Despite the reported limited success of conventional treatments and growing evidence of the effectiveness of adult bariatric surgery, weight loss operations for (morbidly) obese children and adolescents are still considered to be controversial by health care professionals and lay people alike. This paper describes an explorative, qualitative study involving obesity specialists, morbidly obese adolescents, and parents and identifies attitudes and normative beliefs regarding pediatric bariatric surgery. Views on the etiology of obesity—whether it should be considered primarily a medical condition or (...) more a psychosocial problem—seem to affect the specialists’ normative opinions concerning the acceptability of bariatric procedures as a treatment option, the parents’ feelings regarding both being able to influence their child’s health and their child being able to control their own condition, and the adolescents’ sense of competence and motivation for treatment. Moreover, parents and adolescents who saw obesity as something that they could influence themselves were more in favor of non-surgical treatment and vice versa. Conflicting attitudes and normative views—e.g., with regard to concepts of disease, personal influence on health, motivation, and the possibility of a careful informed consent procedure—play an important role in the acceptability of bariatric surgery for childhood obesity. (shrink)

In recent years, there has been a rapidly increasing interest in self-management strategies in psychiatry and psychosomatic medicine. Among the conditions in which self-management is currently investigated in these contexts are bipolar disorder, depression, post-traumatic stress disorder, schizophrenia, attention deficit hyperactivity disorder, irritable bowel syndrome, chronic fatigue syndrome (Meng, Friedberg, &...

In a recent attempt to update the 1948 World Health Organization definition of health as a state of complete well-being and absence of disease, it has now been proposed to change its emphasis to the ability to adapt and self manage in the face of social, physical and emotional challenges. The question how we should conceptualize such self-management, however, is rarely raised and its theoretical foundations remain largely unexplained. Still, to an increasing extent, scholars, health professionals, researchers, caretakers and policy (...) makers emphasize the great potential of self-management strategies in somatic as well as mental healthcare. Patients, so the argument runs, should not be treated... (shrink)

Dissociative identity disorder is a dissociative disorder that gained a significant rise in the past few decades. There has been less than 50 DID cases recorded between 1922 and 1972, while 20,000 cases are recorded by 1990. Therefore, it becomes of great significant to assess the various concepts related to DID to further understand the disorder. The current review has a goal of understanding whether an individual suffering from DID is legally responsible for the committed crime, and whether or not (...) he or she can be considered competent to stand trial. These two questions are to be raised in understanding DID, by first shedding a light on the nature of the disorder and second by examining the past legal case examples. Despite the very nature of the disorder is characterized by dissociative amnesia and the fact that the host personality may have limited or no contact with the alters, there is no consensus within the legal system whether the DID patients should be responsible for their actions. Further to that, courts generally deny the insanity claims for DID suffering patients. In conclusion, more studies in the field are suggested to incorporate primary data into research, as the extensive reliance on secondary data forces us to believe the conclusions that were previously made, and no opportunity to verify those conclusions is present. (shrink)

This paper examines the structure of moral responsibility for outcomes. A central feature of the analysis is a condition that we term the ‘avoidance potential’, which gives precision to the idea that moral responsibility implies a reasonable demand that an agent should have acted otherwise. We show how our theory can allocate moral responsibility to individuals in complex collective action problems, an issue that sometimes goes by the name of ‘the problem of many hands’. We also show how it allocates (...) moral responsibility in the classic Frankfurt example. (shrink)

For many physicists quantum theory contains strong conceptual difficulties, while for others the apparent conclusions about the reality of our physical world and the ways in which we discover that reality remain philosophically unacceptable. This book focuses on recent theoretical and experimental developments in the foundations of quantum physics, including topics such as the puzzles and paradoxes which appear when general relativity and quantum mechanics are combined; the emergence of classical properties from quantum mechanics; stochastic electrodynamics; EPR experiments and Bell's (...) Theorem; the consistent histories approach and the problem of datum uniqueness in quantum mechanics; non-local measurements and teleportation of quantum states; quantum non-demolition measurements in optics and matter wave properties observed by neutron, electron and atomic interferometry. Audience: This volume is intended for graduate students of physics and those interested in the foundations of quantum theory. (shrink)

This paper relates the origin, the principles and the evolution of the financial participation in HBK-Spaarbank. This participation in the capital is concretized by the cooperative company Personnel Cooperative HBK. Founded in 1979, this cooperative company which represents all workers of HBK-Spaarbank has now become a very significant shareholder. At present it owns 22.50% of the capital of the savings bank.

