Many methods are used in research on complexity. One of these is qualitative comparative analysis. Although many authors allude to the relationships between complexity and QCA, these links are rarely made explicit. We propose that one way of doing so is by using critical realism as a meta-framework. This article discusses the viability of this approach by examining the extent to which QCA is a complexity-informed method. This question is answered in three steps. First, we discuss the nature of complexity (...) and its epistemological implications. Second, we focus on Bhaskar’s perspective on critical realism and show how it can be used as a framework for understanding social complexity. Third, we examine the ontological and epistemological assumptions underlying QCA and synthesize these with our critical realist approach to complexity. We argue that complex reality is non-decomposable, contingent, non-compressible and time-asymmetric. We conclude that, although QCA is inevitably reductive and partial, its core premises are built upon the notions of contingency and time-asymmetry. Therefore, it is not only a powerful method for doing complexity-informed research, but is also a complexity-informed method by itself. (shrink)

Due to its emphasis on experiential interests, animal ethics tends to focus on individuals as the sole unit of moral concern. Many issues in animal ethics can be fruitfully analysed in terms of obligations towards individual animals, but some problems require reflection about collective dimensions of animal life in ways that individualist approaches can’t offer. Criticism of the individualist focus in animal ethics is not new; it has been put forward in particular by environmental ethics approaches. However, the latter tend (...) to be so far removed from the concerns of animal ethicists that both groups talk at cross purposes. We think the gap between environmental and animal ethics could be bridged by on the one hand focusing more on the collective dimensions of our concerns with animals - after all, individuals are constituted by the collective of which they are a part - and on the other hand, by showing that moral status can also be attributed to groups in an indirect way, related to the moral status of their individual members. In our paper we explore various ways of conceptualising the moral relevance of collectiveness in animal life. We draw on insights from public health ethics, as this field of inquiry has also developed - at least partly—in response to individualist approaches in human bioethics, creating more room for recognizing the value of population health, interpersonal relations, solidarity, and ways in which a collective is constituted. (shrink)

ABSTRACTIn this article, we explore the debate on corporate citizenship and the role of business in global governance. In the debate on political corporate social responsibility it is assumed that under globalization business is taking up a greater political role. Apart from economic responsibilities firms assume political responsibilities taking up traditional governmental tasks such as regulation of business and provision of public goods. We contrast this with a subsidiarity-based approach to governance, in which firms are seen as intermediate actors who (...) have political co-responsibilities in society endowed upon them by national governmental institutions. We argue that both approaches face conceptual and empirical problems, and do not make clear the content and scope of political corporate responsibility. Based on Iris Marion Young’s account of political responsibility we argue that corporate actors and governmental actors have a shared responsibility to tackle societal problems. Taking political corporate responsibility not only entails engaging in private action or engaging in public–private partnerships, but it also includes aiding governmental actors to remedy injustice or even create public institutions where they do not yet exist. By adding this perspective we contribute to the debate on responsibility in corporate citizenship and clarify the political role business can play in global governance. (shrink)

Die Frage nach der Technik ist eine Art der Heideggerschen Frage nach dem Sein, die die Fragen nach dem Menschen in der Moderne und nach der Zivilisation überhaupt impliziert. Im Rahmen der sogenannten "Seinsgeschichte" bildet sie eine Kreuzungsstelle, die von verschiedenen Linien gebildet wird, welche wiederum in ihrer Verschiedenheit zu berücksichtigen sind und nicht einfach textuell hermetisiert werden dürfen. Heidegger besorgt nicht zuletzt mit Hilfe der seinsgeschichtlichen Konstellation des Gestells seine Selbstinterpretation hinsichtlich der Haltung zum Nationalsozialismus. Verweigert wird die falsche (...) Alternative eines platt-realistischen oder biographischen Reduktionismus zum einen und des Jüngerschar-Minimalismus oder kalauernden dekonstruktivistischen Textdesigns zum andern. Genauso einseitig wie der absicherungsstrategische Jargon der Orthodoxie ist die positivistische Abschiebung Heideggers in die Ecke der "Begriffsdichtung". Tatsächlich besteht ein arbeitsteiliger Konsens zwischen beiden Seiten. Gegen diesen Konsens im Dissens opponiert vorliegender Text. (shrink)

Stefan Collini challenges the common claim that universities need to show that they help to make money in order to justify getting more money.

