Making sense of risk. Donor risk communication in families considering living liverdonation to a child

This paper contributes to the growing line of thought in bioethics that respect for autonomy should not be equated to the facilitation of individualistic self determination through standard requirements of informed consent in all healthcare contexts. The paper describes how in the context of donation for living related liver transplantation (LRLT) meaningful, responsible decision making is often embedded within family processes and its negotiation. We suggest that good donor risk communication in families promote “conscientious autonomy” and “reflective trust”. From this, the paper offers the suggestion that transplant teams and other relevant professionals have to broaden their role and responsibility for risk communication beyond proper disclosure by addressing the impact of varied psychosocial conditions on risk interpretation and assessment for potential donors and family stakeholders. In conclusion, we suggest further research questions on how professional responsibility and role-taking in risk communication should be morally understood

'Not a matter of choice' : ethical perspectives on decision making about living parental liver donation

Since 2004 children waiting for a liver transplant can also receive a partial liver graft from a living donor, usually a parent. The introduction of parent to child LRLT changed the character of the involvement between the transplant team and the family of the patient. When this option of living liver donations was introduced, professionals and relatives around a patient faced new responsibilities. Parents of young patients or other relatives had to consider whether to donate or wait for a deceased donor liver graft, whether their family could cope with an extra patient, and if they were willing to accept the risk. Professionals also had to reconsider their responsibilities. Under which circumstances could they account for the involvement in risking the life and health of a healthy donor? How should they handle different vieuws of colleagues on the subject? how could they inform and talk with parents or other relatives about the option of living donation without presurring hem? In the views that parents and professionals developed on such questions, understandings about professional and family relations formed an important background. This background of moral understandings about parenthood, about what it means to be a good doctor, about good patient-doctor relationships surround the course of decision about LRLT. The aim of this thesis is threefold. 1. To undertake a refelctive ananlysis of moral understandings in decision making about LRLT. Reflective analysis involves mapping how participants in the practise of LRLT understand what they are doing. 2. To offer a critical reflection on the moral understandings that guide decision making. In critical refelction the authority and adequacy of moral understandings are examined. 3. To offer a normative reflection on questions about good moral understandings. Are the moral understandings good or better than other that might be imagined? These different forms of analysis and reflection are intertwined, and they are based on qualitative ethical research.

Overcoming the tragedy of urban commons. Collective practices for a healthy city ecology in disadvantaged neighborhoods

This paper provides insight into collective practices for promoting a healthy city ecology in disadvantaged neighborhoods. Using ethnography, we analyze the actions of a citizen collective to improve a park as 'urban commoning' and 'placemaking.' The analysis shows that first, the collective received ambivalent bureaucratic support; second, the open character of space commons enabled collective responsibility and democratic publics, but also made them vulnerable; and third, in providing informal security, the collective restrained itself to avoid stigma and retaliation. We conclude that open commons enable collective responsibility, but in disadvantaged city areas, they suffer from ongoing bureaucratic governance and accumulations of adversity

Overcoming the tragedy of urban commons. Collective practices for a healthy city ecology in disadvantaged neighborhoods

This paper provides insight into collective practices for promoting a healthy city ecology in disadvantaged neighborhoods. Using ethnography, we analyze the actions of a citizen collective to improve a park as 'urban commoning' and 'placemaking.' The analysis shows that first, the collective received ambivalent bureaucratic support; second, the open character of space commons enabled collective responsibility and democratic publics, but also made them vulnerable; and third, in providing informal security, the collective restrained itself to avoid stigma and retaliation. We conclude that open commons enable collective responsibility, but in disadvantaged city areas, they suffer from ongoing bureaucratic governance and accumulations of adversity

The making of new care spaces. How micropublic places mediate inclusion and exclusion in a Dutch city

This paper provides insight into strategies used by social care initiatives to create caring environments for people with a variety of abilities and disabilities. The analysis is guided by the concept of 'micropublic places' and builds on research about changing spaces of care and three types of spatial, symbolic and public-private boundary logics. Using ethnographic methods, we map three hybridization strategies that challenged spatial separations of functions, professional diagnostic labels, and public-private distinctions While these hybridization strategies have been analyzed separately in literature about specific vulnerable groups like psychiatric patients, this analysis shows how they combined to form new spaces of care

Sorteermachine of knooppunt?:Hoe werkt openbare ruimte voor jongeren en jongvolwassenen?

De coronapandemie heeft het belang van fysieke ontmoetingsplekken voor jongeren en jongvolwassenen scherper dan ooit onder de aandacht gebracht. Deze zijn van groot belang in informele leerprocessen zoals omgaan met angsten, conflicten en emoties delen. Hoe goed is onze openbare ruimte als informele leeromgeving voor jongeren en jongvolwassenen?De coronapandemie heeft het belang van fysieke ontmoetingsplekken voor jongeren en jongvolwassenen scherper dan ooit onder de aandacht gebracht. Deze zijn van groot belang in informele leerprocessen zoals omgaan met angsten, conflicten en emoties delen. Hoe goed is onze openbare ruimte als informele leeromgeving voor jongeren en jongvolwassenen