Objectives: To analyse legislation and medical professional positions concerning the doctor’s role in assisted dying in western Europe, and to discuss their implications for doctors.Method: This paper is based on country-specific reports by experts from European countries where assisted dying is legalised , or openly practiced , or where it is illegal .Results: Laws on assisted dying in The Netherlands and Belgium are restricted to doctors. In principle, assisted suicide is not illegal in either Germany or Switzerland, but a doctor’s (...) participation in Germany would violate the code of professional medical conduct and might contravene of a doctor’s legal duty to save life. The Assisted Dying for the Terminally Ill Bill proposed in the UK in 2005 focused on doctors, whereas the Proposal on Assisted Dying of the Norwegian Penal Code Commission minority in 2002 did not.Professional medical organisations in all these countries except The Netherlands maintain the position that medical assistance in dying conflicts with the basic role of doctors. However, in Belgium and Switzerland, and for a time in the UK, these organisations dropped their opposition to new legislation. Today, they regard the issue as primarily a matter for society and politics. This “neutral” stance differs from the official position of the Royal Dutch Medical Association which has played a key role in developing the Dutch practice of euthanasia as a “medical end-of-life decision” since the 1970s.Conclusion: A society moving towards an open approach to assisted dying should carefully identify tasks to assign exclusively to medical doctors, and distinguish those possibly better performed by other professions. (shrink)

This article focuses on three scenarios in which residual biological materials are turned into research collections during the procedure of procuring these materials for diagnostic, therapeutic or other non-research purposes. These three scenarios differ from each other primarily because they employ different models of consent: (a) precautionary consent, which may be secured during the collecting procedure; (b) the presumed consent model, which may be applied during the collection of materials; and (c) consent for research use of identifiable human biological materials, (...) which may be skipped entirely. These scenarios offer additional sources of biological samples for research purposes and at the same time seem to offer even more flexibility in terms of stringency of consent as compared with the more traditional models of broad consent in prospective research collections and the waiver of consent in retrospective research. Our discussion leads us to think that precautionary consent is preferable to presumed consent and no consent when handling issues of consent in the use of residual human biological materials for research. However, such precautionary consent should not be construed as blanket, unrestricted consent for any future use. (shrink)

In today'sbioethical debates, the concept of the person plays a major role. However, it does not hold this role justly. The purpose of this paper is to argue that the concept of the person is unsuited to be a central concept in bioethical debates, because its use is connected with serious problems. First, the concept is superfluous. Secondly, it is a confusing concept and it lacks pragmatic use. Thirdly, its use leads to simplifications. Finally, the concept can easily be used (...) as a cover-up concept. Therefore, it is argued that relinquishing the concept of the person could enhance the clarity and quality of bioethical debate. Moreover, the historic origin of much of the present confusion surrounding the concept of the person is clarified. It is demonstrated that three influences resulting from Locke'sideas on the person and personal identity can be determined as contributing factors to the confusion and controversy within the present bioethical debates centering around the person. (shrink)

This article discusses the latest developments regarding euthanasia and palliative care in the Netherlands. On the one hand, a legally codified practice of euthanasia has been established. On the other hand, there has been a strong development of palliative care. The combination of these simultaneous processes seems to be rather unique. This contribution first focuses on these remarkable developments. Subsequently, the analysis concentrates on the question of how these new developments have influenced the ethical debate.

