The relationship between sociology and bioethics has been an uneasy one. It has been described as contentious and adversarial, and at least some of the sociologists who have ventured into the territory of medical ethics report back on unfriendly natives. This bioethical ill will toward sociology is not without cause. Sociologists have been quite critical of what they call (with not-so-subtle pejorative overtones) the bioethical project.Two decades ago - when bioethics was just getting up on its organizational feet - Renée (...) Fox and Judith Swazey leveled the charge of cultural myopia against bioethics, noting that this myopia generally manifests itself in the form of systematic inattention to the social and cultural sources and implications of its own thought. They go on to sayifbioethics is an indicator of the general state of American ideas, values, and beliefs, of our collective self knowledge, and our understanding of other societies and cultures - then there is every reason to be worried about who we are, what we have become, and where we are going. (shrink)

Since the introduction of the U.S. Sarbanes-Oxley Act in 2002 and several other national corporate governance codes, whistleblowing policies have been implemented in a growing number of companies. Existing research indicates that this type of governance codes has a limited direct effect on ethical or whistleblowing behaviour whereas whistleblowing policies at the corporate level seem to be more effective. Therefore, evidence on the impact of (inter)national corporate governance codes on the content of corporate whistleblowing policies is important to understand their (...) indirect impact on whistleblowing behaviour. This study analyzes the contents of whistleblowing policies, and parts of corporate codes of conduct and codes of ethics, describing such policies of 56 leading European companies. By classifying the contents in seven categories, an exploratory framework was created. General contents often identified were: applicability to all employees, a group-wide scope and an authoritative tone. The most common general violations to report were breaches of internal policies and external regulations or laws. The more specific violations most frequently mentioned were criminal offences and dangers to health and safety or the environment. Contacts to report to were the direct or indirect supervisors, a compliance officer or a confidential “hotline” facility. A confidentiality guarantee was common and anonymous reporting was often possible, though sometimes discouraged. Protection against retaliation is stated by ensuring that retaliation will not happen, prohibiting it or making it punishable. The requirement of good faith was frequently given. Finally, investigation of the report was often guaranteed. Surprisingly little information is given on the treatment of whistleblowers reporting an unfounded complaint in good faith, or reporting a violation they were involved in. The study’s findings are most relevant to companies without a whistleblowing policy or those that intend to benchmark their policies, and to pan-European standard setters. (shrink)

Clinical ethics support (CES) for health care professionals and patients is increasingly seen as part of good health care. However, there is a key drawback to the way CES services are currently offered. They are often performed as isolated and one-off services whose ownership and impact are unclear. This paper describes the development of an integrative approach to CES at the Center of Expertise and Care for Gender Dysphoria (CEGD) at Amsterdam University Medical Center. We specifically aimed to integrate CES (...) into daily work processes at the CEGD. In this paper, we describe the CES services offered there in detail and elaborate on the 16 lessons we learned from the process of developing an integrative approach to CES. These learning points can inform and inspire CES professionals, who wish to bring about greater integration of CES services into clinical practice. (shrink)

The relationship between sociology and bioethics has been an uneasy one. It has been described as contentious and adversarial, and at least some of the sociologists who have ventured into the territory of medical ethics report back on unfriendly natives. This bioethical ill will toward sociology is not without cause. Sociologists have been quite critical of what they call (with not-so-subtle pejorative overtones) the bioethical project.Two decades ago - when bioethics was just getting up on its organizational feet - Renée (...) Fox and Judith Swazey leveled the charge of cultural myopia against bioethics, noting that this myopia generally manifests itself in the form of systematic inattention to the social and cultural sources and implications of its own thought. They go on to sayifbioethics is an indicator of the general state of American ideas, values, and beliefs, of our collective self knowledge, and our understanding of other societies and cultures - then there is every reason to be worried about who we are, what we have become, and where we are going. (shrink)

