Inspired by the work of Richard Abel, the authors conduct a N=1 study into the career path and disciplinary records of a Dutch immigration advocate. Their aim is to offer explanations as to why some lawyers seem so impervious to discipline. The authors analyse the case from three different angles: (1) characteristics of the disciplinary system (2) the social network of the advocate in question, including his professional network, and (3) the advocate?s personality. According to the authors, the key to (...) explaining non-compliance with ethical rules lies in the interaction between these three perspectives. In the case of the immigration lawyer a lack of professional socialization and the fact that he operated on his own, without substantial feedback or criticism from his social network were important explanatory factors. The article also offers a detailed insight into the effects of an accelerated disciplinary proceeding in which a local bar president ex officio assumes a new role. (shrink)

BackgroundThis article is part of a study to gain insight into the decision-making process by looking at the views of the relatives of potential brain dead donors. Alongside a literature review, focus interviews were held with healthcare professionals about their role in the request and decision-making process when post-mortal donation is at stake. This article describes the perspectives of the relatives.MethodsA content-analysis of 22 semi-structured in-depth interviews with relatives involved in an organ donation decision.ResultsThree themes were identified: ‘conditions’, ‘ethical considerations’ (...) and ‘look back’. Conditions were: ‘sense of urgency’, ‘incompetence to decide’ and ‘agreement between relatives’. Ethical considerations result in a dilemma for non-donor families: aiding people or protecting the deceased’s body, especially when they do not know his/her preference. Donor families respect the deceased’s last will, generally confirmed in the National Donor Register. Looking back, the majority of non-donor families resolved their dilemma by justifying their decision with external arguments. Some non-donor families would like to be supported during decision-making.DiscussionThe discrepancy between general willingness to donate and the actual refusal of a donation request can be explained by multiple factors, with a cumulative effect. Firstly, half of the participants stated that they felt that they were not competent to decide in such a crisis and they seem to struggle with utilitarian considerations against their wish to protect the body. Secondly, non-donor families refused telling that they did not know the deceased’s wishes or contesting posthumous autonomy of the eligible. Thirdly, the findings emphasise the importance of Donor Registration, because it seems to prevent dilemmas in decision-making, at least for donor families.ConclusionDiscrepancies between willingness to consent to donate and refusal at the bedside can be attributed to an unresolved dilemma: aiding people or protect the body of the deceased. Non-donor families felt incompetent to decide. They refused consent for donation, since their deceased had not given any directive. When ethical considerations do not lead to an unambiguous answer, situational factors were pivotal. Relatives of unregistered eligible donors are more prone to unstable decisions. To overcome ambivalence, coaching during decision-making is worth investigation. (shrink)

In the Netherlands, consent from relatives is obligatory for post mortal donation. This study explored the perspectives of relatives regarding the request for consent for donation in cases without donor registration. A content analysis of narratives of 24 bereaved relatives of unregistered, eligible, brain-dead donors was performed. Relatives of unregistered, brain-dead patients usually refuse consent for donation, even if they harbour pro-donation attitudes themselves, or knew that the deceased favoured organ donation. Half of those who refused consent for donation mentioned (...) afterwards that it could have been an option. The decision not to consent to donation is attributed to contextual factors, such as feeling overwhelmed by the notification of death immediately followed by the request; not being accustomed to speaking about death; inadequate support from other relatives or healthcare professionals, and lengthy procedures. Healthcare professionals could provide better support to relatives prior to donation requests, address their informational needs and adapt their message to individual circumstances. It is anticipated that the number of consenting families could be enlarged by examining the experience of decoupling and offering the possibility of consent for donation after circulatory death if families refuse consent for donation after brain-death. (shrink)

This paper examines the consequences of a culture of “personal ethics” when using new methodologies, such as the use of social media sites as a source of data for research. Using SM research as an example, this paper explores the practices of a number of actors and researchers within the “Ethics Ecosystem” which as a network governs ethically responsible research behaviour. In the case of SM research, the ethical use of this data is currently in dispute, as even though it (...) is seemingly publically available, concerns relating to privacy, vulnerability, potential harm and consent blur the lines of responsible ethical research behaviour. The findings point to the dominance of a personal, bottom-up, researcher-led, ‘ethical barometer’ for making decisions regarding the permissibility of using SM data. We show that the use of different barometers by different researchers can lead to wide disparities in ethical practice - disparities which are compounded by the lack of firm guidelines for responsible practice of SM research. This has widespread consequences on the development of shared norms and understandings at all levels, and by all actors within the Ethics Ecosystem, and risks inconsistencies in their approaches to ethical decision-making. This paper argues that this governance of ethical behaviour by individual researchers perpetuates a negative cycle of academic practice that is dependent on subjective judgements by researchers themselves, rather than governed by more formalised academic institutions such as the research ethics committee and funding council guidelines. (shrink)

