Syltern et al. (2022) propose a new approach to decision-making at the limit of viability: by default, intensive care will be initiated for every infant born in “the gray zone” of viability. This w...

This article examines the ethical validity of using viability as the cutoff point for abortion in the Netherlands, in view of potential changes to the Dutch perinatal care guideline. According to the Dutch Penal Code, abortion is permitted until viability: the point at which a fetus can survive outside the womb with technological assistance. Since the law was enacted in 1984, viability has been set at 24 weeks gestational age. Currently, in the Netherlands, the treatment limit for extreme prematurity is (...) also set at 24 weeks. The potential revision of the guideline could lower this threshold. Such a change could have implications for abortion in the Netherlands. We critically evaluate the use of viability within the Dutch context and offer recommendations for modifying the legal framework concerning abortion. We conclude that relying on any interpretation of viability is morally problematic for abortion regulation, as it is too indeterminate a concept to establish a threshold in a morally relevant way. (shrink)

Social egg freezing has become an expanding clinical practice and there is a growing body of empirical literature on women's attitudes and the sociocultural implications of this phenomenon. Yet, its impact remains subject to ethical controversy. This article reports on a qualitative study, drawing on 18 interviews with women who had elected to initiate at least one egg freezing cycle in Belgium. Our findings, facilitated by a ‘symbiotic empirical ethics’ approach, shed light on the concerns and perceptions that accompany women's (...) decisions while supporting a more context-sensitive reading of the ethical debate. We identified three key themes: feeling overwhelmed with uncertainty and a threatening future, bodily discomfort and distress during the medical process, and the endless pursuit of peace of mind. One of the issues that emerges from these findings is the risk ritual function of social egg freezing, referring to routine actions of risk anticipation that mitigate uncertainty and express a sense of individual responsibility. While more research is needed, this conceptualisation provides a starting point to flesh out the wider context of this moral practice and its symbolic meaning for women. (shrink)

Recently, Petersen provided in this journal a critical discussion of individualisation arguments in the context of social egg freezing. This argument underlines the idea that it is morally problematic to use individual technological solutions to solve societal challenges that women face. So far, however, there is a lack of empirical data to contextualise his central normative claim that individualisation arguments are implausible. This article discusses an empirical study that supports a contextualised reading of the normative work of Petersen. Based on (...) a qualitative interview study, we found that most women could make sense of this argument but addressed other concerns that are overlooked in the premises of moral individualisation arguments, for instance, the influence of relationship formation on the demand of egg freezing. Furthermore, women did not experience social egg freezing as morally problematic. Nonetheless, the interviewees pointed to a need of more societal solutions and even actively advocated for efforts to increase accessibility such as a partial reimbursement and better quality of information. The implications of these findings for empirical bioethics are discussed. While more research is needed, we argue that, in order to better address individualisation arguments and related ethical concerns, we need to contextualise normative evaluations within women’s moral reasoning. (shrink)

In their article, Sedlakova and Trachsel (2023) propose a holistic, ethical, and epistemic analysis of conversational artificial intelligence (CAI) in psychotherapeutic settings. They mainly descri...

Information can be public among a group. Whether or not information is public matters, for example, for accounts of interdependent rational choice, of communication, and of joint intention. A standard analysis of public information identifies it with (some variant of) common belief. The latter notion is stipulatively defined as an infinite conjunction: for p to be commonly believed is for it to believed by all members of a group, for all members to believe that all members believe it, and so (...) forth. This analysis is often presupposed without much argument in philosophy. Theoretical entrenchment or intuitions about cases might give some traction on the question, but give little insight about why the identification holds, if it does. The strategy of this paper is to characterize a practical-normative role for information being public, and show that the only things that play that role are (variants of) common belief as stipulatively characterized. In more detail: a functional role for “taking a proposition for granted” in non-isolated decision making is characterized. I then present some minimal conditions under which such an attitude is correctly held. The key assumption links this attitude to beliefs about what is public. From minimal a priori principles, we can argue that a proposition being public among a group entails common commitment to believe among that group. Later sections explore partial converses to this result, the factivity of publicity and publicity from the perspective of outsiders to the group, and objections to the aprioricity of the result deriving from a posteriori existential presuppositions. (shrink)