An important and supposedly impactful form of clinical ethics support is moral case deliberation. Empirical evidence, however, is limited with regard to its actual impact. With this literature review, we aim to investigate the empirical evidence of MCD, thereby a) informing the practice, and b) providing a focus for further research on and development of MCD in healthcare settings. A systematic literature search was conducted in the electronic databases PubMed, CINAHL and Web of Science. Both the data collection and the (...) qualitative data analysis followed a stepwise approach, including continuous peer review and careful documentation of our decisions. The qualitative analysis was supported by ATLAS.ti. Based on a qualitative analysis of 25 empirical papers, we identified four clusters of themes: 1) facilitators and barriers in the preparation and context of MCD, i.e., a safe and open atmosphere created by a facilitator, a concrete case, commitment of participants, a focus on the moral dimension, and a supportive organization; 2) changes that are brought about on a personal and inter-professional level, with regard to professional’s feelings of relief, relatedness and confidence; understanding of the perspectives of colleagues, one’s own perspective and the moral issue at stake; and awareness of the moral dimension of one’s work and awareness of the importance of reflection; 3) changes that are brought about in caring for patients and families; and 4) changes that are brought about on an organizational level. This review shows that MCD brings about changes in practice, mostly for the professional in inter-professional interactions. Most reported changes are considered positive, although challenges, frustrations and absence of change were also reported. Empirical evidence of a concrete impact on the quality of patient care is limited and is mostly based on self-reports. With patient-focused and methodologically sound qualitative research, the practice and the value of MCD in healthcare settings can be better understood, thus making a stronger case for this kind of ethics support. (shrink)

New and Emerging Science and Technology (NEST) based innovations, e.g. in the field of Life Sciences or Nanotechnology, frequently raise societal and political concerns. To address these concerns NEST researchers are expected to deploy socially responsible R&D practices. This requires researchers to integrate social and ethical aspects (SEAs) in their daily work. Many methods can facilitate such integration. Still, why and how researchers should and could use SEAs remains largely unclear. In this paper we aim to relate motivations for NEST (...) researchers to include SEAs in their work, and the requirements to establish such integration from their perspectives, to existing approaches that can be used to establish integration of SEAs in the daily work of these NEST researchers. Based on our analyses, we argue that for the successful integration of SEAs in R&D practice, collaborative approaches between researchers and scholars from the social sciences and humanities seem the most successful. The only way to explore whether that is in fact the case, is by embarking on collaborative research endeavours. (shrink)

The animalist says we are animals. This thesis is commonly understood as the universal generalization that all human persons are human animals. This article proposes an alternative: the thesis is a generic that admits of exceptions. We defend the resulting view, which we call ‘generic animalism’, and show its aptitude for diagnosing the limits of eight case-based objections to animalism.

Thanks to the exchange of arguments, groups outperform individuals on some tasks, such as solving logical problems. However, these results stem from experiments conducted among Westerners and they could be due to cultural particularities such as tolerance of contradiction and approval of public debate. Other cultures, collectivistic cultures in particular, are said to frown on argumentation. Moreover, some influential intellectual movements, such as Confucianism, disapprove of argumentation. In two experiments, the hypothesis that Easterners might not share the benefits of argumentation (...) was tested. In Experiment 1, Japanese participants had to solve a standard logical problem individually and then in groups. They performed significantly better in groups. In Experiment 2, Japanese participants had to estimate the weight of various animals. They did so individually, then after learning of another participant's estimates, then after discussing these estimates with the other participant, and then indi.. (shrink)