The development of neonatology and the establishment of neonatal intensive care units has led to a vast array of new medical ethical problems and dilemmas centered around discontinuing treatment or nontreatment decisions. Neonatology has become one of the fields that has made clear that medical success is only rarely nonproblematic. The new technology can be a blessing for some, but it may also become a sad experience to others, with life-long repercussions.The ethical problems of neonatology transcend national boundaries. Nevertheless, there (...) are differences in approach among various countries. In The Netherlands, the ethical deliberations have been a matter of public debate, but most of the decision making is left to the medical profession; these decisions are considered too harsh for the general public. Recently, two developments have emerged. The Royal Dutch Medical Association and the Dutch Pediatrics Society have published reports with guidelines and ethical reflections. Over the same period of time, cases have been brought to court for legal analysis and the development of case precedence. (shrink)

Over 30 million people worldwide have taken a commercial at-home DNA test, because they were interested in their genetic ancestry, disease predisposition or inherited traits. Yet, these consumer DNA data are also increasingly used for a very different purpose: to identify suspects in criminal investigations. By matching a suspect’s DNA with DNA from a suspect’s distant relatives who have taken a commercial at-home DNA test, law enforcement can zero in on a perpetrator. Such forensic use of consumer DNA data has (...) been performed in over 200 criminal investigations. However, this practice of so-called investigative genetic genealogy raises ethical concerns. In this paper, we aim to broaden the bioethical analysis on IGG by showing the limitations of an individual-based model. We discuss two concerns central in the debate: privacy and informed consent. However, we argue that IGG raises pressing ethical concerns that extend beyond these individual-focused issues. The very nature of the genetic information entails that relatives may also be affected by the individual customer’s choices. In this respect, we explore to what extent the ethical approach in the biomedical genetic context on consent and consequences for relatives can be helpful for the debate on IGG. We argue that an individual-based model has significant limitations in an IGG context. The ethical debate is further complicated by the international, transgenerational and commercial nature of IGG. We conclude that IGG should not only be approached as an individual but also—and perhaps primarily—as a collective issue. There are no data in this work. (shrink)

Dutch developments on euthanasia have drawn much attention over the years. Defenders and opponents have been telling very different stories about the practice of euthanasia and the frequency of cases, and the Dutch government has been struggling with the legal and moral problems involved. Concern about the procedures followed by physicians as well as questions on the “real” figures led the government to decide to organize an epidemiological study on the extent and the decision making. The results of the study (...) were published in November 1991. Interpretation of the data may lead to a final settlement of the debate on euthanasia and has inevitably led to a revival of the moral debate of the 1970s. For the moment it has been decided that euthanasia will remain officially illegal under the Penal Code. However, in cases where euthanasia does occur, Attorneys General will continue to check the procedures followed by physicians to ensure no abuses have occurred and to safeguard physicians against prosecution. In this contribution, we discuss the development and intertwinement of legal, medical, and moral aspects of euthanasia in The Netherlands and the effects of the empirical studies of 1991, both on definitions and procedures for medical decisions at the end of life. (shrink)

Millions of human biological samples are stored worldwide for medical research or treatment purposes. These biospecimens are of enormous potential value to law enforcement as DNA profiles can be obtained from these samples. However, forensic use of such biospecimens raises a number of ethical questions. This article aims to explore ethical issues of using human bodily material in medical biobanks for crime investigation and prosecution purposes. Concerns about confidentiality, trust, autonomy and justice will be discussed. We explore how to balance (...) these concerns against the importance of crime solving. Relevant case examples of forensic use of medical biobanks show that requests by law enforcement to access biobanks are handled in disparate ways. We identify some core ethical issues and conclude that further research on these issues is needed to provide ethical guidance. (shrink)

ABSTRACT In ethics, the use of empirical data has become more and more popular, leading to a distinct form of applied ethics, namely empirical ethics. This ‘empirical turn’ is especially visible in bioethics. There are various ways of combining empirical research and ethical reflection. In this paper we discuss the use of empirical data in a special form of Reflective Equilibrium (RE), namely the Network Model with Third Person Moral Experiences. In this model, the empirical data consist of the moral (...) experiences of people in a practice. Although inclusion of these moral experiences in this specific model of RE can be well defended, their use in the application of the model still raises important questions. What precisely are moral experiences? How to determine relevance of experiences, in other words: should there be a selection of the moral experiences that are eventually used in the RE? How much weight should the empirical data have in the RE? And the key question: can the use of RE by empirical ethicists really produce answers to practical moral questions? In this paper we start to answer the above questions by giving examples taken from our research project on understanding the norm of informed consent in the field of pediatric oncology. We especially emphasize that incorporation of empirical data in a network model can reduce the risk of self‐justification and bias and can increase the credibility of the RE reached. (shrink)

New developments in genetics are rapidly spreading over the Western World. The standards of clinical practice differ however according to local value- and health-care systems. In this article a short survey is given of Dutch developments in this field. An effort is made to explain the philosophical and ethical background of Dutch policy by concentrating on autonomy, responsibility and the right not to know.