Bridging the gap between the world of science and the realm of the spiritual, B. Alan Wallace introduces a natural theory of human consciousness that has its roots in contemporary physics and Buddhism. Wallace's "special theory of ontological relativity" suggests that mental phenomena are _conditioned_ by the brain, but do not _emerge_ from it. Rather, the entire natural world of mind and matter, subjects and objects, arises from a unitary dimension of reality that is more fundamental than these dualities, as (...) proposed by Wolfgang Pauli and Carl Jung. To test his hypothesis, Wallace employs the Buddhist meditative practice of _samatha_, refining one's attention and metacognition, to create a kind of telescope to examine the space of the mind. Drawing on the work of the physicist John Wheeler, he then proposes a more general theory in which the participatory nature of reality is envisioned as a self-excited circuit. In comparing these ideas to the Buddhist theory known as the Middle Way philosophy, Wallace explores further aspects of his "general theory of ontological relativity," which can be investigated by means of _vipasyana_, or insight, meditation. Wallace then focuses on the theme of symmetry in reference to quantum cosmology and the "problem of frozen time," relating these issues to the theory and practices of the Great Perfection school of Tibetan Buddhism. He concludes with a discussion of the general theme of complementarity as it relates to science and religion. The theories of relativity and quantum mechanics were major achievements in the physical sciences, and the theory of evolution has had an equally deep impact on the life sciences. However, rigorous scientific methods do not yet exist to observe mental phenomena, and naturalism has its limits for shedding light on the workings of the mind. A pioneer of modern consciousness research, Wallace offers a practical and revolutionary method for exploring the mind that combines the keenest insights of contemporary physicists and philosophers with the time-honored meditative traditions of Buddhism. (shrink)

PurposeThe purpose of this paper is to develop a critique of value sensitive design (VSD) and to propose an alternative approach that does not depart from a heuristic of value(s), but from virtue ethics, called virtuous practice design (VPD).Design/methodology/approachThis paper develops a philosophical argument, draws from a philosophical method (i.e. virtue ethics) and applies this method to a particular case study that draws from a narrative interview.FindingsIn this paper, authors show how an approach that takes virtue instead of value as (...) the central notion for aiming at a design that is sensitive to ethical concerns can be fruitful both in theory and in practice.Originality/valueThis paper presents the first attempt to ground an approach aimed at ethical technology design on the tradition of virtue ethics. As such, it presents VPD as a potentially fruitful alternative to VSD. (shrink)

Bridging the gap between the world of science and the realm of the spiritual, B. Alan Wallace introduces a natural theory of human consciousness that has its roots in contemporary physics and Buddhism. Wallace's "special theory of ontological relativity" suggests that mental phenomena are _conditioned_ by the brain, but do not _emerge_ from it. Rather, the entire natural world of mind and matter, subjects and objects, arises from a unitary dimension of reality that is more fundamental than these dualities, as (...) proposed by Wolfgang Pauli and Carl Jung. To test his hypothesis, Wallace employs the Buddhist meditative practice of _samatha_, refining one's attention and metacognition, to create a kind of telescope to examine the space of the mind. Drawing on the work of the physicist John Wheeler, he then proposes a more general theory in which the participatory nature of reality is envisioned as a self-excited circuit. In comparing these ideas to the Buddhist theory known as the Middle Way philosophy, Wallace explores further aspects of his "general theory of ontological relativity," which can be investigated by means of _vipasyana_, or insight, meditation. Wallace then focuses on the theme of symmetry in reference to quantum cosmology and the "problem of frozen time," relating these issues to the theory and practices of the Great Perfection school of Tibetan Buddhism. He concludes with a discussion of the general theme of complementarity as it relates to science and religion. The theories of relativity and quantum mechanics were major achievements in the physical sciences, and the theory of evolution has had an equally deep impact on the life sciences. However, rigorous scientific methods do not yet exist to observe mental phenomena, and naturalism has its limits for shedding light on the workings of the mind. A pioneer of modern consciousness research, Wallace offers a practical and revolutionary method for exploring the mind that combines the keenest insights of contemporary physicists and philosophers with the time-honored meditative traditions of Buddhism. (shrink)

The late Jacob Klein’s important book is, remarkably, a lucid presentation of esoteric argument. Dealing with the famed Platonic triad, Theaetetus, Sophist, and Statesman, Klein settles the dispute about the missing dialogue, "The Philosopher," by first denying that it is missing and second showing that it is unnecessary. He argues, in short, that the triad is a dyad. That argument is reinforced by the distinction Klein strongly implies between the Socratic Theaetetus and the Eleatic Sophist and Statesman. "We can now (...) understand why the conversations of the ‘trilogy’ occur in two, not three, days and why the Sophist, the Statesman, and the Philosopher are dealt with in two, not three, dialogues". (shrink)

