error-prone and a scientific publication landscape with fewer spurious findings. (shrink)

Many of our interactions in the twenty-first century - both good and bad - take place by means of institutions, technology, and artefacts. We inhabit a world of implements, instruments, devices, systems, gadgets, and infrastructures. Technology is not only something that we make, but is also something that in many ways makes us. The discipline of ethics must take this constitutive feature of institutions and technology into account; thus, ethics must in turn be embedded in our institutions and technology. The (...) contributors to this book argue that the methodology of 'designing in ethics' - addressing and resolving the issues raised by technology through the use of appropriate technological design - is the way to achieve this integration. They apply their original methodology to a wide range of institutions and technologies, using case studies from the fields of healthcare, media and security. Their volume will be important for philosophical practitioners and theorists alike. (shrink)

We report on the small-scale (0.5 13 h - 1M, a large-scale bias of ~2.0 and a satellite fraction of 12 ± 2 per cent. Thus, these galaxies occupy haloes with average masses in between those of the higher redshift BOSS CMASS sample and the original SDSS I/II luminous red galaxy sample © 2012 The Authors Published by Oxford University Press on behalf of the Royal Astronomical Society © doi:10.1093/mnras/sts314.

Introduction Sartre at One Hundred — a Man of the Nineteenth Century Addressing the Twenty-First? THOMAS R. FLYNN We are celebrating the centennial year of ...

Dans l'oeuvre d'Edith Stein, l'alterite apparait comme constitutive de la personne humaine. D'un point de vue proprement subjectif, l'alterite renvoie... l'alter ego,... la dimension communautaire et, dans une perspective croyante, au Tout-Autre. D'un point de vue objectif, elle designe les valeurs, qui faconnent la personnalite, et la foi, qui vient au secours de la raison humaine. Un parcours des oeuvres principales de l'auteur permet de prendre la mesure... la fois de la continuite et de l'evolution de sa pensee. A partir (...) de l..., l'etude entreprend de mettre en evidence, d'une part, l'originalite de la pensee d'Edith Stein par rapport... celle de Husserl et, d'autre part, comment Edith Stein se situe par rapport... la pensee de Thomas d'Aquin. L'influence de l'oeuvre de Jean de la Croix est egalement abordee. Enfin, en dialogue avec des auteurs comme Ricoeur, Levinas ou Ladriere, la troisieme partie du livre aborde de maniere critique la question de l'alterite comme fondement de la personne et cela selon trois parcours, l'un lie... la phenomenologie d'Edith Stein, l'autre... sa philosophie chretienne, et le dernier... son attrait pour la mystique. (shrink)

Any system for the protection of intellectual property rights (IPRs) has three main kinds of distributive effects. It will determine or influence: (a) the types of objects that will be developed and for which IPRs will be sought; (b) the differential access various people will have to these objects; and (c) the distribution of the IPRs themselves among various actors. What this means to the area of pharmaceutical research is that many urgently needed medicines will not be developed at all, (...) that the existing medicines will not be suitable for countries with a precarious health infrastructure or not target the disease variety that is prevalent in poorer regions. Such effects are commonly captured under the rubric of the “10/90 gap” in biomedical research. High prices will also restrict access to medicines as well endanger compliance to treatment schemes. IPRs are mainly held by multinational corporations situated in the developed world, which not only raises egalitarian concerns, but also severely limits the possibilities of companies in poorer countries to realize improvements on existing inventions, as they cannot financially afford to secure freedom to operate, which systematically shrinks the number of potential innovators. Those inequities lead to an enormous burden for the global poor and since no institution is willing to assume the responsibility to fulfil the right to health and the corresponding right of access to essential medicines, we have to analyse alternatives or additions to the actual intellectual property regimes in order to create new incentives to fill this gap. (shrink)

International negotiations on anthropogenic climate change are far from running smoothly. Opinions are deeply divided on what are the respective responsibilities of developed and developing countries with regard to the reduction of greenhouse gas emissions and the alleviation of the negative effects of global warming. A major bone of contention concerns the role of intellectual property rights (especially patents) in the development and diffusion of climate-friendly technologies. While developing countries consider IPRs as a formidable barrier to the rapid transfer and (...) the widest possible diffusion of such technologies, developed countries, by contrast, see IPRs as a vital prerequisite for the development and transfer of these same technologies. This debate shows some similarity with the earlier debate on patents and access to lifesaving medicines, although there are also important differences. In our contribution we will explore both the analogies and the differences with this earlier debate. To provide a focus for our discussion, we will examine whether something similar to the Health Impact Fund (HIF), which has been proposed by philosopher Thomas Pogge as a reasonable solution to the ethical dilemmas of protection and accessibility in the field of pharmaceuticals, can also be elaborated for the development and diffusion of climate-friendly technologies. Thus the central question is how an analogous ‘Climate Impact Fund’ would look like and how it would work. This whole exercise will also yield a normative yardstick for assessing the various designs for a Green Climate Fund or a Technology Mechanism that are currently on the table of the international climate negotiations. (shrink)

In Zadig , published in 1748, Voltaire wrote of “the great principle that it is better to run the risk of sparing the guilty than to condemn the innocent.” At about the same time, Blackstone noted approvingly that “the law holds that it is better that ten guilty persons escape, than that one innocent suffer.” In 1824, Thomas Fielding cited the principle as an Italian proverb and a maxim of English law. John Stuart Mill endorsed it in an address (...) to Parliament in 1868. General acceptance of this maxim continues into our own period, yet it is difficult to find systematic attempts to defend the maxim. It is treated as a truism in no need of defense. But the principle within it is not at all obvious; and since it undergirds many of our criminal justice policies, we should be sure that it is justifiable. First, however, we must clarify what the principle means. (shrink)