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)

Deception is part of the natural repertoire of adaptive behaviours in many organisms. In humans we see it in all domains of human activity including health care. Within health care, deception can be a matter of concern, but it is also used to protect patients, for instance against overwhelming and negative diagnostics. This paper demonstrates that deception and self‐deception are closely interlinked and that self‐deception facilitates deception. Furthermore, self‐deception tends to be used to reduce the discomfort we feel when we (...) are dishonest (cognitive dissonance). The paper includes references to core psychological mechanisms and ethical aspects. (shrink)

Okay, Professor Turner is not Rodney King. He is not responding to bioethicists and social scientists running amuck, setting automobiles aflame, and pelting each other with rocks and broken bottles. He does not come right out and ask, “Why can't we all just get along?” But in its academic way, Turner's essay is an effort to negotiate a truce in the interdisciplinary squabbles that plague bioethics, a plea to move bioethics beyond the “misleading” and “unhelpful” “demarcation of disciplinary goals” that (...) leads to “dichotomous thinking” and “polemical accusations.”. (shrink)

According to H. H. Price, there have been two major approaches to understanding what it is to have a concept: the classical theory and the symbolist theory. The classical theory, whose heritage extends at least to Plato, takes having a concept to be a relation to a special sort of object, usually called a concept or universal. The kind of relation the thinking mind has to this object is most often conceived as analogous to sight, a version of the classical (...) theory which Price calls inspectivism. (shrink)

Unearthing the radical potential at the heart of canonical political thought, this book uses the work of Foucault and Deleuze to re-imagine theory in a way that embraces difference and resistance.

The silencing of the epistemologies, theories, principles, values, concepts and experiences of the global South constitutes a particularly egregious epistemic injustice in bioethics. Our shared responsibility to rectify that injustice should be at the top of the ethics agenda. That it is not, or only is in part, is deeply problematic and endangers the credibility of the entire field. As a first step towards reorienting the field, this paper offers a comprehensive account of epistemic justice for global health ethics. We (...) first introduce several different conceptions of justice and decolonisation in relation to knowledge, purposefully drawing on work emanating from the global South as well as the global North. We then apply those conceptions to the global health ethics context to generate a tripartite account of the layers of epistemic justice in the field: who is producing ethics knowledge; what theories and concepts are being applied to produce ethics knowledge; and whose voices are sought, recorded and used to generate ethics knowledge. These layers reflect that the field spans conceptual and empirical research. We conclude by proposing that, going forward, three avenues are key to achieve greater epistemic justice at each layer and to help decolonise global health ethics: namely, understanding the problem, dialogue and structural change. (shrink)

Providing equitable food security for a growing population while minimizing environmental impacts and enhancing resilience to climate shocks is an ongoing challenge. Here, we quantify the resource intensity, environmental impacts and nutritional output of a small (0.075 ha) low-input subsistence Mediterranean agroecological farm in a developed nation that is based on intercropping and annual crop rotation. The farm provides one individual, the proprietor, with nutritional self-sufficiency (adequate intake of an array of macro- and micro-nutrients) with limited labor, no synthetic fertilizers (...) or herbicides, and zero waste, effectively closing a full farm-table-farm cycle. We find that the agroecological farm outperforms conventional farming as practiced in the same country in terms of both lower environmental burdens, across all examined environmental metrics (63% lower on average) per kg produce, and higher nutritional score (66% higher on average). Per equal farmland, the environmental lopsidedness was even higher (79% lower than conventional farming on average), with nearly the same nutritional score (3% lower on average). Moreover, when considering total land area, which includes farmland and supporting non-agricultural lands, as well as postgate impacts and food losses, the advantage of the agroecological system over conventional farming is even more pronounced. Situated within a Mediterranean region that is undergoing rapid climate change, this food system is a unique case study of nutrition- and environment-oriented food production system. While its deployment potential is limited by lack of supportive policies, it nonetheless represents one of the most starkly bold alternatives to current food systems. (shrink)

Modern Proposals for Regulating Ecocide: pragmatic, ideological or diplomatic. Towards a legal concept befitting the ecological challenges of our time. This article argues that the current debate on ecocide law is gridlocked due to an overlooked incongruency within the 2021 Independent Expert Panel’s ecocide proposal. To reinvigorate the discussion, the Panel’s proposal is compared with earlier proposals by Polly Higgins and Richard Falk. Analysis of the challenges, objectives, and legal solutions in each proposal reveals a respectively ideological, diplomatic or pragmatic (...) approach. Incongruencies are found in Higgins’ and the Panel’s proposals, while Falk’s proposal shows consistency. The incongruence between the challenges, objectives and legal solutions arguably has its roots in fundamental methodological discrepancies between ideal and non-ideal theory. For a juridically viable solution a congruent non-ideal approach should be adopted, resulting in a multitude of laws and regulations addressing various objectives that are often incompatible in one singular article to effectively tackle environmental challenges. (shrink)

An account of the Rosicrucian manifestos, and in particular their call for a general reformation, in relation to medieval and early modern traditions and reform programs.