AbstractWhile the literature on oncofertility decision-making was central to the bioethics debate on social egg freezing when the practice emerged in the late 2000s, there has been little discussion juxtaposing the two forms of egg freezing since. This article offers a new perspective on this debate by comparing empirical qualitative data of two previously conducted studies on medical and social egg freezing. We re-analysed the interview data of the two studies and did a thematic analysis combined with interdisciplinary collaborative auditing (...) for empirical ethics projects. Despite their different contexts, major similarities in women’s decision-making and reasoning were found. We developed two main common themes. Firstly, women felt a clear need to plan for future options. Secondly, they manipulated decision-times by postponing definitive decisions and making micro-decisions. The comparison highlights that the passage of time and the preservation of future choice seems to permeate all aspects of the patient experiences in both studies. As a result of considering real-world lived experiences, we suggest that there are many overlaps in women’s reasoning about egg freezing regardless of why they are making a decision to freeze. These overlaps are morally relevant and thus need to be further integrated into the existing arguments that have been canvassed in the flourishing egg freezing and fertility preservation debates across the field, and in policy and practice globally. (shrink)

Male fertility–related mHealth (MFmHealth), including smartphone applications that allow men to test their fertility at home, is getting some attention now and then. In this commentary, I argue that MFmHealth technology has the potential to undermine established norms around male reproduction but cannot be examined using traditional individualist frameworks in bioethics. Instead, theoretical literature on the concept of vulnerability in feminist bioethics allow a theoretical alliance with critical studies of men and masculinities. Proposed benefits like empowerment, shared responsibility, and democratization (...) may justify disruptive innovation but may also obscure more fundamental ethical concerns about vulnerability and social justice. (shrink)

It is a dominant dictum in ethics that ‘ought implies can’ (OIC): if an agent morally ought to do an action, the agent must be capable of performing that action. Yet, with current technological developments, such as in direct-to-consumer genomics, big data analytics and wearable technologies, there may be reasons to reorient this ethical principle. It is our modest aim in this article to explore how the current wave of allegedly disruptive innovation calls for a renewed interest for this dictum. (...) As an effect of prevention and prediction oriented technological innovation, an increased focus on assumedly controllable lifestyle risks may be anticipated. For lay people who might turn into patients, this may entail a reinforced behavior-based individual responsibilisation. Holding on to the OIC dictum, such responsibilisation seems to require that individuals can actually control what is framed as ‘lifestyle risks’ when there is not always a reliable consensus about what one should do. As such, reference to OIC may be mobilised in function of a political task of designing institutions so as to enable such choice and control. (shrink)

Recent discussion on artificial womb technology (AWT) has given rise to a proliferation of terms to denote the subject of AWT. De Bie et al. opt for “fetal neonate” or “fetonate’ as “the best way t...

Freezing Fertility: Oocyte Cryopreservation and the Gender Politics of Aging is the fourth path-breaking monography in the flourishing literature on egg freezing in just a few years. In April 2019, The Oocyte Economy: The Changing Meaning of Human Eggs by the renowned Australian social scientist Catherine Waldby, was published, the first book to examine the emergence of a global market for eggs through biomedical innovation. In September 2019, sociologist Kylie Baldwin of De Montfort University published Egg Freezing, Fertility and Reproductive (...) Choice: Negotiating Responsibility, Hope and Modern Motherhood, in which she explores the experiences of some pioneering women who are having eggs frozen in the United... (shrink)

Cho and Martinez-Martin (2023) discuss the ethical challenges associated with the use of digital simulacra (also known as digital twins) in biomedicine, specifically focusing on the issue of episte...

