This paper argues that there exists a collective epistemic state of ‘Broad Medical Uncertainty’ regarding the effectiveness of many medical interventions. We outline the features of BMU, and describe some of the main contributing factors. These include flaws in medical research methodologies, bias in publication practices, financial and other conflicts of interest, and features of how evidence is translated into practice. These result in a significant degree of uncertainty regarding the effectiveness of many medical treatments and unduly optimistic beliefs about (...) the benefit/harm profiles of such treatments. We argue for an ethical presumption in favour of openness regarding BMU as part of a ‘Corrective Response’. We then consider some objections to this position, including concerns that public honesty about flaws in medical research could undermine trust in healthcare institutions. We suggest that, as it stands, the Anti-Corrective Response is unconvincing. (shrink)

This paper discusses the ethics of public health communication. We argue that a number of commonplace tools of public health communication risk qualifying as non-honest and question whether or not using such tools is ethically justified. First, we introduce the concept of honesty and suggest some reasons for thinking it is morally desirable. We then describe a number of common ways in which public health communication presents information about health-promoting interventions. These include the omission of information about the magnitude of (...) benefits people can expect from health-promoting interventions, and failure to report uncertainty associated with the outcomes of interventions. Next we outline some forms of behaviour which are generally recognised by philosophers as being non-honest, including deception, manipulation, and so on. Finally, we suggest that many of the public health communicative practices identified earlier share features with the non-honest behaviours described and suggest this warrants reflection upon whether such non-honesty is justified by the goals of public health communication. (shrink)

This research investigates how consumers’ ethical brand perceptions are affected by differentially valenced information. Drawing on literature from person-perception formation and using a sequential, mixed method design comprising qualitative interviews and two experiments with a national representative population sample, our findings show that only when consumers perceive their judgment of a brand’s ethicality to be pertinent, do they process information holistically and in line with the configural model of impression formation. In this case, negative information functions as a diagnostic cue (...) to form an unethical brand perception, irrespective of other positive information at hand. However, in the case where processing relevance of the un/ethical information provided is low, brand perception formation is algebraic, in which case positive information can counterbalance and neutralize the detrimental impact of brand misbehavior. Our findings extend existing research on consumer perceived ethicality as well as consumer reactions to corporate social responsibility and sustainability initiatives, which has so far assumed the asymmetric impact of negative information on ethical perceptions and consumer attitudes to be prevalent. We derive a range of academic and managerial implications and present a number of important avenues for future research. (shrink)

Mechanisms for QoS provisioning in communication networks range from flow-based resource reservation schemes, providing QoS guarantees, through QoS differentiation based on reservation aggregation techniques to adaptation of applications, compensating for incomplete reservations. Scalable, aggregation-based reservations can also be combined with adaptations for a more flexible and robust overall QoS provisioning. Adaptation is particularly important in wireless networks, where reservations schemes are more difficult to realize. It is widely accepted that usability of Cellular or Mobile IP can be largely improved if (...) adaptation is incorporated. Adaptation, in turn, depends on coding techniques involved and on user requirements. Those impose certain preferences and ordering relations on QoS hierarchies or degradation paths to be followed along when adaptation is performed. With the advent of MPEG4 coding techniques, more sophisticated adaptation schemes are more likely to be supported in the future. (shrink)

The expression that professionals should be led by their moral or ethical compass is increasingly used by academics, policy makers, professionals, and educational institutes. Dutch universities of applied sciences (UAS), for example, explicitly aim to educate their students to become professionals equipped with a moral compass. This moral or ethical compass is a metaphor of which people intuitively grasp its meaning, but our literature review also shows that various interpretations are possible. We found three clusters of proposed ethical compasses expressing (...) its a) content, b) form, or c) use, which we present in this article. Thereafter, we evaluate which compass can meaningfully assist (young) professionals and, therefore, should be part of the aims and content of education provided by UAS. Based on this evaluation, we describe the possibilities and boundaries of UAS’ contribution to the development of their students’ ethical compass. (shrink)

This article is incorrectly classified as Review Paper in the online and print publication. The correct classification for this article is Original Paper. The publisher apologizes for the inconvenience caused.

The introduction of non-invasive prenatal testing in healthcare systems around the world offers an opportunity to reconsider funding policies for prenatal screening. In some countries with universal access healthcare systems, pregnant women and their partners are asked to pay for NIPT. In this paper, we discuss two important rationales for charging women for NIPT: to prevent increased uptake of NIPT and to promote informed choice. First, given the aim of prenatal screening, high or low uptake rates are not intrinsically desirable (...) or undesirable. Using funding policies to negatively affect uptake, however, is at odds with the aim of screening. Furthermore, copayment disproportionally affects those of lower socioeconomic status, which conflicts with justice requirements and impedes equal access to prenatal screening. Second, we argue that although payment models may influence pregnant women’s choice behaviours and perceptions of the relevance of NIPT, the copayment requirement does not necessarily lead to better-informed choices. On the contrary, external influences on women’s personal choices for or against prenatal screening should ideally be avoided. To improve informed decision-making, healthcare systems should instead invest in adequate non-directive, value-focused pretest counselling. This paper concludes that requiring copayments for NIPT in universal access healthcare systems fails to promote reproductive autonomy and is unfair. (shrink)

The offer of the fast food company gives rise to suspicion. This seems to be based on unfounded stereotypes, however. This paper argues that we need to preserve choices in taking particular courses of action. There is nothing inherently wrong in fast food consumption so long as consumers are made aware of the importance of weight management and proper nutrition.

We study a propositional bimodal logic consisting of two S4 modalities £ and [a], together with the interaction axiom scheme a £ϕ → £ aϕ. In the intended semantics, the plain £ is given the McKinsey-Tarski interpretation as the interior operator of a topology, while the labelled [a] is given the standard Kripke semantics using a reflexive and transitive binary relation a. The interaction axiom expresses the property that the Ra relation is lower semi-continuous with respect to the topology. The (...) class of topological Kripke frames characterised by the logic includes all frames over Euclidean space where Ra is the positive flow relation of a differential equation. We establish the completeness of the axiomatisation with respect to the intended class of topological Kripke frames, and investigate tableau calculi for the logic, although tableau completeness and decidability are still open questions. (shrink)