ABSTRACT:Many companies engage in dialogue with nongovernmental organizations about societal issues. The question is what a regulative ideal for such dialogues should be. In the literature on corporate social responsibility, the Habermasian notion of communicative action is often presented as a regulative ideal for stakeholder dialogue, implying that actors should aim at consensus and set strategic considerations aside. In this article, we argue that in many cases, communicative action is not a suitable regulative ideal for dialogue between companies and NGOs. (...) We contend that there is often an adversarial element in the relation between companies and NGOs, and that an orientation towards consensus can be in tension with this adversarial relation. We develop an alternative approach to stakeholder dialogue called ‘agonistic deliberation.’ In this approach, conflict and strategic considerations play a legitimate and, up to a certain point, desirable role. (shrink)

This paper describes a global pattern of declining academic freedom, often driven by powerful political interference with core functions of academic communities. It argues that countering threats to academic freedom requires doubling down on ethics, specifically standards of justice and fairness in pursuing knowledge and assigning warrant to beliefs. Using the example of the selection of a Qatari university to host the 2024 World Congress of Bioethics, the authors urge fairness towards diverse groups over time and efforts to counter injustices (...) that conferences generate. (shrink)

Artificial Intelligence (AI) is increasingly adopted in society, creating numerous opportunities but at the same time posing ethical challenges. Many of these are familiar, such as issues of fairness, responsibility and privacy, but are presented in a new and challenging guise due to our limited ability to steer and predict the outputs of AI systems. This chapter first introduces these ethical challenges, stressing that overviews of values are a good starting point but frequently fail to suffice due to the context (...) sensitivity of ethical challenges. Frequently, additional (ethical) values emerge for specific applications, as e.g. challenges with fraud detection are very different from those around language technologies. Second, methods to tackle these challenges are discussed. Main ethical theories (virtue ethics, consequentialism, and deontology) are shown to provide a starting point, but often lack the details needed for actionable AI Ethics. Instead, mid-level philosophical theories coupled to design-approaches such as Design for Values, together with interdisciplinary working methods, offer the best way forwards. The chapter aims to show how these approaches can lead to an ethics of AI that is actionable and that can be proactively integrated in the design of AI systems. (shrink)

This article discusses the difference between comradeship, brotherhood, and friendship in a military context. The difference between these bonds will be made clear with the help of the story of Achilles and Patroclus, poems of the war poets, and Aristotle's books on friendship in the Ethica Nicomachea, amplified with insightful reflections on this classical text by several present-day philosophers.

Emerging infectious diseases such as Ebola, Hendra, SARS, West Nile, Hepatitis E and avian influenza have led to a renewed recognition of how diseases in human beings, wildlife and livestock are interlinked. The changing prevalence and spread of such infections are largely determined by human activities and changes in environment and climate—where the latter are often also caused by human activities. Since the beginning of the 21st century, these insights have been brought together under the heading of OneHealth—a concept that (...) calls for interdisciplinary collaboration between various sciences as well as professional practices to promote and protect the health of human and non-human animals and the natural environment. Just as insights from public health have led to a broadened focus for health policy and medical care, from treating individual patients to protecting and promoting population health, OneHealth calls for an even broader perspective, including a concern for the environment and animals, and for social-cultural factors that affect human, animal and environmental health. OneHealth not only covers collaborative work to understand and control zoonotic diseases, but also other ways in which interactions between animals, plants and humans may positively or negatively impact on each other’s health. Thus, studies in veterinary medicine and environmental sciences may lead to new insights in human medicine, and vice versa. Acknowledgment of the links between environmental, animal and social health is of course not a novel insight. Hippocrates already pointed to the importance of a clean environment as a requirement for good health; the early public health movements emphasized hygienic living conditions including good-quality housing, sewage systems and clean air and water; and the founders of modern medicine such as William Osler and Rudolf Virchow promoted …. (shrink)

An intro. to Didaktic (the heart of thinking about teaching/teacher educ in Germany) for English-speaking readers, drawing on a range of writings assoc. w/ this tradition. Throws light on assumptions, characteristics, & weaknesses of curriculum thought.