Pozzi1 has thoroughly analysed testimonial injustices in the automated Prediction Drug Monitoring Programmes (PDMPs) case. Although Pozzi1 suggests that ‘the shift from an interpersonal to a structural dimension … bears a significant moral component’, her topical investigation does not further conceptualise the type of collective knowledge practices necessary to achieve epistemic justice. As Pozzi1 concludes: ‘this paper shows the limitations of systems such as automated PDMPs, it does not provide possible solutions’. In this commentary, we propose that an Ubuntu perspective—which, (...) so far, has received little attention in connection with epistemic injustice in medical machine learning (MML)—can fill this gap. This perspective can be used to mitigate some of the harmful effects of epistemic injustices by encouraging community involvement and forward-looking responsibility. It may be instructive to note first and foremost that the debate on epistemic justice and artificial intelligence in medicine has mostly been restricted to the Western World, that is, Europe and North America. There has been very little insight or accommodation of insights from the Global South. Ubuntu is a concept originating from Southern Africa that focuses on the close connections and mutual …. (shrink)

Paragraph 12 of the revised International Code of Medical Ethics (ICoME) states that ‘the physician should strive to practise medicine in ways that are environmentally sustainable with a view to minimising environmental health risks to current and future generations.’1 This emphasis on environmental sustainability is in line with popular discourse as well growing scholarly attention in medical ethics for healthcare’s contribution to climate change. Recent research analyses, for instance, the ‘greening’ of informed consent and related bioethical principles.2 3 It is (...) unclear what the duty of practising sustainable healthcare means at the level of doctor–patient interaction. Parsa-Parsi et al flag the potential conflict in the ICoME’s provisions if ‘the actions of physicians are influenced by environmental considerations to the detriment of patients’ (p. 2), noting that the ICoME does not provide a handhold to improve understanding of such tensions. The code ‘does not go into extensive detail, does not include comprehensive explanations nor any rules or guidance on how to reconcile its principles when they conflict’ (p. 4). For Parsa-Parsi et al, not codes, but textbooks have a crucial role to play in resolving this conflict. It is rife that professional codes can lead to internal inconsistencies and …. (shrink)

This perspective article explores the use of digital twins (DTs) in medicine, highlighting its capacity to simulate risks and personalize treatments while examining the emerging bioethical concerns. Central concerns include power dynamics, exclusion, and misrepresentation. We propose adopting a relational bioethical approach that advocates for a comprehensive assessment of DTs in medicine, extending beyond individual interactions to consider broader structural relations and varying levels of access to power. This can be achieved through two key relational recommendations: acknowledging the impact of (...) uneven relational structures on access to medical care and promoting social justice by evaluating resource allocation. While DTs in medicine offer promising advancements, a relational bioethical lens may provide a nuanced understanding, fostering equitable, inclusive and responsible integration of DTs into medical practice. (shrink)

Recent medical innovations like ‘omics’ technologies, mobile health (mHealth) applications or telemedicine are perceived as part of a shift towards a more preventive, participatory and affordable healthcare model. These innovations are often regarded as ‘disruptive technologies’. It is a topic of debate to what extent these technologies may transform the medical enterprise, and relatedly, what this means for medical ethics. The question of whether these developments disrupt established ethical principles like respect for autonomy has indeed received increasing normative attention during (...) the past years. Yet, more fundamental ethical considerations of a possible disruption of the concept of ‘medical necessity’ (and the potential ensuing clinical ramifications) have been limited if not absent. It is our modest – though morally and practically relevant – aim to address this objective in this article, by exploring how the current wave of allegedly disruptive innovation is invoking a resurgence of this concept and related debates on ‘the’ goal(s) of medicine. (shrink)

The achievements of the textile industry in Roman Britain are often underestimated as a result of the meagreness of our available evidence. The Edict on maximum prices issued by Diocletian in A.D. 301 shows that British capes commanded high prices on the markets of the Empire, and that in the late third century A.D. British rugs were the best in the world. In view of the competition from the traditional centres of rug manufacture in the East, this is an astonishing (...) achievement. (shrink)

The received translation and interpretation of many of the technical terms current in the textile industry of the Roman Empire are inaccurate, because lexicographers have either fought shy of being precise, or have thought that they recognized in the ancient world technical processes which originated at a much later date. The evidence is often equivocal or insufficient, but may still yield details that have been overlooked. The textile expression scutulatus, to take an example, deserves more attention than Blümner has devoted (...) to it. When it refers to the appearance of a garment, Lewis and Short, s.v. scutulatus, translate ‘diamond or lozenge-shaped, checkered’. It seems worth while to attempt a more precise translation, and, if possible, to estimate the significance in context of the goods so designated. (shrink)