Within current debates about the future impact of Artificial Intelligence on human society, roughly three different perspectives can be recognised: the technology-centric perspective, claiming that AI will soon outperform humankind in all areas, and that the primary threat for humankind is superintelligence; the human-centric perspective, claiming that humans will always remain superior to AI when it comes to social and societal aspects, and that the main threat of AI is that humankind’s social nature is overlooked in technological designs; and the (...) collective intelligence-centric perspective, claiming that true intelligence lies in the collective of intelligent agents, both human and artificial, and that the main threat for humankind is that technological designs create problems at the collective, systemic level that are hard to oversee and control. The current paper offers the following contributions: a clear description for each of the three perspectives, along with their history and background; an analysis and interpretation of current applications of AI in human society according to each of the three perspectives, thereby disentangling miscommunication in the debate concerning threats of AI; and a new integrated and comprehensive research design framework that addresses all aspects of the above three perspectives, and includes principles that support developers to reflect and anticipate upon potential effects of AI in society. (shrink)

We present a pole expansion for the propagators in the framework of normalized quantum electrodynamics and compare it with the more canonical results from S-matrix theory.

Previous studies suggest in line with dual process models that interoceptive skills affect controlled decisions via automatic or implicit processing. The “framing effect” is considered to capture implicit effects of task-irrelevant emotional stimuli on decision-making. We hypothesized that cardiac awareness, as a measure of interoceptive skills, is positively associated with susceptibility to the framing effect. Forty volunteers performed a risky-choice framing task in which the effect of loss versus gain frames on decisions based on identical information was assessed. The results (...) show a positive association between cardiac awareness and the framing effect, accounting for 24% of the variance in the framing effect. These findings demonstrate that good interoceptive skills are linked to poorer performance in risky choices based on ambivalent information when implicit bias is induced by task-irrelevant emotional information. These findings support a dual process perspective on decision-making and suggest that interoceptive skills mediate effects of implicit bias on decisions. (shrink)

As thousands of healthy research participants are being included in small and large imaging studies, it is essential that dilemmas raised by the detection of incidental findings are adequately handled. Current ethical guidance indicates that pathways for dealing with incidental findings should be in place, but does not specify what such pathways should look like. Building on an interview study of researchers’ practices and perspectives, we identified key considerations for the set-up of pathways for the detection, management and communication of (...) incidental findings in imaging research. We conducted an interview study with a purposive sample of researchers at research facilities across the Netherlands. Based on a qualitative analysis of these interviews and on existing guidelines found in the literature, we developed a prototype ethical framework, which was critically assessed and fine-tuned during a two-day international expert meeting with bioethicists and representatives from large population-based imaging studies from the United Kingdom, Germany, Sweden and Belgium. Practices and policies for the handling of incidental findings vary strongly across the Netherlands, ranging from no review of research scans and limited feedback to research participants, to routine review of scans and the arrangement of clinical follow-up. Respondents felt that researchers do not have a duty to actively look for incidental findings, but they do have a duty to act on findings, when detected. The principle of reciprocity featured prominently in our interviews and expert meeting. We present an ethical framework that may guide researchers and research ethics committees in the design and/or evaluation of appropriate pathways for the handling of incidental findings in imaging studies. The framework consists of seven steps: anticipation of findings, information provision and informed consent, scan acquisition, review of scans, consultation on detected abnormalities, communication of the finding, and further clinical management and follow-up of the research participant. Each of these steps represents a key decision to be made by researchers, which should be justified not only with reference to costs and/or logistical considerations, but also with reference to researchers’ moral obligations and the principle of reciprocity. (shrink)

Policy makers call upon researchers from the natural and social sciences to collaborate for the responsible development and deployment of innovations. Collaborations are projected to enhance both the technical quality of innovations, and the extent to which relevant social and ethical considerations are integrated into their development. This could make these innovations more socially robust and responsible, particularly in new and emerging scientific and technological fields, such as synthetic biology and nanotechnology. Some researchers from both fields have embarked on collaborative (...) research activities, using various Technology Assessment approaches and Socio-Technical Integration Research activities such as Midstream Modulation. Still, practical experience of collaborations in industry is limited, while much may be expected from industry in terms of socially responsible innovation development. Experience in and guidelines on how to set up and manage such collaborations are not easily available. Having carried out various collaborative research activities in industry ourselves, we aim to share in this paper our experiences in setting up and working in such collaborations. We highlight the possibilities and boundaries in setting up and managing collaborations, and discuss how we have experienced the emergence of ‘collaborative spaces.’ Hopefully our findings can facilitate and encourage others to set up collaborative research endeavours. (shrink)