This imaginative and unusual book explores the moral sensibilities and cultural assumptions that were at the heart of political debate in Victorian and early twentieth-century Britain. It focuses on the role of intellectuals as public moralists and suggests ways in which their more formal political theory rested upon habits of response and evaluation that were deeply embedded in wider social attitudes and aesthetic judgments. Collini examines the characteristic idioms and strategies of argument employed in periodical and polemical writing, and reconstructs (...) the sense of identity and of relation to an audience exhibited by social critics from John Stuart Mill and Matthew Arnold to J.M. Keynes and F.R. Leavis. (shrink)

This study explores the relationship between moral intensity and the use of different sensemaking strategies in military critical incidents. First, narratives of military personnel were used to select prototypical high/low moral intensity critical incidents. In a follow-up, a scenario study was conducted with active duty military personnel to examine the relationship between moral intensity and the use of sensemaking tactics. This study offers three main conclusions. First, the use of sensemaking tactics is strongly tied to the level of moral intensity (...) in the situation. In high-intense situations, the servicemen draw on previous experiences, prediction of consequences, and help of others to recognize and interpret the situation. Less attention goes out to higher level critical thinking. Thus, it seems that in these critical incidents, the servicemen react without giving room for thorough consideration and deliberation. Second, the number of deployments a serviceman experienced influences the perceived seriousness and harmfulness of the situation negatively in low-intense situations. Finally, and in line with earlier studies, the results indicate that the concept of moral intensity is formed out of three rather than the six dimensions originally proposed by Jones. The implications of these findings are discussed. (shrink)

For contagious diseases like measles a successful immunization program can result in herd protection. Small outbreaks may still occur but fade out soon, because the possibilities for the pathogen to spread in the ‘herd’ are very small. This implies that people who refuse to participate in such a program will still benefit from the protection it offers, but they don’t do their part in maintaining protection. Isn’t that a case of freeriding—and isn’t that unfair towards all the people who do (...) collaborate? If so, that might be considered an additional ground for making vaccination mandatory or compulsory.In this paper I argue that vaccination refusal can be considered as freeriding, but that this might not be unfair. The public good of herd protection is a peculiar public good because it supervenes on private benefits that are enjoyed by all who do opt for vaccination. For vaccinated individuals, the additional benefit of herd protection comes about, as it were, for free, and hence they can’t complain that others benefit without sharing in the burdens. There are however still other grounds for making vaccination compulsory or at least for seeing refusal as a morally wrong choice. (shrink)

Whereas theories on health generally argue in favor of one specific concept, we argue that, given the variety of health practices, we need different concepts of health. We thus approach health concepts as a Wittgensteinian family of thick concepts. By discussing five concepts of health offered by theory, we argue that all capture something that seems relevant when we talk and think about health. Classifying these concepts reveals their family resemblances: each of these concepts differs from the others in at (...) least one respect and resembles the others in several respects. Moreover, our classification shows that “health” always both describes a condition and evaluates that condition at the same time. Having both descriptive and evaluative dimensions, we can see health concepts as “thick concepts.” It is because of this evaluative dimension that it is important to reflect on the question of what understanding of health guides specific practices. We show that the distinctions revealed by our classification can serve as a conceptual toolbox for reflection on the assumptions and purposes of particular health practices. Finally, we illustrate how such reflection could work out by briefly exploring three specific health practices. (shrink)

At the height of the COVID-19 crisis in the Netherlands a shortness of intensive care beds was looming. Dutch professional medical organizations asked a group of ethicists for assistance in drafting guidelines and criteria for selection of patients for intensive care treatment in case of absolute scarcity, when medical selection criteria would no longer suffice. This article describes the Dutch context, the process of drafting the advice and reflects on the role of ethicists and lessons learned. We argue that timely (...) interaction between clinical and ethical expertise is necessary since the distinction between medical and non-medical considerations is not as clearcut as sometimes assumed. Furthermore, pragmatic considerations related to the specifics of an epidemic are of importance, for example, in relation to prioritizing health care workers. As a consequence, any protocol already present before the pandemic would need alterations to fit the current situation. The ‘fair innings’ criterion we proposed, rephrased as an argument of intergenerational solidarity, was considered reasonable by professionals as well as patient organizations. While it is desirable to draft ethical guidelines in ‘peacetime’ as a matter of pandemic preparedness, the pressure of an actual crisis facilitates decision-making, although it will also complicate a more democratic approach. (shrink)

