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)

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 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)

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)

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.

The de minimis principle states that some risks are so trivial that they can be ignored or treated categorically differently from non-trivial risks. Lundgren and Stefánsson criticize the de minimis principle, arguing that it either has to be applied locally or globally and that problems arise whichever application is chosen. Aven and Seif respond to Lundgren and Stefánsson’s argument and defend the de minimis principle as a “meaningful and useful perspective for handling risk in practice.” The response highlights some aspects (...) of the argument in Lundgren and Stefánsson that needs clarification, which is what we do in this note. (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)

Continued concern for animal welfare may be alleviated when welfare would be monitored on farms. Monitoring can be characterized as an information system where various stakeholders periodically exchange relevant information. Stakeholders include producers, consumers, retailers, the government, scientists, and others. Valuating animal welfare in the animal-product market chain is regarded as a key challenge to further improve the welfare of farm animals and information on the welfare of animals must, therefore, be assessed objectively, for instance, through monitoring. Interviews with Dutch (...) stakeholder representatives were conducted to identify their perceptions about the monitoring of animal welfare. Stakeholder perceptions were characterized in relation to the specific perspectives of each stakeholder. While producers tend to perceive welfare from a production point of view, consumers will use visual images derived from traditional farming and from the animals’ natural environments. Scientists’ perceptions of animal welfare are affected by the need to measure welfare with quantifiable parameters. Retailers and governments (policy makers) have views of welfare that are derived from their relationships with producers, consumers, non-governmental organizations (NGOs), and scientists. All interviewed stakeholder representatives stated that animal welfare is important. They varied in the extent to which they weighted economic considerations relative to concern for the animals’ welfare. Many stakeholders emphasized the importance of communication in making a monitoring system work. Overall, the perspectives for the development of a sustainable monitoring system that substantially improves farm animal welfare were assessed as being poor in the short term. However, a reliable system could be initiated under certain conditions, such as integrated chains and with influential and motivated stakeholders. A scheme is described with attention points for the development of sustainable monitoring systems for farm animal welfare in the long term. (shrink)

This essay considers how scholarly approaches to the development of molecular biology have too often narrowed the historical aperture to genes, overlooking the ways in which other objects and processes contributed to the molecularization of life. From structural and dynamic studies of biomolecules to cellular membranes and organelles to metabolism and nutrition, new work by historians, philosophers, and STS scholars of the life sciences has revitalized older issues, such as the relationship of life to matter, or of physicochemical inquiries to (...) biology. This scholarship points to a novel molecular vista that opens up a pluralist view of molecularizations in the twentieth century and considers their relevance to current science. (shrink)

PurposeTo explore the mindfulness practice, its long-term effects, facilitators and barriers, in clinical clerkship students 2 years after participation in an 8-week mindfulness-based stress reduction training.MethodA qualitative study was performed by semi-structured in-depth interviews with 16 clinical clerkship students selected by purposive sampling. Students had participated in a MBSR training 2 years before and were asked about their current mindfulness practice, and the long-term effects of the MBSR training. Thematic analysis was conducted using the constant comparison method. Data saturation was (...) reached after 16 interviews.ResultsMost interviewees were still engaged in regular, predominantly informal, mindfulness practice, although some discontinued mindfulness practice and reported an “unchanged lifestyle.” Three main themes came forward; “focused attention and open awareness” during daily activities as core elements of long-term mindfulness practice; “changes in behavior and coping” that resulted from taking a pause, reflecting, recognizing automatic behavioral patterns and making space for a conscious response; “integration in personal and professional life” by enhanced enjoyment of daily activities, improved work-life-balance and making different career choices. Barriers and facilitators in starting and maintaining mindfulness practice were understanding and intention as “pre-conditions”; practical, personal, and professional factors of students in maintaining practice.ConclusionTwo years after participation in a MBSR training, many interviewees were still engaged in mindfulness practice contributing to both personal and professional changes. In light of the high clerkship demands, MBSR training could be a valuable addition to medical curricula, supporting medical students in developing necessary competencies to become well-balanced professionals. (shrink)

In 'Een handvol filosofen' staan de filosofen centraal die sinds de oprichting van de Vrije Universiteit in 1880 aan deze instelling verbonden zijn geweest. Het gaat hierbij niet alleen om de inhoud van hun werk, maar ook om de personen zelf. Er waren filosofiedocenten die zich met de universiteit identificeerden en zich volledig konden ontplooien. Er waren er echter ook voor wie dit niet gold, die geïsoleerd of in gewetensnood raakten. Veel filosofiestudenten waren actief betrokken bij wat er in hun (...) faculteit gebeurde. Zij namen initiatieven, protesteerden soms tegen de gang van zaken en kozen partij in conflictsituaties. Sinds het eind van de jaren zestig van de twintigste eeuw verloor de Vrije Universiteit geleidelijk haar christelijk karakter. Tegenwoordig werken alle stafleden vanuit hun eigen motivatie mee aan een hoofdzakelijk seculier geworden universiteit, die ruimte biedt voor religieuze en levensbeschouwelijke diversiteit. (shrink)

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)

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.