At the height of the COVID-19 crisis in the Netherlands a shortness of intensive care beds was looming. Dutch professional medical organizations asked a group of ethicists for assistance in drafting guidelines and criteria for selection of patients for intensive care treatment in case of absolute scarcity, when medical selection criteria would no longer suffice. This article describes the Dutch context, the process of drafting the advice and reflects on the role of ethicists and lessons learned. We argue that timely (...) interaction between clinical and ethical expertise is necessary since the distinction between medical and non-medical considerations is not as clearcut as sometimes assumed. Furthermore, pragmatic considerations related to the specifics of an epidemic are of importance, for example, in relation to prioritizing health care workers. As a consequence, any protocol already present before the pandemic would need alterations to fit the current situation. The ‘fair innings’ criterion we proposed, rephrased as an argument of intergenerational solidarity, was considered reasonable by professionals as well as patient organizations. While it is desirable to draft ethical guidelines in ‘peacetime’ as a matter of pandemic preparedness, the pressure of an actual crisis facilitates decision-making, although it will also complicate a more democratic approach. (shrink)

For contagious diseases like measles a successful immunization program can result in herd protection. Small outbreaks may still occur but fade out soon, because the possibilities for the pathogen to spread in the ‘herd’ are very small. This implies that people who refuse to participate in such a program will still benefit from the protection it offers, but they don’t do their part in maintaining protection. Isn’t that a case of freeriding—and isn’t that unfair towards all the people who do (...) collaborate? If so, that might be considered an additional ground for making vaccination mandatory or compulsory.In this paper I argue that vaccination refusal can be considered as freeriding, but that this might not be unfair. The public good of herd protection is a peculiar public good because it supervenes on private benefits that are enjoyed by all who do opt for vaccination. For vaccinated individuals, the additional benefit of herd protection comes about, as it were, for free, and hence they can’t complain that others benefit without sharing in the burdens. There are however still other grounds for making vaccination compulsory or at least for seeing refusal as a morally wrong choice. (shrink)

Environmental pollution and greenhouse gas emissions that contribute to climate change have adverse impacts on global health. Somewhat paradoxically, health care systems that aim to prevent and cure disease are themselves major emitters and polluters. In this paper we develop a justification for the claim that solidaristic health care systems should include sustainability as one of the criteria for determining which health interventions are made available or reimbursed – and which not. There is however a complication: most adverse health effects (...) due to climate change do occur elsewhere in the world. If solidarity would commit us to take care of everyone’s health, worldwide, it might imply that solidaristic health system cannot justifiably restrict universal access to their own national populations. In response we explain health solidarity is to be considered as a moral ideal. Such an ideal does not specify what societies owe to whom, but it does have moral implications. We argue that ignoring sustainability in political decision making about what health care is to be offered, would amount to betrayal of the ideal of solidarity. (shrink)

The concept of empathy describes our capacity to understand the emotions and intentions of others and to relate to our conspecifics. Numerous studies investigated empathy as a state as well as a stable personality trait. For example, recent studies in neuroscience suggest, among other brain areas such as the insula or the ACC, a role of the somatosensory cortices for empathy. Since the classic understanding of the primary somatosensory cortex is to represent touch on the body surface, we here aimed (...) to test whether tactile performance is linked to the personality trait empathy. To test this, we examined the tactile acuity of 95 healthy participants by using a two-point discrimination threshold task at the index fingers. Trait empathy was assessed by employing the interpersonal reactivity index, which measures self-reported empathy with four scales. Results of regression analyses suggested the subscale empathic concern to be positively associated with performance in the tactile acuity task. We discuss this finding in the light of recent studies on empathy and consider possible implications of tactile training to enhance empathy. (shrink)

The development of the individual attributes of ethics of responsibility in conjunction with the principles of civic liberalism in Slovak political thought is associated with the thinking of Ján Palárik. His political ideas published in the second half of the 19th century come out of an effort to characterize and achieve reform of the Habsburg monarchy on the basis of constitutionalism and federalism. These attributes, in Palárik’s opinion, were to bring more effective solutions to the issue of educating people in (...) their mother tongue and the creation of civic culture. A part of Palárik’s approach to the formation of civic skills is also the advocating of free expression, the idea of pluralism and gradualism within the idea of the unity of the different. His realistic approach to politics was framed by knowing and respecting the objective limits when implementing the aims of national civic freedom. Palárik linked the development of the state and the process of acculturation of the people with application of the principles of practical reasonableness and ethics of responsibility. He found its essence in understanding the interconnectedness of political goals and ideals, which were to be reflected in close association with the real limitations of the capabilities of individuals and social circumstances. (shrink)