Thanks to developments in genomics,dietary recommendations adapted to genetic riskprofiles of individual persons are no longerscience fiction. But what are the consequencesof these diets? An examination of possibleimpacts of genetically tailor-made diets raisesmorally relevant concerns that are analogous to(medical-ethical) considerations aboutscreening and testing. These concerns oftengive rise to applying norms for informedconsent and for the weighing of burdens andbenefits. These diets also have a broaderimpact, especially because food patterns arefull of personal, social and cultural meanings.Diets will change one's food patterns (...) and one'sattitude towards food, and this may implychanges in one's identity. We argue that suchan impact does not necessarily raise moralproblems. Moral concerns are, however, relevantif collective values and shared meanings infood practices are at issue. Therefore, thedevelopment of genetically tailor-made dietsdoes not merely require emphasis on weighingpersonal benefits and burdens and on informedconsent. It also asks for attention to andmoral reflection on the collective valuesinvolved in food practices. (shrink)

In these twelve papers notable ethicists use the resources of ethical theory to illuminate important theoretical and practical topics, including the nature of public health, notions of community, population bioethics, the legitimate role of law, the use of cost-effectiveness as a methodology, vaccinations, and the nature of infectious disease.

Explainable artificial intelligence (XAI) aims to help people understand black box algorithms, particularly of their outputs. But what are these explanations and when is one explanation better than another? The manipulationist definition of explanation from the philosophy of science offers good answers to these questions, holding that an explanation consists of a generalization that shows what happens in counterfactual cases. Furthermore, when it comes to explanatory depth this account holds that a generalization that has more abstract variables, is broader in (...) scope and/or more accurate is better. By applying these definitions and contrasting them with alternative definitions in the XAI literature I hope to help clarify what a good explanation is for AI. (shrink)

One of the important discussions in the philosophy of mathematics, is that centered on Benacerraf’s Dilemma. Benacerraf’s dilemma challenges theorists to provide an epistemology and semantics for mathematics, based on their favourite ontology. This challenge is the point on which all philosophies of mathematics are judged, and clarifying how we might acquire mathematical knowledge is one of the main occupations of philosophers of mathematics. In this thesis I argue that this discussion has overlooked an important part of mathematics, namely mathematics (...) as it is exercised by ordinary people. I do so by looking at the different theories that have been put forward in the recent debate, and showing for each of these that they are unable to account for the mathematical practices of ordinary people. In order to show that these practices do need to be accounted for, I also argue that ordinary people are doing mathematics, i.e. that they engage in properly mathematical practices. Because these practices are properly mathematical, they should be accounted for by any philosophy of mathematics. The conclusion of my thesis, then, is that current theories fail to do something that they should do, while remaining neutral on how well they perform when it comes to accounting for the practices of professional mathematicians. (shrink)

In this article, we argue that apart from evaluating the causes and the social determinants of health inequalities, an evaluation of the effects of health inequalities is due. For this, we propose the ideal of relational equality as an evaluative framework, and test to what extent health inequalities threaten this ideal of a society of equals. We identify three ways in which they do and argue that these risks are especially great for those lower down the socio-economic strata. We thus (...) conclude that equality in health is instrumental to social justice, and that socio-economic inequalities in health are not only unjust due to their causes but also due to their consequences. We continue to argue that our instrumental approach opens a perspective to mitigate the identified injustices by changing society, rather than reducing inequalities in health, and argue that this is an advantage in the light of the realistic assumption that of the socio-economic health inequalities will persist. The article thus offers a complementary approach to both the evaluation and the mitigation of the injustice of socio-economic inequalities in health. (shrink)

ABSTRACTThe responsibility of the food and beverage industry for noncommunicable diseases is a controversial topic. Public health scholars identify the food and beverage industry as one of the main contributors to the rise of these diseases. We argue that aside from moral duties like not doing harm and respecting consumer autonomy, the food industry also has a responsibility for addressing the structural injustices involved in food-related health problems. Drawing on the work of Iris Marion Young, this article first shows how (...) food-related public health problems can be understood as structural injustices. Second, it makes clear how the industry is sustaining these health injustices, and that due to this connection, corporate actors share responsibility for addressing food-related health problems. Finally, three criteria are discussed as grounds for attributing responsibility, allowing for further specification on what taking responsibility for food-related health problems can entail in corporate practice. (shrink)