ABSTRACT In genomic research the ideal standard of free, informed, prior and explicit consent is sometimes difficult to apply. This has raised concern that important genomic research will be restricted. Different consent procedures have therefore been proposed. This paper explicitly examines the question how, in genomic research, the principles of solidarity and justice can be used to justify forms of diminished individual control over personal data and bio‐samples. After a discussion of the notions of solidarity and justice and how they (...) can be related to health care and genomic research, we examine how and in which situations these notions can form a strong moral basis for demanding certain financial sacrifices. Then we examine when these principles can justify consent procedures which diverge from the ideal standard. Because much genomic research is not expected to lead to immediate (clinical) benefits we also discuss the question of whether we can be obliged to make any sacrifices for future (not yet existing) patients. We conclude with the formulation of a number of conditions that have to be met before autonomy sacrifices can be reasonably demanded in genomic research. (shrink)

This paper explores the relevance of the debate about ethical expertise for the practice of clinical ethics. We present definitions, explain three theories of ethical expertise, and identify arguments that have been brought up to either support the concept of ethical expertise or call it into question. Finally, we discuss four theses: the debate is relevant for the practice of clinical ethics in that it (1) improves and specifies clinical ethicists' perception of their expertise; (2) contributes to improving the perception (...) of moral competence of non-ethicists; (3) gives insight into complementary styles of argumentation of ethicists and non-ethicists; and (4) contributes to the awareness of the problem of profession-building of (clinical) ethicists. (shrink)

In this article, the question is discussed if and how Healthcare Ethics Committees (HECs) should be regulated. The paper consists of two parts. First, authors from eight EC member countries describe the status quo in their respective countries, and give reasons as to the form of regulation they consider most adequate. In the second part, the country reports are analysed. It is suggested that regulation of HECs should be central and weak. Central regulation is argued to be apt to improve (...) HECs’ accountability, relevance and comparability. To facilitate biomedical citizenship and ethical reflection, regulation should at the same time be weak rather than strict. Independence of HECs to deliberate about ethical questions, and to give solicited and unsolicited advice, should be supported and only interfered with by way of exception. One exception is when circumstances become temporary adversarial to ethical deliberation in healthcare institutions. In view of European unification, steps should be taken to develop consistent policies for both Eastern and Western European countries. (shrink)

The article at hand presents the results of a literature review on the ethical issues related to scientific authorship. These issues are understood as questions and/or concerns about obligations, values or virtues in relation to reporting, authorship and publication of research results. For this purpose, the Web of Science core collection was searched for English resources published between 1945 and 2018, and a total of 324 items were analyzed. Based on the review of the documents, ten ethical themes have been (...) identified, some of which entail several ethical issues. Ranked on the basis of their frequency of occurrence these themes are: 1) attribution, 2) violations of the norms of authorship, 3) bias, 4) responsibility and accountability, 5) authorship order, 6) citations and referencing, 7) definition of authorship, 8) publication strategy, 9) originality, and 10) sanctions. In mapping these themes, the current article explores major ethical issue and provides a critical discussion about the application of codes of conduct, various understandings of culture, and contributing factors to unethical behavior. (shrink)

Nanotechnology is a swiftly developing field of technology that is believed to have the potential of great upsides and excessive downsides. In the ethical debate there has been a strong tendency to strongly focus on either the first or the latter. As a consequence ethical assessments of nanotechnology tend to radically diverge. Optimistic visionaries predict truly utopian states of affairs. Pessimistic thinkers present all manner of apocalyptic visions. Whereas the utopian views follow from one-sidedly focusing on the potential benefits of (...) nanotechnology, the apocalyptic perspectives result from giving exclusive attention to possible worst-case scenarios. These radically opposing evaluations hold the risk of conflicts and unwanted backlashes. Furthermore, many of these drastic views are based on simplified and outdated visions of a nanotechnology dominated by self-replicating assemblers and nanomachines. Hence, the present state of the ethical debate on nanotechnology calls for the development of more balanced and better-informed assessments. As a first step in this direction this contribution presents a new method of framing the ethical debate on nanotechnology. Thus, the focus of this paper is on methodology, not on normative analysis. (shrink)