Living out of silence, out of a fully functioning, lovingly attentive mind, and not just out of thought, out of a partially functioning mind, is requisite for depth or profundity in living or relating. A fully attentive, truly silent or meditative mind sees that there is real dualism of time and the timeless and that time and the timeless each has its own unique value. The timeless, or real silence, that which alone can make for depth in one's living and (...) relating, can be there only when, in one's awareness, time and all that is related to time, have come to an end. An examination of a wide variety of statements made by writers, both past and present, shows that these understandings are seldom there in contemporary writings, just as they were not there in writings that have come down to us from the past. 'Living beyond the One and the Many' invites readers to consider the possibility that what is presented in it can bring deep meaning to one's way of living in the world"--Publisher's description, back cover. (shrink)

If the world itself is metaphysically indeterminate in a specified respect, what follows? In this paper, we develop a theory of metaphysical indeterminacy answering this question.

Husserlian phenomenology, as the study of conscious experience, has often been accused of solipsism. Husserl’s method, it is argued, does not have the resources to provide an account of consciousness of other minds. This chapter will address this issue by providing a brief overview of the multiple angles from which Husserl approached the theme of intersubjectivity, with specific focus on the details of his account of the concrete interpersonal encounter – “empathy.” Husserl understood empathy as a direct, quasi-perceptual form of (...) intentionality through which the sense of the Other is constituted. Furthermore, his account of empathy is holistically integrated with his overall theory of intersubjectivity, including his discussions of the objectivity of nature, and the social, historical, and communal aspects of subjectivity. Husserl’s theory of empathy continues to cast a long shadow, influencing both the analytic and continental approaches to the problem of other minds, as well as contemporary account of social cognition in the cognitive sciences. (shrink)

An Essay on Human Action seeks to provide a comprehensive, detailed, enlightening, and (in its detail) original account of human action. This account presupposes a theory of events as abstract, proposition-like entities, a theory which is given in the first chapter of the book. The core-issues of action-theory are then treated: what acting in general is (a version of the traditional volitional theory is proposed and defended); how actions are to be individuated; how long actions last; what acting intentionally is; (...) what doing one thing by doing another is; what basic action is; and what omitting to do something is. Attention is also given to the concepts of causation, intention, volition, deciding, choosing, and trying. Finally, a libertarian account of free action is tentatively proposed and defended. (shrink)

Amsterdam University Press is a leading publisher of academic books, journals and textbooks in the Humanities and Social Sciences. Our aim is to make current research available to scholars, students, innovators, and the general public. AUP stands for scholarly excellence, global presence, and engagement with the international academic community.

We develop and apply a multi-dimensional conception of explanatory depth towards a comparative analysis of inflationary and bouncing paradigms in primordial cosmology. Our analysis builds on earlier work due to Azhar and Loeb (2021) that establishes initial condition fine-tuning as a dimension of explanatory depth relevant to debates in contemporary cosmology. We propose dynamical fine-tuning and autonomy as two further dimensions of depth in the context of problems with instability and trans-Planckian modes that afflict bouncing and inflationary approaches respectively. In (...) the context of the latter issue, we argue that the recently formulated trans-Planckian censorship conjecture leads to a trade-off for inflationary models between dynamical fine-tuning and autonomy. We conclude with the suggestion that explanatory preference with regard to the different dimensions of depth is best understood in terms of differing attitudes towards heuristics for future model building. (shrink)

Telling a patient that the outcome of his illness is not good, or even hopeless, requires sensitivity and the ability to communicate with him in the setting of a hospital which is an unnatural environment divorced from family and friends. It is a task which must be taught and learned by doctors and nurses.

Global Media Ethics is the first comprehensive cross-cultural exploration of the conceptual and practical issues facing media ethics in a global world. A team of leading journalism experts investigate the impact of major global trends on responsible journalism. The first full-length, truly global textbook on media ethics; Explores how current global changes in media promote and inhibit responsible journalism; Includes relevant and timely ethical discussions based on major trends in journalism and global media; Questions existing frameworks in media ethics in (...) light of the impact of global media; Contributors are leading experts in global journalism and communication. (shrink)

The existential analysis -- The death of dasein -- The timeliness of dasein -- The derivation of time -- The time of being.