In this article, we critically reflect on the responsibilities that the food industry has for public health. Although food companies are often significant contributors to public health problems, the mere possibility of corporate responsibility for public health seems to be excluded in the academic public health discourse. We argue that the behavior of several food companies reflects a split corporate personality, as they contribute to public health problems and simultaneously engage in activities to prevent them. By understanding responsibility for population (...) health as a shared responsibility, we reassess the moral role of the food industry from a forward-looking perspective on responsibility and ask what food companies can and should do to promote health. (shrink)

Some screening tests for donor blood that are used by blood services to prevent transfusion-transmission of infectious diseases offer relatively few health benefits for the resources spent on them. Can good ethical arguments be provided for employing these tests nonetheless? This paper discusses—and ultimately rejects—three such arguments. According to the ‘rule of rescue’ argument, general standards for cost-effectiveness in healthcare may be ignored when rescuing identifiable individuals. The argument fails in this context, however, because we cannot identify beforehand who will (...) benefit from additional blood screening tests. On the ‘imposed risk’ argument, general cost-effectiveness standards do not apply when healthcare interventions impose risks on patients. This argument ignores the fact that imposing risks on patients is inevitable in healthcare and that these risks can be countered only within reasonable limits. Finally, the ‘manufacturing standard’ argument premises that general cost-effectiveness standards do not apply to procedures preventing the contamination of manufactured medical products. We contend that while this argument seems reasonable insofar as commercially manufactured medical products are concerned, publicly funded blood screening tests should respect the standards for general healthcare. We conclude that these particular arguments are unpersuasive, and we offer directions to advance the debate. (shrink)

In his article, ‘Social constructionism and climate science denial’, Hansson claims to present empirical evidence that the cultural theory developed by Dame Mary Douglas, Aaron Wildavsky and ourselves leads to science denial. In this reply, we show that there is no validity to these claims. First, we show that Hansson’s empirical evidence that cultural theory has led to climate science denial falls apart under closer inspection. Contrary to Hansson’s claims, cultural theory has made significant contributions to understanding and addressing climate (...) change. Second, we discuss various features of Douglas’ cultural theory that differentiate it from other constructivist approaches and make it compatible with the scientific method. Thus, we also demonstrate that cultural theory cannot be accused of epistemic relativism. (shrink)

Environmental pollution and greenhouse gas emissions that contribute to climate change have adverse impacts on global health. Somewhat paradoxically, health care systems that aim to prevent and cure disease are themselves major emitters and polluters. In this paper we develop a justification for the claim that solidaristic health care systems should include sustainability as one of the criteria for determining which health interventions are made available or reimbursed – and which not. There is however a complication: most adverse health effects (...) due to climate change do occur elsewhere in the world. If solidarity would commit us to take care of everyone’s health, worldwide, it might imply that solidaristic health system cannot justifiably restrict universal access to their own national populations. In response we explain health solidarity is to be considered as a moral ideal. Such an ideal does not specify what societies owe to whom, but it does have moral implications. We argue that ignoring sustainability in political decision making about what health care is to be offered, would amount to betrayal of the ideal of solidarity. (shrink)

The American Journal of Bioethics, Volume 12, Issue 9, Page 47-48, September 2012.

The futility debate may be considered as an effort to provide a clear and justified borderline between physician and patient decision–making authority. In this paper we argue that the search for a definition of futility that provides physicians with a final argument in discussions about life–prolonging treatment, is misplaced. An acceptable and meaningful criterion of futility that satisfies this effort seems impossible. As a consequence, we reject a dichotomous domain of decision–making power as the starting point for definitions of futility. (...) A good decision about withholding life–sustaining treatment should be justified from the perspectives of both physician and patient. In this light, a range of definitions of futility is still useful as it can clarify intuitions that a treatment is inappropriate. (shrink)