This empirical study examines corporate responses to activist shareholder groups filing social-policy shareholder resolutions. Using resource dependency theory as our conceptual framing, we identify some of the drivers of corporate responses to shareholder activists. This study departs from previous studies by including a fourth possible corporate response, engaging in dialogue. Dialogue, an alternative to shareholder resolutions filed by activists, is a process in which corporations and activist shareholder groups mutually agree to engage in ongoing negotiations to deal with social issues. (...) Based on a unique dataset of resolutions filed by member organizations of the Interfaith Center on Corporate Responsibility from 2002 to 2005 and the outcomes of these resolutions, our analysis finds that corporate managers are more likely to engage in dialogue with shareholder activists when the firm is larger, is more responsive to stakeholders, the CEO is the board chair, and the firm has a relatively lower percentage of institutional investors. (shrink)

The popular view of shareholder activism focuses on shareholder resolutions and the shareholder vote via proxy statements at the annual meeting, which is treated as a "David vs. Goliath" showdown between the small group of socially responsible investors and the powerful corporation. This article goes beyond the popular view to examine where the real action typically occurs-in the Dialogue process where corporations and shareholder activist groups mutually agree to ongoing communications to deal with a serious social issue. Use of the (...) capitalized word "Dialogue" is intended to distinguish this formal process between corporations and shareholders from all the other forms of dialogue or twoway communication exchanged between a corporation and its stakeholders. The phenomenon of Dialogue between a corporation and dissident shareholders has not been analyzed in the academic literature or in the popular press because it occurs behind the scenes and out of sight from media scrutiny. Yet this is where a great deal of social change initiated by shareholder activists is negotiated. This article contributes both theoretically and empirically to the study of Dialogues between shareholder activists and corporations. We explain how Dialogues occur in the context of the shareholder resolution process and examine two Dialogues that focus on international labor issues in two industries. Then data on Dialogues during the period, 1999-2005, from the Interfaith Center on Corporate Responsibility are analyzed. This research contributes to knowledge about the Dialogue process and the emerging literature on corporation-stakeholder engagement. (shrink)

We report three studies which test a sexual selection hypothesis for male war heroism. Based on evolutionary theories of mate choice we hypothesize that men signal their fitness through displaying heroism in combat. First, we report the results of an archival study on US-American soldiers who fought in World War II. We compare proxies for reproductive success between a control sample of 449 regular veterans and 123 surviving Medal of Honor recipients of WWII. Results suggest that the heroes sired more (...) offspring than the regular veterans. Supporting a causal link between war heroism and mating success, we then report the results of two experimental studies. We find evidence that female participants specifically regard men more sexually attractive if they are war heroes. This effect is absent for male participants judging female war heroes, suggesting that bravery in war is a gender specific signal. Finally, we discuss possible implications of our results. (shrink)

This content analysis examines the ways that genocide is included in the high school world history content standards of eleven states with legislative mandates requiring genocide education, as well as if the content standards in those states differ from those of states without mandated genocide education. The null curriculum theorizes that the content that is not taught may be as important as what is taught; this lens allows for a nuanced analysis of the ways that genocide is included and excluded (...) in state standards. The findings suggest that states with legislative mandates requiring genocide education do not necessarily have high school world history content standards that require genocide education. The content standards in states with legislative mandates often omit acts of genocide, refrain from using the term “genocide,” and frame genocides as less important than the Holocaust, perpetuating the null curriculum of genocides. (shrink)

There have been few empirical studies into what non-medical factors influence physicians and nurses when deciding about admission and discharge of ICU patients. Information about the attitudes of healthcare professionals about this process can be used to improve decision-making about resource allocation in intensive care. To provide insight into ethical problems that influence the ICU admission and discharge process, we aimed to identify and explore ethical dilemmas healthcare professionals are faced with.