We live in turbulent times, our world is changing at accelerating speed. Information is everywhere, but wisdom appears in short supply when trying to address key inter-related challenges of our time such as; runaway climate change, the loss of biodiversity, the depletion of natural resources, the on-going homogenization of culture, and rising inequity. Living in such times has implications for education and learning. This book explores the possibilities of designing and facilitating learning-based change and transitions towards sustainability. In 31 chapters (...) contributors from across the world discuss (re)emerging forms of learning that not only assist in breaking down unsustainable routines, forms of governance, production and consumption, but also can help create ones that are more sustainable. The book has been divided into three parts: re-orienting science and society, re-connecting people and planet and re-imagining education and learning. This is essential reading for educators, educational designers, change agents, researchers, students, policymakers and entrepreneurs alike, who are concerned about the well-being of the planet and convinced of our ability to do better. The content and related issues can be discussed on the blog by editor Arjen Wals: Transformative learning. 'We are living in times of incertitude, complexity, and contestation, but also of connectivity, responsibility, and new opportunities. This book analyses the consequences of these times for learning in formal, non-formal, and informal education. It explores the possibilities offered by the concept of sustainability as a central category of a holistic paradigm which harmonizes human beings with Earth. To change people and to change the world are interdependent processes - this book contributes to both.' Moacir Gadotti, Director of Paulo Freire Institute, São Paulo, Brazil 'I hope you share my excitement about the innovations for sustainability that this book catalogues and analyses. While the ecological news is grim, the human news is not. Even in a time of accelerating change, people are showing their enormous capacities to learn, adapt, restore and protect.' From the Foreword by Juliet Schor, author of ‘True Wealth: how and why millions of Americans are creating a time-rich, ecologically-light, small-scale high-satisfaction economy’ 'This book implies a ‘culture of critical commitment’ in educational thinking and practice - engaged enough to make a real difference to social-ecological resilience and sustainability but reflexively critical enough to learn constantly from experience and to keep options open in working for a sustainability transformation.' From the Afterword by Stephen Sterling, Professor of Sustainability Education, Centre for Sustainable Futures, Plymouth University, United Kingdom. (shrink)

What Is Political Theory? provides students with a comprehensive overview of the current state of the discipline. Ten substantive chapters address the most pressing topics in political theory today, including: - what resources do the classic texts still provide for political theorists? - what areas will political theorists focus on in the future? - can western political theory alone continue to provide a framework for responding to the challenges of modern political life? The authors assess the intellectual challenges to conventional (...) political theory, such as post-structuralism and the scientific study of politics that have revitalized the field in the last 30 years. They also broaden the perspective to take in non-western ideas and to reconceptualize political theory in the light of specifically global challenges. Students and teachers of political theory and political philosophy will find this book invaluable in understanding the factors that have shaped current political theory and which will guide its future development. (shrink)