The tendency towards an increasing integration of the informational web into our daily physical world (in particular in so-called Ambient Intelligent technologies which combine ideas derived from the field of Ubiquitous Computing, Intelligent User Interfaces and Ubiquitous Communication) is likely to make the development of successful profiling and personalization algorithms, like the ones currently used by internet companies such as Amazon, even more important than it is today. I argue that the way in which we experience ourselves necessarily goes through (...) a moment of technical mediation. Because of this algorithmic profiling that thrives on continuous reconfiguration of identification should not be understood as a supplementary process which maps a pre-established identity that exists independently from the profiling practice. In order to clarify how the experience of one’s identity can become affected by such machine-profiling a theoretical exploration of identity is made (including Agamben’s understanding of an apparatus, Ricoeur’s distinction between idem- and ipse-identity, and Stiegler’s notion of a conjunctive–disjunctive relationship towards retentional apparatuses). Although it is clear that no specific predictions about the impact of Ambient Intelligent technologies can be made without taking more particulars into account, the theoretical concepts are used to describe three general scenarios about the way wherein the experience of identity might become affected. To conclude, I argue that the experience of one’s identity may affect whether the cases of unwarranted discrimination resulting from ubiquitous differentiations and identifications within an Ambient Intelligent environment, will become a matter of societal concern. (shrink)

Genetic engineering evokes a number of objections that are not directed at the negative effects the technique might have on the health and welfare of the modified animals. The concept of animal integrity is often invoked to articulate these kind of objections. Moreover, in reaction to the advent of genetic engineering, the concept has been extended from the level of the individual animal to the level of the genome and of the species. However, the concept of animal integrity was not (...) developed in the context of genetic engineering. Given this external origin, the aim of this paper is to critically examine the assumption that the concept of integrity, including its extensions to the level of the genome and the species, is suitable to articulate and justify moral objections more specifically directed at the genetic engineering of animals. (shrink)

Intrinsic value and animal integrity are two key concepts in the debate on the ethics of the genetic engineering of laboratory animals. These concepts have, on the one hand, a theoretical origin and are, on the other hand, based on the moral beliefs of people not directly involved in the genetic modification of animals. This ‘external’ origin raises the question whether these concepts need to be adjusted or extended when confronted with the moral experiences and opinions of people directly involved (...) in the creation or use of transgenic laboratory animals. To answer this question, 35 persons from the practice of biomedical research who are directly involved in genetic engineering (scientists, biotechnicians, animal caretakers and laboratory animal scientists) were interviewed. They were asked to give their moral opinion on different aspects of the genetic engineering of animals and to react to statements about the concepts of intrinsic value and animal integrity. Analysis of the interviews showed that, contrary to what is often assumed, the respondents embraced these concepts, even those senses that (more) specifically apply to genetic engineering. And although the respondents raised some objections that go beyond issues of animal welfare, these objections could quite well be expressed in terms of the concepts of intrinsic value and animal integrity. In short, the results of the present study strongly suggest that these concepts do not have to be adjusted or extended in the light of the moral experiences and opinions from practice. (shrink)

The “best interests of the patient” standard—a complex balance between the principles of beneficence and autonomy—is the driving force of ethical clinical care. Clinicians’ fear of litigation is a challenge to that ethical paradigm. But is it ever ethically appropriate for clinicians to undertake a procedure with the primary goal of protecting themselves from potential legal action? Complicating that question is the fact that tort liability is adjudicated based on what most clinicians are doing, not the scientific basis of whether (...) they should be doing it in the first place. In a court of law, clinicians are generally judged based on the “reasonably prudent” standard: what a reasonably prudent practitioner in a similar situation would do. But this legal standard can have the effect of shifting the medical standard of care—enabling a standard-of-care sprawl where actions undertaken for the primary purpose of avoiding liability reset the standard of care against which clinicians will be adjudicated. While this problem has been recognized in the legal literature, neither current ethical models of care nor legal theory offer workable solutions. One of the best examples of the conflict between evidence-based medicine and common clinical practice is the use of electronic fetal monitoring. Despite strong evidence and professional guidelines that argue against the use of EFM for healthy pregnancies, the practice persists. One of the main reasons for this is often assumed to be physicians’ concerns about liability. (shrink)

Objective The study evaluated patient informed consent for the Quad screen and examined differences in IC between test acceptors and test refusers. A multidimensional model of IC was used. Methods Women seeking prenatal care at nine obstetrics clinics in a large Midwestern city completed surveys between February and December 2006. Surveys contained measures for three dimensions of IC: intention, understanding and controlling influence. Results 56.2% of women did not meet criteria for all three of our dimensions of IC and therefore (...) failed to give it. The failure rate was higher among women who choose to screen than women who choose not screen. Women who met all criteria for IC were over three times less likley to choose to screen ) than women who did not meet criteria for IC. Conclusion The decision to screen for fetal anomalies is less of a deliberated action than the decision not to screen. Women who lack a fundamental understanding of the purpose and nature of the screen may be operating on the belief that the screen is part of standard care and presents no need to deliberate. (shrink)