In ethics, the use of empirical data has become more and more popular, leading to a distinct form of applied ethics, namely empirical ethics. This ‘empirical turn’ is especially visible in bioethics. There are various ways of combining empirical research and ethical reflection. In this paper we discuss the use of empirical data in a special form of Reflective Equilibrium (RE), namely the Network Model with Third Person Moral Experiences. In this model, the empirical data consist of the moral experiences (...) of people in a practice. Although inclusion of these moral experiences in this specific model of RE can be well defended, their use in the application of the model still raises important questions. What precisely are moral experiences? How to determine relevance of experiences, in other words: should there be a selection of the moral experiences that are eventually used in the RE? How much weight should the empirical data have in the RE? And the key question: can the use of RE by empirical ethicists really produce answers to practical moral questions?In this paper we start to answer the above questions by giving examples taken from our research project on understanding the norm of informed consent in the field of pediatric oncology. We especially emphasize that incorporation of empirical data in a network model can reduce the risk of self‐justification and bias and can increase the credibility of the RE reached. (shrink)

In recent years the cognitive science community has witnessed the rise of a new, dynamical approach to cognition. This approach entails a framework in which cognition and behavior are taken to result from complex dynamical interactions between brain, body, and environment. The advent of the dynamical approach is grounded in a dissatisfaction with the classical computational view of cognition. A particularly strong claim has been that cognitive systems do not rely on internal representations and computations. Focusing on this claim, we (...) take as a starting point a question recently raised by Cliff and Noble: " if evolution did produce a design that used internal representations, how would we recognize it?" (Knowledge-based vision and simple visual machines, Philosophical Transactions of the Royal Society: Biological Sciences, 352 , 1165-1175, 1997). We will argue that cognitive science lacks a proper operationalization of the notion of representation, and therefore is unable to fruitfully discuss whether a particular system has representations or not. A basic method to detect representations in a physical system, grounded in isomorphism, turns out to be quite unconstrained. We will look at a practical example of this problem by examining the debate on whether or not van Gelder's (What might cognition be, if not computation? Journal of Philosophy, 92 , 345-381, 1995) controversial example of the Watt Governor is representational. We will conclude that cognitive science, as of yet, has no empirically applicable means to answer Cliff and Noble's question unequivocally. This makes the recent representationalism vs. anti-representationalism debate a debate for the sake of appearance. (shrink)

Sometimes people posit "beliefs" to explain mundane instrumental actions (e.g., Neil believes the switch is connected to the light, so he flipped the switch to illuminate the room). Sometimes people posit "beliefs" to explain group affiliation or identity (e.g., in order to belong to the Christian Reformed Church Neil must believe that God is triune). If we set aside the commonality of the word "belief," we can pose a crucial question: Is the cognitive attitude typically involved in the first "light (...) switch" sort of case the same as the cognitive attitude typically involved in the second "Trinity" sort of case? Or: Is mundanely believing the same cognitive relation as groupishly believing? In this essay, I argue that the answer is no. Mundane Beliefs play their instrumental roles well if they are true, and their manner of processing is accordingly sensitive to evidence. Groupish Beliefs play their identity-constituting roles well if they are distinctive, and their manners of processing accordingly allow for and often support distortions of evidence and truth. The manners of processing are thus so different that--despite the common word "belief"--philosophy of mind and epistemology would do well to recognize distinct cognitive attitudes. (shrink)

The recent claiming of Simone de Beauvoir's legacy by French feminists for a policy of assimilation of Muslim women to Western models of self and society reduces the complexity and richness of Beauvoir's views in inacceptable ways. This article explores to what extent a politics of difference that challenges the ideals and political strategies of abstract liberalism can be extracted from and legitimized by the philosophies of Simone de Beauvoir and Jean-Paul Sartre. Without assuming their thought is identical, we can (...) read them as elucidating each other and as implicitly exposing weak and strong points in their respective philosophies on ethnocultural relations and social identities. (shrink)