Genetic relatedness figures heavily in contemporary ethical debates on egg freezing, although the arguments lack empirical‐based evidence. Rather than adding another theoretical view on the moral relevance of genetic connections, this paper instead proposes an empirically grounded perspective based on two independent qualitative interview‐based studies conducted in Belgium and France. Three themes emerge from our empirical data: (1) prioritizing family building; (2) centering the gestational experience of motherhood; and (3) identifying the complexities and limitations of adoption. These themes suggest that (...) the relationship between egg freezing, genetics, biological motherhood, and adoption is highly complex and less straightforward than what is often assumed in the egg freezing debate. Our study provides more detailed insights into women's ambivalent experiences regarding those reproductive options. We discuss the ethical implications of our empirical findings and hold that pursuing genetic desire is not necessarily the main moral reason why women freeze their eggs. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Cognitive Error and Contemplative Practices:The Cultivation of Discernment in Mind and HeartWesley J. WildmanBrains are amazing organs in all creatures with central nervous systems and especially in human beings. But they are not perfect. Without forgetting the larger success story of cognitive evolution, I want to explore the way that cognitive biases sometimes produce errors in both religious and secular social settings and how such errors can be diagnosed (...) and corrected when they occur. This will involve noticing that error diagnosis and correction is a process that certain social groups have a vested interest in resisting or neglecting, in some respects, while the very same social groups may furnish resources that support the detection of cognitive errors, in other respects.This presents a moral quandary for both secular and religious groups. Should we educate children to be fully aware of their cognitive vulnerability to advertising, thereby learning how to resist and eventually become immune to one of the fundamental power sources of modern market economies? Should religious groups explain to young people their cognitive tendencies to posit the action of supernatural beings whether or not any such action exists, even though this may disrupt the power of religious groups to forge bracing social togetherness that supports psychologically useful coping skills? While I do not seek to answer such complex moral questions in this paper, I do argue that knowledge of cognitive biases and the resulting tendencies to cognitive error, self-defeating behaviors, and self-deception should be made available to those individuals and groups who are interested in promoting a high degree of critical self-awareness in the analysis of beliefs and behaviors in both secular and religious contexts.The term "error" is a potentially problematic one in that it misleadingly suggests that there might be a uniquely correct way in which cognition should work. I do not wish to suggest such a binary opposition. After all, biases exist in the human cognitive system either because they have been selected in the evolutionary process for their survival benefits or because they are side effects of other traits selected for their usefulness. My concern is with the wondrous human discovery that we can analyze [End Page 61] our behaviors and beliefs with such precision that we can sometimes detect when our cognitive biases produce mistaken beliefs and self-defeating behaviors. This forms the basis for my contention that cognition can often work better than it does—more accurately, less self-destructively—when tendencies to cognitive error are diagnosed, corrected, and perhaps even systematically resisted.The profound irony here is that the very same social groups (secular and religious) with an obvious vested interest in resisting such enlightenment in some respects can also promote processes of discernment and insight in other respects. Existing literature in the cognitive psychology of religion rarely bothers with such subtleties. It is common to assume that simply to notice the operation of cognitive biases in religion—say, in supporting belief in supernatural entities who providentially interact in human affairs, or in establishing and reinforcing people's willingness to defer to certain kinds of religious authority—is at the same time to establish the presence of rampant cognitive error, massive resistance to diagnosing and correcting it, and thus the infliction of pernicious cruelties on young children who have no way of escaping the resulting irrational indoctrination.This moral reflex to condemn religious groups because of their characteristic reluctance to acknowledge the role of cognitive biases in their beliefs and practices is understandable given the irrationality, ignorance, or denial that such reluctance suggests. I frankly acknowledge that I share this moral concern. But the actual complexities of religious practice demonstrate that the situation demands a subtler evaluation. Resistance to awareness of cognitive biases exists both inside and outside religious groups; economic and political practices in all eras and of all types have every bit as much to gain from neglecting to enlighten people about their cognitive operations as religious groups do—just consider the techniques employed in commercial advertising and political campaigns. Moreover, religious groups also promote methods of discernment and self-awareness that have historically been, and continue to be, the dominant method by which... (shrink)

The legal environment -- Regulation of nursing practice -- Nurses in legal actions -- Standards of care -- Defenses to negligence or malpractice -- Prevention of malpractice -- Nurses as witnesses -- Professional liability insurance -- Accepting or refusing an assignment/patient abandonment -- Delegation to unlicensed assistive personnel -- Patients' rights and responsibilities -- Confidential communication -- Competency and guardianship -- Informed consent -- Refusal of treatment -- Pain control -- Patient teaching and health counseling -- Medication administration -- Clients (...) with AIDS and HIV testing -- Abusive situations -- Reproductive services -- Restraints -- Emergency psychiatric admissions -- Organ and tissue donation and transplantation -- Discharge against medical advice -- The medical record and documentation standards -- Electronic health information and communications -- Interdependent nursing functions: verbal orders and telenursing -- Event reporting and compliance -- Quality and safety in nursing practice -- Forensic issues -- Employer and employee rights -- Contracts -- Corporate liability -- Employment contracts and unionization -- Employment status liability -- Staffing issues and floating -- Americans with Disabilities Act -- Employees with AIDS/HIV infection and exposure to bloodborne pathogens -- Impaired nurses -- Sexual harassment in the workplace -- Violence in the workplace -- Intentional torts -- Environmental health and safety -- Ethical decision making -- Professional boundaries and patient relationships -- Moral courage and patient advocacy -- Social media and online professionalism -- Reporting illegal, unethical, or unsafe conduct -- Maternal versus fetal rights -- Futility of care -- Advance directives and end-of-life decisions -- Assisted suicide. (shrink)