In this paper we present a dynamic assignment language which extends the dynamic predicate logic of Groenendijk and Stokhof [1991: 39–100] with assignment and with generalized quantifiers. The use of this dynamic assignment language for natural language analysis, along the lines of o.c. and [Barwise, 1987: 1–29], is demonstrated by examples. We show that our representation language permits us to treat a wide variety of donkey sentences: conditionals with a donkey pronoun in their consequent and quantified sentences with donkey pronouns (...) anywhere in the scope of the quantifier. It is also demonstrated that our account does not suffer from the so-called proportion problem.Discussions about the correctness or incorrectness of proposals for dynamic interpretation of language have been hampered in the past by the difficulty of seeing through the ramifications of the dynamic semantic clauses (phrased in terms of input-output behaviour) in non-trivial cases. To remedy this, we supplement the dynamic semantics of our representation language with an axiom system in the style of Hoare. While the representation languages of barwise and Groenendijk and Stokhof were not axiomatized, the rules we propose form a deduction system for the dynamic assignment language which is proved correct and complete with respect to the semantics. (shrink)

Engineering, as a complex and multidimensional practice of technology development, has long been a source of ethical concerns. These concerns have been approached from various perspectives. There are ongoing debates in the literature of the philosophy of engineering/technology about how to organize an optimized view of the values entailed in technology development processes. However, these debates deliver little in the way of a concrete rationale or framework that could comprehensively describe different types of engineering values and their multi-aspect interrelations in (...) real engineering practices. Approaching engineering values from a meaning-based perspective, as in this paper, can be a reliable method of tackling such a controversial problem. This paper therefore proposes that technology development be considered a systemic normative practice and attempts to provide a comprehensive view of various built-in values, their different origins and features, and a way of prioritizing them in real engineering processes. Studying two cases of the Zayandeh Rood Dam and the Abbasi Dam will lead to practical insights into how to understand norms in technology development and incorporate them into engineering practice. (shrink)

The social and legal implications of forensic DNA are paramount. For this reason, forensic DNA enjoys ample attention from legal, bioethics, and science and technology studies scholars. This article contributes to the scholarship by focusing on the neglected issue of sameness. We investigate a forensic courtroom case which started in the early ’90s and focus on three modes of making similarities: creating equality before the law, making identity, and establishing standards. We argue that equality before the law is not merely (...) a principle but a practice. In the context of DNA research, equality refers to using standardized technology and procedures to identify the criminal suspect. Our case shows the work at stake in introducing a new technology into the courtroom and serves as a lens, magnifying how contingencies and uncertainties are managed and ordered in everyday court practices to arrive at an equal treatment of the suspect. (shrink)

In sharp contrast with Heidegger's insistence that the metaphysics of presence, in particular the objectivation of beings in terms of their being “ready at hand” culminating in the techno‐scientific world‐view, be destructed and overcome in light of a more fundamental thinking of “presencing” or “coming into presence” (Anwesen), the philosophy of the infinitely Other introduced (or should we say: rearticulated) by Emmanuel Levinas marks a radical rupture with all ontology. Indeed, it breaks away from every thought of Being, from the (...) notion of the event or eventhood (Ereignis) of Being, but also from the notion of the gift implied in Heidegger's formula that Being “is” what “there is,” that Being “is” what essentially “gives,” or, finally, that Being “is” (what is) fundamentally given (Es gibt das Sein). From the publication of his earliest phenomenological studies in the 1930s and late 1940s onwards, but especially since the appearance, in 1961, of his first major book Totalité et Infini: Essai sur l'extériorité (Totality and Infinity: An Essay on Exteriority), Levinas has left no doubt that the central concern of his philosophical thinking was to leave the parameters – indeed, the very “climate” – of Heideggerian thought behind. This flight, as it were, not merely from ontology but also from Heidegger's later thinking‐of (Andenken) of Being consists, in its first phase, in the reorientation rather than destruction or deconstruction of traditional Western philosophy – a tradition which, according to Levinas, has been by and large a philosophy of the Same (le Même) – in the direction of the Other (l'Autre) or, more precisely, other human beings (autrui). At first glance, therefore, Levinas's first major work is characterized by the attempt to establish ethics as the genuine first philosophy. The ethical relation here is at once the primum intelligibele that puts an end to the essential arbitrariness and the anarchy of the world of opinions and truths, of appearances and idealized constructs. For all its apparent abstraction, it signals itself in the concrete event of obligation, more specifically in the introduction of a responsibility that precedes and exceeds contracts and rules, reciprocity and recognition, norms and conventions. In Totality and Infinity this relation of the self to the other is described in terms of the asymmetrical structure of discourse, of dialogue, and, most importantly, of the face‐to‐face with the other's visage. For, so the argument goes, it is solely in the face‐to‐face that the Desire (désire) for the other arouses, provokes, or evokes. It is in this singular relation without relation alone that the self is accused and made responsible. (shrink)