Many nursing homes have an influenza vaccination policy in which it is assumed that express (proxy) consent is not necessary. Tacit consent procedures are more efficient if one aims at high vaccination rates. In this paper I focus on incompetent residents and proxy consent. Tacit proxy consent for vaccination implies a deviance of standard proxy consent requirements. I analyse several arguments that may possibly support such a deviance. The primary reason to offer influenza vaccination is that vaccinated persons have a (...) significantly reduced risk of getting the flu. This reason however cannot support the assumption that each nursing home resident is ‘better off ’ if she is vaccinated. Neither can it support tacit proxy consent policies. More promising are arguments that take the collective nature of infectious diseases into account. A potentially strong, but ultimately insufficient, argument for non‐express consent is that vaccination contributes to prevention of harm to others. Other arguments emphasise the importance of group protection: herd immunity. I discuss three collective reasons for aiming at herd immunity: solidarity, a common interest in reducing the risk of illness, and a common interest in the prevention of an influenza outbreak. The latter argument appears to be most important. An outbreak is not just detrimental to the health of residents; it is detrimental to their everyday social life as well. Outbreaks can be seen as a collective evil. My analysis shows that there are valid (though not necessarily sufficient) moral arguments for a tacit proxy consent policy. (shrink)

Counterexamples to reassurance relative to a relation between models of the logic of paradox are provided. Another relation, designed to fix the problem in logic without equality, is introduced and discussed in connection with the issue of classical recapture.

There has been increased interest in the potential of maternal immunisation to protect maternal, fetal, and infant health. Maternal tetanus vaccination is part of routine antenatal care and immunisation campaigns in many countries, and it has played an important part in the reduction of maternal and neonatal tetanus. Additional vaccines that have been recommended for routine maternal immunisation include those for influenza and pertussis, and other vaccines are being developed. Maternal immunisation is controversial since regulators, professionals, and the public are (...) often reluctant to accept pharmaceutical interventions during pregnancy. So far, little attention has been given to the ethics of vaccination during pregnancy. In this Personal View we argue that maternal immunisation should be offered in response to concrete, severe risks of disease for mother and child, and we explain how this requirement of serious risk can be used to guide ethical decision-making about maternal immunisation. (shrink)

The rule of rescue holds that special weight should be given to protecting the lives of assignable individuals in need, implying that less weight is given to considerations of cost-effectiveness. This is sometimes invoked as an argument for funding or reimbursing life-saving treatment in public healthcare even if the costs of such treatment are extreme. At first sight one might assume that an individualist approach to ethics—such as Scanlon’s contractualism—would offer a promising route to justification of the rule of rescue. (...) In this chapter I argue that contractualism cannot endorse the rule of rescue, whereas a collectivist approach that appeals to group solidarity would offer support for rescue cases. The argument, however, has its limitations, and though solidarity is of central concern in shaping public healthcare, there are good reasons for not endorsing the rule of rescue as a moral basis for allocating scarce resources in clinical care. (shrink)

The title of the article in the initial online publication was mixed up with copy editing information. The original article has been corrected.

(No abstract is available for this citation).

Propose une étude sur une période particulière de l'histoire du philosophe, celle de sa compromission avec le nazisme en 1933.

" Si, après Auschwitz, croire en un Dieu-raison n'est plus possible, reste, d'un côté, la foi simple - la foi qui n'est qu'un cri -, de l'autre la raison, pure de religion. Philosopher comme avant, on ne le peut, mais seulement mieux qu'avant - ou pas du tout. Refermée, pour la philosophie, la parenthèse judéo-chrétienne ; fini le temps des castors - des Descartes, Kant, Hegel, des bâtisseurs de digues pour dompter le flot de la Libre Pensée issu de la (...) source grecque. L'heure est aux philosophies du refus. Refus de toute logicisation philosophico-théologique du monde, où le mal absolu n'est plus qu'un détail. De là une vision a-théiste et a-cosmique du monde, une vision déréalisante du " réel ", mais aussi, devant la vie, l'appel à un nouveau courage. Car, dans la défaite des absolus sécurisants, reste, comme corrélat du mal absolu, l'absolu de la mort et du Temps. " M. C. (shrink)

Name der Zeitschrift: Semiotica Jahrgang: 2015 Heft: 206 Seiten: 1-3.

The curious philosopher often answers questions by raising further, more fundamental questions. How can this be fruitful and practical in the context of Wageningen University? Philosophy offers critical reflection on conceptual and normative assumptions in science and society, and that is necessary for responsible practices. I illustrate this by analyzing the concept of quality of life – a key value in the mission of our university – and by questioning current debates about responsibility for health.

Assuming that liberalism, liberal democracy, and the free market are here to stay, this book asks how sustainability can be interpreted in ways that respect liberal democratic values and institutions. Among the problems addressed are the compatibility of liberal procederalism with substantive "green" ideals, the existence and potential of eco-friendly principles and ideas in clasical liberal political theory, the role of rights and duties and of democracy and deliberation, and the "greening" potential of modern environmentally-focused practices in liberal democracies.