BackgroundFor many decades, the debate on children’s competence to give informed consent in medical settings concentrated on ethical and legal aspects, with little empirical underpinnings. Recently, data from empirical research became available to advance the discussion. It was shown that children’s competence to consent to clinical research could be accurately assessed by the modified MacArthur Competence Assessment Tool for Clinical Research. Age limits for children to be deemed competent to decide on research participation have been studied: generally children of 11.2 (...) years and above were decision-making competent, while children of 9.6 years and younger were not. Age was pointed out to be the key determining factor in children’s competence. In this article we reflect on policy implications of these findings, considering legal, ethical, developmental and clinical perspectives.DiscussionAlthough assessment of children’s competence has a normative character, ethics, law and clinical practice can benefit from research data. The findings may help to do justice to the capacities children possess and challenges they may face when deciding about treatment and research options. We discuss advantages and drawbacks of standardized competence assessment in children on a case-by-case basis compared to application of a fixed age limit, and conclude that a selective implementation of case-by-case competence assessment in specific populations is preferable. We recommend the implementation of age limits based on empirical evidence. Furthermore, we elaborate on a suitable model for informed consent involving children and parents that would do justice to developmental aspects of children and the specific characteristics of the parent-child dyad.SummaryPrevious research outcomes showed that children’s medical decision-making capacities could be operationalized into a standardized assessment instrument. Recommendations for policies include a dual consent procedure, including both child as well as parents, for children from the age of 12 until they reach majority. For children between 10 and 12 years of age, and in case of children older than 12 years in special research populations of mentally compromised patients, we suggest a case-by-case assessment of children’s competence to consent. Since such a dual consent procedure is fundamentally different from a procedure of parental permission and child assent, and would imply a considerable shift regarding some current legislations, practical implications are elaborated. (shrink)

Advances in genetic and genomic research have introduced challenges in obtaining informed consent for research in low and middle-income settings. However, there are only few studies that have explored challenges in obtaining informed consent in genetic and genomic research in Africa and none in South Africa. To start filling this gap, we conducted an empirical study to investigate the efficacy of informed consent procedures for an H3Africa genomic study on Rheumatic Heart Disease at the University of Cape Town in South (...) Africa. The main aim of the study was to understand ethical challenges in obtaining informed consent in the RHDGen study. We used a qualitative study methodology involving in-depth interviews and participant observations. Our study participants were RHDGen cases, healthy controls and research staff involved in the recruitment of RHDGen cases and controls. In total, we conducted 32 in-depth interviews with RHDGen cases and controls, 2 in-depth interviews with research staff and 57 direct observations of the consent procedures of RHDGen cases and controls. The interviews were conducted in English, audio-recorded and transcribed verbatim. Data were analyzed using thematic content analysis. The study was conducted in 3 sites within Cape Town, South Africa. Most healthy controls joined the RHDGen study in order to be screened for rheumatic heart disease. A majority of RHDGen cases decided to join the RHDGen study because of therapeutic misconception. The ethical challenges that impacted on obtaining informed consent in the RHDGen study were complex. In this study, the main challenges were diagnostic misconception among RHDGen controls and therapeutic misconception among RHDGen cases. (shrink)

The field of bioethics continues to struggle with the problem of cultural diversity: can universal principles guide ethical decision making, regardless of the culture in which those decisions take place? Or should bioethical principles be derived from the moral traditions of local cultures? Ten Have and Gordijn and Bracanovic defend the universalist position, arguing that respect for cultural diversity in matters ethical will lead to a dangerous cultural relativity where vulnerable patients and research subjects will be harmed. We challenge the (...) premises of moral universalism, showing how this approach imports and imposes moral notions of Western society and leads to harm in non-western cultures. (shrink)

New Zealand’s curriculum, in terms of its approach to technological literacy, attempts to deliver a sound, philosophy-­based understanding of the nature of technology. The curriculum’s main authors claim that it conforms well to Mitcham’s (2014) categorization of different aspects of technology’s nature. Nevertheless, taking advantage of the existing literature of the philosophy of technology, this paper will reveal that the intended urriculum, though an admirable approach, still has a number of points needing improvement, and there are also certain gaps to (...) be bridged in the claimed conformity. This analysis primarily makes use of the method initiated by Nia and De Vries (2016a), based upon Mitcham’s suggested framework and other philosophers’ opinions as to the nature and various features of technology. (shrink)

This article seeks to illustrate the relevance of social theory for the study and practice of law. As social theory reports on changes that influence societal structures, the question for lawyers is how these changes affect law and what this means for its role and function. To this end, the article draws on Ulrich Beck’s theory of the risk society and reflexive modernization to provide the relevant perspective. This theory reports upon and explains the so-called side effects of modernization that (...) take the shape of environmental, industrial and political risks. It is these side effects that constitute the problem in risk society and dealing with them demands a reflexive approach towards modernization. The article seeks to highlight the relevance of this theory for law by placing it in the tradition of social contacts theory. It does so by reformulating the central problem of the risk society and by identifying the main social actors who would be party to a “new” social contract. The article then identifies and formulates the instruments of negotiation, at which point it becomes clear what the role of law may be. It concludes with a tentative indication of what the main terms of the social contract could look like. (shrink)