When someone says she believes that God exists, is she expressing the same kind of mental state as when she says she thinks that a lake bigger than Lake Michigan exists⎯i.e., does she refer to the same kind of cognitive attitude in both cases? Using evidence from linguistic corpora (Study 1) and behavioral experiments (Studies 2-4), the current work provides evidence that individuals typically use the word “believe” more in conjunction with statements about religious credences and “think” more in conjunction (...) with factual statements, pointing to two different understandings of claims made with these two terms. These patterns do not appear to reflect low-level differences based on the amount of consensus surrounding a particular claim, the extent to which the truth of a particular claim is known to the participant, or linguistic differences between religious and factual statements. We discuss implications of these findings for religious cognition (e.g., as supporting the theory that religious credences are qualitatively distinct from factual beliefs) as well as cognitive processes more broadly. Finally, we relate the present findings to prior theoretical work on differences between factual belief and religious credence. (shrink)

Imagination contributes to human agency in ways that haven't been well understood. I argue here that pathways from imagistic imagining to emotional engagement support three important agential capacities: 1. bodily preparedness for potential events in one's nearby environment; 2. evaluation of potential future action; and 3. empathy-based moral appraisal. Importantly, however, the kind of pathway in question (I-C-E-C: imagining-categorization-emotion-conceptualization) also enables engagement with fiction. So human enchantment with fiction is a consequence of imaginative pathways that make us the kind of (...) agents we are. Finally, I use this approach to address imaginative resistance and the paradox of fiction. [The version archived here is a penultimate draft. Please email me at [email protected] to receive a pdf of the final in accordance with fair use.]. (shrink)

Als Plato de hedendaagse academie zou aanschouwen, zou hij niet alleen stomverbaasd zijn over de massificatie en de byzantijnse bureaucratie, maar gezien het ethische doel van de universiteit zou hij ook reden hebben om bezorgd te zijn.

A computational theory of consciousness should include a quantitative measure of consciousness, or MoC, that (i) would reveal to what extent a given system is conscious, (ii) would make it possible to compare not only different systems, but also the same system at different times, and (iii) would be graded, because so is consciousness. However, unless its design is properly constrained, such an MoC gives rise to what we call the boundary problem: an MoC that labels a system as conscious (...) will do so for some – perhaps most – of its subsystems, as well as for irrelevantly extended systems (e.g., the original system augmented with physical appendages that contribute nothing to the properties supposedly supporting consciousness), and for aggregates of individually conscious systems (e.g., groups of people). This problem suggests that the properties that are being measured are epiphenomenal to consciousness, or else it implies a bizarre proliferation of minds. We propose that a solution to the boundary problem can be found by identifying properties that are intrinsic or systemic: properties that clearly differentiate between systems whose existence is a matter of fact, as opposed to those whose existence is a matter of interpretation (in the eye of the beholder). We argue that if a putative MoC can be shown to be systemic, this ipso facto resolves any associated boundary issues. As test cases, we analyze two recent theories of consciousness in light of our definitions: the Integrated Information Theory and the Geometric Theory of consciousness. (shrink)

BackgroundIn specific situations it may be necessary to make an exception to the general rule of informed consent for scientific research with an intervention. Earlier reviews only described subsets of arguments for exceptions to waive consent.MethodsHere, we provide a more extensive literature review of possible exceptions to the rule of informed consent and the accompanying arguments based on literature from 1997 onwards, using both Pubmed and PsycINFO in our search strategy.ResultsWe identified three main categories of arguments for the acceptability of (...) a consent waiver: data validity and quality, major practical problems, and distress or confusion of participants. Approval by a medical ethical review board always needs to be obtained. Further, we provide examples of specific conditions under which consent waiving might be allowed, such as additional privacy protection measures.ConclusionsThe reasons legitimized by the authors of the papers in this overview can be used by researchers to form their own opinion about requesting an exception to the rule of informed consent for their own study. Importantly, rules and guidelines applicable in their country, institute and research field should be followed. Moreover, researchers should also take the conditions under which they feel an exception is legitimized under consideration. After discussions with relevant stakeholders, a formal request should be sent to an IRB. (shrink)

A recently proposed model of sensory processing suggests that perceptual experience is updated in discrete steps. We show that the data advanced to support discrete perception are in fact compatible with a continuous account of perception. Physiological and psychophysical constraints, moreover, as well as our awake-primate imaging data, imply that human neuronal networks cannot support discrete updates of perceptual content at the maximal update rates consistent with phenomenology. A more comprehensive approach to understanding the physiology of perception (and experience at (...) large) is therefore called for, and we briefly outline our take on the problem. (shrink)