In diesem Beitrag diskutieren drei interdisziplinär ausgebildete Akademiker, die als klinisch tätige Ethiker auch viele Jahre Erfahrungen mit Gesundheitssystemen in verschiedenen Ländern haben, die Frage nach dem Kern klinisch-ethischer Expertise: der niederländische Mediziner und Philosoph Henk ten Have, Direktor des Center for Healthcare Ethics in Pittsburgh, USA, der deutsche Theologe und Philosoph Norbert Steinkamp, Professor für theologisch-ethische Grundlagen sozialprofessionellen Handelns an der katholischen Hochschule für Sozialwesen in Berlin, der 12 Jahre die klinische Ethik der Universitätsklinik Nijmegen, Niederlande, geleitet hat, sowie (...) der niederländische Philosoph und Historiker Bert Gordijn, Direktor des Institute of Ethics der Dublin City University, Irland, Präsident der International Association of Education in Ethics und u. a. Herausgeber von Medicine, Health Care and Philosophy. (shrink)

In this book, developed by a group of collaborating scholars in bioethics from different European countries, an overview is given of the most salient themes in present-day bioethics. The themes are discussed in order to enable the reader to have an in-depth overview of the state of the art in bioethics. Introductory chapters will guide the reader through the relevant dimensions of a particular area, while subsequent case discussions will help the reader to apply the ethical theories to specific clinical (...) problems and health policy queries. The book focuses on perspectives typical for the European context. This highlights not only particular bioethical themes such as social justice, choices in health care, and health policy (e.g., in post-communist countries), it also emphasizes specific approaches in ethical theory, in relation to Continental philosophies such as phenomenology and hermeneutics. Because of its articulation of what is typical for the European health care setting as well as for bioethical debate, this book is unique in comparison to existing textbooks in bioethics. The book is an introductory textbook acquainting the reader with the major issues in present-day health care as well as the various theoretical and practical approaches to clarify these issues. (shrink)

The development of “smart stadia”, i.e. the use of “smart technologies” in the way sports stadia are designed and managed, promises to enhance the experience of attending a live match through innovative and improved services for the audience, as well as for the players, vendors and other stadium stakeholders. These developments offer us a timely opportunity to reflect on the ethical implications of the use of smart technologies and the emerging Internet of Things (IoT). The IoT has the potential to (...) radically transform society and is representative of the ways that novel technologies will alter human life. We use Dublin’s Croke Park stadium smart project as a case study for examining the development of smart stadia. (shrink)

This paper analyses the concept of empirical ethics as well as three meta-ethical fallacies that empirical ethics is said to face: the is-ought problem, the naturalistic fallacy and violation of the fact-value distinction. Moreover, it answers the question of whether empirical ethics (necessarily) commits these three basic meta-ethical fallacies.

The volume contributes to the ongoing nanoethics debate in four topical areas. The first part tackles questions of what could be called ‘meta-nanoethics’. Its focus lies on basic concepts and the issue of what - if anything - is truly novel and special about the new field of nanoethics or its subject matter. The second part of this volume presents a selection of interesting perspectives on some of the opportunities and challenges of nanotechnology. Part three takes a more in depth (...) look at one of the most pressing current concerns: how to deal with the risks and uncertainties surrounding nanotechnology in a responsible manner. In its fourth and final part the volume touches on issues of public debate and policy. (shrink)

The objective of this article is to analyse and compare four methods of ethical case deliberation. These include Clinical Pragmatism, The Nijmegen Method of ethical case deliberation, Hermeneutic dialogue, and Socratic dialogue. The origin of each method will be briefly sketched. Furthermore, the methods as well as the related protocols will be presented. Each method will then be evaluated against the background of those situations in which it is being used. The article aims to show that there is not one (...) ideal method of ethical case deliberation, which fits to all possible kinds of moral problems. Rather, as each of the methods highlights a limited number of morally relevant aspects, each method has its strengths and weaknesses as well. These strengths and weaknesses should be evaluated in relation to different types of situations, for instance moral problems in treatment decisions, moral uneasiness and residue, and the like. The suggestion arrived at on the basis of the findings of this paper is a reasonable methodological plurality. This means that a method can be chosen depending on the type of moral problem to be deliberated upon. At the same time it means, that by means of a method, deliberation should be facilitated. (shrink)