When making an assessment of animal welfare, it is important to take environmental (housing) or animal-based parameters into account. An alternative approach is to focus on the behavior and appearance of the animal, without making actual measurements or quantifying this. None of these tell the whole story. In this paper, we suggest that it is possible to find common ground between these (seemingly) diametrically opposed positions and argue that this may be the way to deal with the complexity of animal (...) welfare. The model will have to be acceptable for the different parties that will be affected by it and real benefits for the animal should result from it. This will be the basis of a practical ethical approach. All this can be condensed into a model that essentially is made up out of three basic elements: the classical welfare analysis with an existing welfare assessment tool, an assessment of the stockholder, and an implementation of the Free Choice Profiling technique. This new framework does not pretend to be a different or better animal welfare matrix; it is intended to integrate existing knowledge and to provide a practical tool to improve animal welfare. It identifies whether there are welfare problems on a farm, if present whether these problems are caused by the housing system or the stockholder, and what can be done to improve the situation. (shrink)

Preventive medicine is sometimes criticised as it contributes to medicalization of normal life. The concept ‘medicalization’ has been introduced by Zola to refer to processes in which the labels ‘healthy’ and ‘ill’ are made relevant for more and more aspects of human life. If preventive medicine contributes to medicalization, would that be morally problematic? My thesis is that such a contribution is indeed morally problematic. The concept is sometimes used to express moral intuitions regarding the practice of prevention and health (...) promotion. Through analysis of these intuitions as well as some other moral concerns, I give an explication of the moral problems of medicalization within the context of preventive medicine. (shrink)

How do we get out knowledge of the natural numbers? Various philosophical accounts exist, but there has been comparatively little attention to psychological data on how the learning process actually takes place. I work through the psychological literature on number acquisition with the aim of characterising the acquisition stages in formal terms. In doing so, I argue that we need a combination of current neologicist accounts and accounts such as that of Parsons. In particular, I argue that we learn the (...) initial segment of the natural numbers on the basis of the Fregean definitions, but do not learn the natural number structure as a whole on the basis of Hume's principle. Therefore, we need to account for some of the consistency of our number concepts with the Dedekind-Peano axioms in other terms. (shrink)

In the past few decades, a growth in ethical consumerism has led brands to increasingly develop conscientiousness and depict ethical image at a corporate level. However, most of the research studying business ethics in the field of corporate brand management is either conceptual or has been empirically conducted in relation to goods/products contexts. This is surprising because corporate brands are more relevant in services contexts, because of the distinct nature of services and the key role that employees have in the (...) services sector. Accordingly, this article aims at empirically examining the effects of customer perceived ethicality in the context of corporate services brands. Based on data collected for eight service categories using a panel of 2179 customers, the hypothesized structural model is tested using path analysis. The results show that, in addition to a direct effect, customer perceived ethicality has a positive and indirect effect on customer loyalty, through the mediators of customer affective commitment and customer perceived quality. Further, employee empathy positively influences the impact of customer perceived ethicality on customer affective commitment, and customer loyalty positively impacts customer positive word-of-mouth. The first implication of these results is that corporate brand strategy needs to be aligned with human resources policies and practices if brands want to turn ethical strategies into employee behavior. Second, corporate brands should build more authentic communications grounded in their ethical beliefs and supported by evidence from actual employees. (shrink)

ABSTRACT If we have a duty not to infect others, how far does it go? This question is often discussed with respect to HIV transmission, but reflection on other diseases like influenza raises a number of interesting theoretical issues. I argue that a duty to avoid infection not only yields requirements for persons who know they carry a disease, but also for persons who know they are at increased risk, and even for those who definitely know they are completely healthy. (...) Given the numerous ways in which human interaction facilitates the spread of communicable diseases, a maximum level of precaution would be very demanding – possibly unreasonably demanding. The ‘over‐demandingness problem’ is mostly invoked as a criticism of utilitarianism, as this theory requires moral agents to always maximise general welfare, even at significant cost for themselves. However, I argue that, with respect to precautions against infectious diseases like influenza, utilitarianism is able to avoid the over‐demandingness problem. A contractualist account, on the other hand, whilst able to explain how one's obligations to avoid infection can be limited, given that other persons have opportunities and responsibilities to protect themselves, in the end requires precautions that raise the over‐demandingness problem. (shrink)