ABSTRACTIn the present study, we refer to Carr's theory on the nature of educational practice for evaluating teaching as a praxis in relation to two major changes, i.e. ubiquitous learning and massive communication caused by MOOCs. With regard to the first change, we argue that the teacher is faced with the problem of encouraging the learners to get involved in the educational activities. The second change has resulted in a reduction of teacher’s agency and loss of teaching legitimacy and hence (...) its natural feature as a morally committed action. In addition, massive communication has affected the potential encounters between teacher and student considered as the ‘Other’ and has replaced conversation with texting. We highlight the significance of teacher-student conversation as an essential element for developing reflection and self-reflection capacities. Finally, we discuss that the responsibility of teaching is beyond designing and implementing education technically through MOOCs. (shrink)

This article discusses the relation between empirical and normative approaches in bioethics. The issue of dwarf tossing, while admittedly unusual, is chosen as a point of departure because it challenges the reader to look with fresh eyes upon several central bioethical themes, including human dignity, autonomy, and the protection of vulnerable people. After an overview of current approaches to the integration of empirical and normative ethics, we consider five ways that the empirical and normative can be brought together to speak (...) to the problem of dwarf tossing: prescriptive applied ethics, theoretical ethics, critical applied ethics, particularist ethics and integrated empirical ethics. We defend a position of critical applied ethics that allows for a two-way relation between empirical and normative theories. Against efforts fully to integrate the normative and the empirical into one synthesis, we propose that the two should stand in tension and relation to one another. The approach we endorse acknowledges that a social practice can and should be judged both by the gathering of empirical data and by normative ethics. Critical applied ethics uses a five stage process that includes: (a) determination of the problem, (b) description of the problem, (c) empirical study of effects and alternatives, (d) normative weighing and (e) evaluation of the effects of a decision. In each stage, we explore the perspective from both the empirical (sociological) and the normative ethical point of view. We conclude by applying our five-stage critical applied ethics to the example of dwarf tossing. (shrink)

### ­ In Who shall go first? A multicriteria approach to patient selection for first clinical trials of cardiac xenotransplantation, Kögel et al recommend the inclusion of patients who (1) have a (high) medical need for an allograft, (2) have the capacity to benefit from a xenograft, (3) have a ‘real’ choice between enrolment in a first-in-human clinical trial and an alternative life-sustaining treatment option and (4) have no clear record of previous non-compliance.1 As the authors discuss, patient selection must (...) promote the goal of gaining reliable and valid knowledge about the risks and benefits of cardiac xenotransplantation. While the four criteria outlined above certainly promote this goal, we argue it is crucial to add a fifth criterion emphasising the need to include diverse populations, particularly regarding sex, age, ethnicity and socioeconomic background.i In this commentary, we present two arguments for our claim and discuss the impact of neglecting diversity from the first trials on. ### The scientific rationale for including diverse populations First, including diverse populations in the first clinical trials of cardiac xenotransplantation enhances the scientific value of the data by assessing safety and efficacy among various populations. Treatment response can differ among patient (sub)groups as a result of genetic, physiological and socioeconomic factors.2 By including diverse populations from the first trials on, researchers can identify these …. (shrink)

Over the past decade, many philosophers have argued that to respect the moral equality of their citizens, states should be neutral toward certain forms of diversity among their populations. Areas in which the state neutrality has been advocated include, but are not limited to, citizens’ different religions; languages; and sexual orientations. However, there remains an important area where its normative (ir)relevance has not been discussed: That of neurodiversity. After identifying several ways in which contemporary states disfavor the interests of neurodivergent (...) groups relative to the neurotypical majority, including those of autistic people; dyslectic people; and people with ADHD, the most promising would be-justifications for such unequal treatment are considered. They maintain respectively that states only have to be neutral toward differences that feature in people’s conceptions of the good life; that addressing the discussed neuro-inequalities is too costly, whether financially or otherwise; that doing so raises intolerable risks of a public backlash; and that a commitment to neuro-neutrality leads to overinclusion. None are found to be convincing across the board, which leads me to conclude that states should become significantly more neuro-neutral than they are today. (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)

Whilst Kolbe and de Melo-Martin (2023) appropriately identify a range of concerns about the validity of existing instruments to measure moral distress, one additional limitation that the authors di...

Modern bioethics was born in the West and thus reflects, not surprisingly, the traditions of Western moral philosophy and political and social theory. When the work of bioethics was confined to the West, this background of socio-political theory and moral tradition posed few problems, but as bioethics has moved into other cultures – inside and outside of the Western world – it has become an agent of moral imperialism. We describe the moral imperialism of bioethics, discuss its dangers, and suggest (...) that global bioethics will succeed only to the extent that it is local. (shrink)