Perceptual experience can be explained by contextualized brain dynamics. An inner loop of ongoing activity within the brain produces dynamic patterns of synchronization and de- synchronization that are necessary, but not sufficient, for visual experience. This inner loop is controlled by evolution, development, socialization, learning, task and perception- action contingencies, which constitute an outer loop. This outer loop is sufficient, but not necessary, for visual experience. Jointly, the inner and outer loop may offer sufficient and necessary conditions for the emergence (...) of visual experience. This hypothesis has methodological, empirical, theoretical, and philosophical implications. (shrink)

In contrast to most Western countries, routine offer of prenatal screening is considered problematic in the Netherlands. The main argument against offering it to every pregnant woman is that women would be brought into a moral dilemma when deciding whether to use screening or not. This paper explores whether the active offer of a prenatal screening test indeed confronts women with a moral dilemma. A qualitative study was developed, based on a randomised controlled trial that aimed to assess the decision-making (...) process of women when confronted with a test offer. A sample of 59 women was interviewed about the different factors balanced in decision-making. Participants felt themselves caught between a need for knowledge and their unwillingness to take on responsibility. Conflict was reported between wishes, preferences and ethical views regarding parenthood; however, women did not seem to be caught in a choice between two or more ethical principles. Participants balanced the interests of the family against that of the fetus in line with their values and their personal circumstances. Therefore, we conclude that they are not so much faced with an ethical dilemma as conflicting interests. We propose that caregivers should provide the opportunity for the woman to discuss her wishes and doubts to facilitate her decision. This approach would help women to assess the meaning of testing within their parental duties towards their unborn child and their current offspring. (shrink)

We propose a new approach for tracing value change. Value change may lead to a mismatch between current value priorities in society and the values for which technologies were designed in the past, such as energy technologies based on fossil fuels, which were developed when sustainability was not considered a very important value. Better anticipating value change is essential to avoid a lack of social acceptance and moral acceptability of technologies. While value change can be studied historically and qualitatively, we (...) propose a more quantitative approach that uses large text corpora. It uses probabilistic topic models, which allow us to trace values that are latent. We demonstrate the approach for five types of value change in technology. Our approach is useful for testing hypotheses about value change, such as verifying whether value change has occurred and identifying patterns of value change. The approach can be used to trace value change for various technologies and text corpora, including scientific articles, newspaper articles, and policy documents. (shrink)

The late Arthur Fox has left us a very fine book on the difficult subject of the relation between faith and philosophy in Spinoza's thought. The attention is focussed on the Theological-Political Treatise, concerned with public policy, the freedom to philosophize, and religious faith. The shift of focus in the interpretation of Spinoza's philosophy, from the Ethics to the Theological-Political Treatise, enables Fox to show his deep involvement in questions regarding the links between philosophy and theology on the one hand (...) and the morality of private and public life on the other. The analysis and interpretation of Spinoza's philosophy thus also throws an interesting light on contemporary problems of moral pluralism, religious faith, and rational political strategy. (shrink)

On April 10, 2001, after extensive committee deliberations, the Second Chamber of the Dutch Parliament passed a bill that was introduced in August 1999 legalizing physician-assisted death. The bill is officially called It was passed by a majority vote in the Second Chamber of Parliament and was supported by the majority parties constituting the present coalition government (i.e., liberals and socialists). Opposition to the law came mainly from a minority of Christian parties. In this report we explore the meaning of (...) this bill and describe some of its problematic and paradoxical items. (shrink)

Appeals to the moral authority of nature play an important role in ethical discussions about the acceptability of prenatal testing. While opponents consider testing a dangerous violation of the moral inviolable course of nature, defenders see testing as a new step in improving dominion over nature. In this study we explored the meaning of appeals to nature among pregnant women to whom a prenatal screening test was offered and the impact of these appeals on their choices regarding the acceptance of (...) screening. Contrary to theoretical debates we found that appeals to the moral authority of nature do not prevent women from welcoming the possibilities of controlling the outcomes of pregnancy, neither do they provide prima facie justification for (not) intervening in the natural course of events. Both acceptors and decliners believed in an inherent morality in nature that must be respected. They welcome the possibility of knowing more about the health of the fetus and to make their own reproductive decisions. Concerns for the quality of their child's life and for their capacity to assure a good life for their family and disabled child appear to play a central role in the decision regarding the use of screening. Appeals to nature can be interpreted as an attempt to justify beliefs regarding suffering that must be avoided and the impact that family interests may have on the decision. These findings have significant implications for ethical guidance in debates about the acceptability and boundaries of control of offspring characteristics by prenatal testing. (shrink)