BACKGROUND: The availability of costly safety measures against transfusion-transmissible infections forces Western countries to confront difficult ethical questions. How to decide about implementing such measures? When are such decisions justified? As a preliminary to addressing these questions, we assessed which concerns shape actual donor blood safety policymaking in five Western countries. STUDY DESIGN AND METHODS: Our qualitative study involved determining which issues had been discussed in advisory committee meetings and capturing these issues in general categories. Appropriate documents were identified in (...) collaboration with local decision-making experts in Canada, Germany, the Netherlands, the United States, and the United Kingdom. The introduction of hepatitis B virus nucleic acid testing and selected measures against variant Creutzfeldt-Jakob disease, West Nile virus, and Q-fever were chosen as cases representing decision-making on safety measures with high costs and low or uncertain added safety. RESULTS: A broad inventory of concerns was established, including: 1) nine categories of advantages and disadvantages of candidate safety policies; 2) six kinds of difficulties in assessing risks and forecasting the effects of safety policies; 3) 13 decision-making principles; and 4) six kinds of practical barriers hampering the translation of candidate policies into decisions. CONCLUSION: Blood safety policymaking involves a wide variety of competing concerns, and approaches to reconcile these considerations are themselves contested. Developing a systematic decision-making approach requires ethical reflection on, among others, reasonable costs of safety and the value of transparency in public policy. (shrink)

Many nursing homes have an influenza vaccination policy in which it is assumed that express (proxy) consent is not necessary. Tacit consent procedures are more efficient if one aims at high vaccination rates. In this paper I focus on incompetent residents and proxy consent. Tacit proxy consent for vaccination implies a deviance of standard proxy consent requirements. I analyse several arguments that may possibly support such a deviance. The primary reason to offer influenza vaccination is that vaccinated persons have a (...) significantly reduced risk of getting the flu. This reason however cannot support the assumption that each nursing home resident is ‘better off ’ if she is vaccinated. Neither can it support tacit proxy consent policies. More promising are arguments that take the collective nature of infectious diseases into account. A potentially strong, but ultimately insufficient, argument for non‐express consent is that vaccination contributes to prevention of harm to others. Other arguments emphasise the importance of group protection: herd immunity. I discuss three collective reasons for aiming at herd immunity: solidarity, a common interest in reducing the risk of illness, and a common interest in the prevention of an influenza outbreak. The latter argument appears to be most important. An outbreak is not just detrimental to the health of residents; it is detrimental to their everyday social life as well. Outbreaks can be seen as a collective evil. My analysis shows that there are valid (though not necessarily sufficient) moral arguments for a tacit proxy consent policy. (shrink)

A vernacular fifteenth-century sermon tells us, in order to warn of the threats to spiritual welfare posed by dance, that cyclic motion and centering of sensory impressions – amongst them intimate conversation – are essential elements of dance. When blending out the parenesis, implicit poetics of medieval dance can be distilled from that sermon. The way how these essential elements of dance are used for generating disruptions within literary plots will be demonstrated in three literary texts dating from the thirteenth (...) to the fifteenth century: Disruptions in connection with dance occur when contrary concepts of motion clash with each other, for example the linearity of the chivalrous way through the Other World with the cyclicity of round dances. ‚Der Württemberger‘, however, collides two contrary concepts of time which can be paraphrased as spatial metaphors, namely the linearity of earthly life which collides with the cyclicity of eternal damnation, a collision symbolized by the expulsion of life out of the dance of the death. Finally in ‚Ritter Sociabilis‘, dance generates a virtual space which subverts the courtly society. The protagonists of all these texts differently manage to resolve disruptions, namely by redemption, by repentance, or by continuing disruptions which they have caused themselves. (shrink)

This article develops an objection to Kant’s proof of freedom from the Critique of Practical Reason. In his proof — the fact of reason argument — Kant deduces the reality of freedom, understood as the ability to act independently of all inclinations, from our consciousness of the unconditional validity of morality. He calls this consciousness the "fact of reason". After a systematic reconstruction of the argument, I develop an objection that relies on three points: (i) the cultural embeddedness of human (...) beings ("fact of culture"), (ii) an "external" perspective on human deliberative processes, and (iii) an alternative interpretation of the unconditional validity of morality that appears in practical deliberation. Contrary to Kant’s claims, I argue that the reality of freedom cannot be deductively derived from the fact of reason. I then discuss two objections to my argument. The first objection claims that my considerations regarding the "external" perspective misunderstand Kant's methodology. The second objection states that, based on my considerations, the fact of reason ultimately turns out to be an illusion. I discuss both objections and refute them. My ultimate conclusion is that Kant's fact of reason argument is not convincing. (shrink)