Seeking consent for genetic and genomic research can be challenging, particularly in populations with low literacy levels, and in emergency situations. All of these factors were relevant to the MalariaGEN study of genetic factors influencing immune responses to malaria in northern rural Ghana. This study sought to identify issues arising in practice during the enrolment of paediatric cases with severe malaria and matched healthy controls into the MalariaGEN study.

Subjects enrolled in studies testing high risk interventions for incurable or progressive brain diseases may be vulnerable to deficiencies in informed consent, such as the therapeutic misconception. However, the definition and measurement of the therapeutic misconception is a subject of continuing debate. Our qualitative pilot study of persons enrolled in a phase I trial of gene transfer for Parkinson disease suggests potential avenues for both measuring and preventing the therapeutic misconception. Building on earlier literature on the topic, we developed and (...) tested an interview guide that focuses on how the subjects decided to participate, emphasizing the integration of subjects’ various statements that are relevant to assessing the therapeutic misconception, rather than evaluating them as isolated statements. The results indicate that a subject’s understanding of the purpose of research is best explored in juxtaposition to the subject’s motivation for participating. (shrink)

Logical frameworks for analysing the dynamics ofinformation processing abound [4, 5, 8, 10, 12, 14, 20, 22]. Some of these frameworks focus on the dynamics of the interpretation process, some on the dynamics of the process of drawing inferences, and some do both of these. Formalisms galore, so it is felt that some conceptual streamlining would pay off. This paper is part of a larger scale enterprise to pursue the obvious parallel between information processing and imperative programming. We demonstrate that (...) logical tools from theoretical computer science are relevant for the logic of information flow. More specifically, we show that the perspective of bare logic [13, 18] can fruitfully be applied to the conceptual simplification of information flow logics. Part one of this program consisted of the analysis of 'dynamic interpretation' in this way, using the example of dynamic predicate logic [10]; the results were published in [7]. The present paper constitutes the second part of the program, the analysis of 'dynamic inference'. Here we focus on Veltman’s update logic [22]. Update logic is an example of a logical framework which takes the dynamics of drawing inferences into account by modelling information growth as discarding of possibilities. This paper shows how information logics like update logic can fruitfully be studied by linking their dynamic principles to static 'correctness descriptions'. Our theme is exemplified by providing a sound and complete HoarelPratt style deduction system for update logic. The Hoare/Pratt correctness statements use modal propositional dynamic logic as assertion language and connect update logic to the modal propositional logic S5. The connection with S5 provides a clear link between the dynamic and the static semantics of update logic. The fact that update logic is decidable was noted already in [2]; the connection with S5 provides an alternative proof. The S5 connection can also be used for rephrasing the validity notions of update logic and for performing consistency checks. In conclusion, it is argued that interpreting the dynamic statements of information logics as dynamic modal operators has much wider applicability. In fact, the method can be used to axiomatize quite a wide range of information logics. (shrink)

While tourism is often seen as a welcome source of economic development, conventional mass tourism is associated with numerous negative effects, such as the destruction of ecological systems and loss of cultural heritage. In response to these concerns, a term that has surfaced recently is, sustainable tourism. This article attempts to define sustainable tourism and asks the question of whether this new term is an acceptable criteria or is merely a marketing ploy to attract the morally conscious tourist.

There are concerns that participation in open science will lead to various forms of exploitation – of researchers and scholars in low-income countries and under-resourced institutions. This article defends a contrary thesis and demonstrates the exact ways the underexplored notions of communal relationships, human dignity and social justice – and the normative principles to which they give rise – grounded in African philosophy can usefully address critical concerns regarding exploitation in the sharing of research resources to facilitate open partnership/collaboration and (...) reuse. Further research is required to study the specific roles different institutions can play in facilitating open practice and contribute towards establishing effective structures that can enhance equity and balance unfavourable power asymmetries. (shrink)

There are concerns that participation in open science will lead to various forms of exploitation – of researchers and scholars in low-income countries and under-resourced institutions. This article defends a contrary thesis and demonstrates the exact ways the underexplored notions of communal relationships, human dignity and social justice – and the normative principles to which they give rise – grounded in African philosophy can usefully address critical concerns regarding exploitation in the sharing of research resources to facilitate open partnership/collaboration and (...) reuse. Further research is required to study the specific roles different institutions can play in facilitating open practice and contribute towards establishing effective structures that can enhance equity and balance unfavourable power asymmetries. (shrink)

_Reflections on Technology for Educational Practitioners_ describes the main ideas of fourteen philosophers of technology and how these ideas are used or can be used in technology education.

Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction (Abbott) and the assignment of responsibilities (Gusfield). This (...) theoretical framework prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as 'intentionally taking the life of another person by a physician, upon that person's request' can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)

Bioethics, Volume 36, Issue 4, Page 411-422, May 2022.

Deterministic models in population dynamics often are really approximations to stochastic models, justified by an appeal to the law of large numbers. It is proposed to call such models pseudodeterministic. Four questions are discussed in this article: (1) What errors may be made by equating deterministically predicted values to expectations? (2) When, and in what sense, may numbers be assumed to be large? (3) How large are the variances, coefficients of variations, etc., as assigned to the variables in the stochastic (...) versions of the models? (4) What role may pseudodeterministic models play in empirical research, where problems of statistical reliability arise?As an example, a modified Nicholson-Bailey model of the interaction between insect parasitoids and their hosts is discussed; the modification consists of assigning a random (density-independent) mortality to the parasitoid population. A stochastic version of this model is discussed. The expectation of the final host density is compared with the value computed from the deterministic model. The latter value is systematically lower than the former. The magnitude of the difference depends on parameter values. The variability to be expected with the stochastic model is characterized by the coefficient of variation of the final host density; its dependence on parameter values and initial conditions is discussed. It is concluded that it is worthwhile in practical applications to estimate parasitoid mortality, and that the coefficient of variation in real situations may be far from negligible. (shrink)

Despite all the hyperbole, Natural Capitalism is not a great book and even less of a radical concept. Indeed, the "natural" is wholly unnecessary, for most of its "radical insights" amounts to nothing more than a rediscovery of the fundamental tenets of a market economy. Good capitalist entrepreneurs have always been able to figure out that pollution and waste are both inefficient and expensive. They never needed government officials or business consultants to tell them that you can do well financially (...) and environmentally at the same time. In spite of all this, if Natural Capitalism succeeds in convincing a large segment of the population that economic growth needn’t coincide with environmental degradation, it will have played a useful role—perhaps one that long-time advocates of market economies simply cannot play. One nonetheless hopes that Hawken and the Lovins will one day take a good look at what their ancestors achieved and give some credit to writers who made all of their good points—and most of their bad ones—long before they were born. (shrink)

This paper shows that the resources mobilized by recent arguments against individualism in the philosophy of mind also suffice to construct a good argument against a Humean-style skepticism about our knowledge of extra-mental reality. The argument constructed, however, will not suffice to lay to rest the attacks of a truly global skeptic who rejects the idea that we usually know what our occurrent mental states are.

The general and deep dissatisfaction with the present-day status of health care is of such intensity that one speaks of a health care crisis. What is most disturbing to the physicians is that society directs its accusation mainly at the health care professional for being responsible for this crisis. If we want to abolish the crisis we must try to get a renewed look at its source, i.e., to answer the questions where did health care go wrong primarily? and with (...) whom lies the ultimate responsibility for health care?. In the following discourse these questions are discussed. Based on the assumption that every human being is a free rational agent the ultimate health care responsibility is assigned to the citizen. Of course, whether such an approach will in fact solve the problems inherent in present-day health systems cannot be predicted. (shrink)

Chaplains often describe their work in health care as “translation” between the world of the patient and the world of hospital medicine. Translators usually work with texts, interpreters with words. However, when chaplains use this metaphor, it describes something other than a discrete task associated with the meaning of words. While medical professionals focus on patients' medical conditions, chaplains seek to read the whole person, asking questions about what people's lives are like outside of the hospital, what they care about (...) most, and where they find joy and support in the world. Chaplains offer a supportive presence that serves to remind patients and caregivers that people are more than just their medical conditions or their current collection of concerns. Some chaplains are skilled at translating patients' experiences and sources of meaning in real time, allowing medical teams to better understand the person they are treating. “Translation” is also defined as metamorphosis. Chaplains provide this sort of translation when they are alone with patients, listening to their deepest concerns, helping them redefine their lives. (shrink)