In genomic research the ideal standard of free, informed, prior, and explicit consent is believed to restrict important research studies. For certain types of genomic research other forms of consent are therefore proposed which are ethically justified by an appeal to the common good. This notion is often used in a general sense and this forms a weak basis for the use of weaker forms of consent. Here we examine how the notion of the common good can be related to (...) individual health, health care, and genomic research and we use this analysis to propose more precise criteria to justify forms of consent which diverge from the ideal standard. (shrink)

The _Platform Sutra_ records the teachings of Hui-neng, the Sixth Patriarch, who is revered as one of the two great figures in the founding of Ch'an (Zen) Buddhism. This translation is the definitive English version of the eighth-century Ch'an classic. Phillip B. Yampolsky has based his translation on the Tun-huang manuscript, the earliest extant version of the work. A critical edition of the Chinese text is given at the end of the volume. Dr. Yampolsky also furnishes a lengthy and detailed (...) historical introduction which contains much information hitherto unavailable even to scholars, and provides the context essential to an understanding of Hui-neng's work. He gives an account of the history and legends of Ch'an Buddhism, with particular attention to the traditions associated with Hui-neng, quoting or summarizing the most important narratives. He then discusses the various texts of the _Platform Sutra_, and analyzes its contents. (shrink)

Solidarity belongs to the basic principles of Catholic Social Teaching (CST) and is part of the ethical repertoire of European moral traditions and European healthcare systems. This paper discusses how leaders of Catholic healthcare organizations (HCOs) can understand their institutional moral responsibility with regard to the preservation of solidarity. In dealing with this question, we make use of Taylor's philosophy of modern culture. We first argue that, just as all HCOs, Catholic ones also can embody and strengthen solidarity by just (...) doing their quintessential job, that is, to care for people with ill health. Second, we focus on the Catholic identity of these organizations and argue that this characteristic can empower a radical commitment to solidarity. Finally, we argue that CST provides a critical ethical framework for approaching solidarity from the perspective of the common good. (shrink)

The field of medicine is generally greeted with great enthusiasm. This can be witnessed in the immense support for medical progress, which is widely hoped to lead to a realization of idealized goals. Indeed, with the help of medicine the human body would be controllable and constructible, human nature perfectible. However, enthusiasm in favor of medical progress is first and foremost a sentiment and, like all sentiments, not necessarily a product of rational contemplation. People are capable of enthusing about the (...) realization of utopian notions, such as life without disease or with the perfect body, without requiring any concrete arguments to back them up. Enthusiasm alone is not a guarantee of ethical desirability, however. Hence, this book takes a closer look at four research fields often referred to in medical utopian literature: 'tissue engineering', 'bioelectronics', 'germ line genome modification' and 'interventions in the biological aging process'. They serve as a basis for analyzing whether ethical arguments can be found to support the euphoric advocacy of the further development of these fields. (shrink)

Geoengineering as a technological intervention to avert the dangerous climate change has been on the table at least since 2006. The global outreach of the technology exercised in a non-encapsulated system, the concerns with unprecedented levels and scales of impact and the overarching interdisciplinarity of the project make the geoengineering debate ethically quite relevant and complex. This paper explores the ethical desirability of geoengineering from an overall review of the existing literature on the ethics of geoengineering. It identifies the relevant (...) literature on the ethics of geoengineering by employing a standard methodology. Based on various framing of the major ethical arguments and their subsets, the results section presents the opportunities and challenges at stake in geoengineering from an ethical point of view. The discussion section takes a keen interest in identifying the evolving dynamics of the debate, the grey areas of the debate, with underdeveloped arguments being brought to the foreground and in highlighting the arguments that are likely to emerge in the future as key contenders. It observes the semantic diversity and ethical ambiguity, the academic lop-sidedness of the debate, missing contextual setting, need for interdisciplinary approaches, public engagement, and region-specific assessment of ethical issues. Recommendations are made to provide a useful platform for the second generation of geoengineering ethicists to help advance the debate to more decisive domains with the required clarity and caution. (shrink)