Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction and the assignment of responsibilities . This theoretical (...) framework prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as ‘intentionally taking the life of another person by a physician, upon that person’s request’ can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (shrink)

Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction and the assignment of responsibilities. This theoretical framework (...) prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as ‘intentionally taking the life of another person by a physician, upon that person’s request’ can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction. (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.

Genetic engineering evokes a number of objections that are not directed at the negative effects the technique might have on the health and welfare of the modified animals. The concept of animal integrity is often invoked to articulate these kind of objections. Moreover, in reaction to the advent of genetic engineering, the concept has been extended from the level of the individual animal to the level of the genome and of the species. However, the concept of animal integrity was not (...) developed in the context of genetic engineering. Given this external origin, the aim of this paper is to critically examine the assumption that the concept of integrity, including its extensions to the level of the genome and the species, is suitable to articulate and justify moral objections more specifically directed at the genetic engineering of animals. (shrink)

We investigated the influence of the compatibility between mood and decision strategies on the subjective value of a decision outcome. Several studies have provided evidence for the idea that a sad mood induces people to analyse information carefully, probably fitting well with a deliberative decision strategy. In a happy mood, people tend to act more strongly on their feelings, probably fitting well with an intuitive decision strategy. However, sometimes the situation demands the use of decision strategies that seem incompatible with (...) mood states. We expected that decision makers would value a decision outcome higher in the case of a fit between mood and decision strategy than in the case of a non-fit. After a mood manipulation, participants were instructed to decide either based on their first affective reaction or after deliberation. Results confirmed our expectations: fitting decisions enhanced the subjective value of a decision outcome. (shrink)

Health technology assessment (HTA) is often biased in the sense that it neglects relevant perspectives on the technology in question. To incorporate different perspectives in HTA, we should pursue agreement about what are relevant, plausible, and feasible research questions; interactive technology assessment (iTA) might be suitable for this goal. In this way a kind of procedural ethics is established. Currently, ethics too often is focussed on the application of general principles, which leaves a lot of confusion as to what really (...) is the matter in specific cases; in an iTA clashes of values should not be approached by use of such ethics. Instead, casuistry, as a tool used within the framework of iTA, should help to articulate and clarify what is the matter, as to make room for explication and consensus building. (shrink)

Health technology assessment (HTA) is often biased in the sense that it neglects relevant perspectives on the technology in question. To incorporate different perspectives in HTA, we should pursue agreement about what are relevant, plausible, and feasible research questions; interactive technology assessment (iTA) might be suitable for this goal. In this way a kind of procedural ethics is established. Currently, ethics too often is focussed on the application of general principles, which leaves a lot of confusion as to what really (...) is the matter in specific cases; in an iTA clashes of values should not be approached by use of such ethics. Instead, casuistry, as a tool used within the framework of iTA, should help to articulate and clarify what is the matter, as to make room for explication and consensus building. (shrink)

From 1991 to 1994 the Dutch Health Insurance Council financed research on Extracorporeal Membrane Oxygenation (ECMO). This is a technique for providing cardiopulmonary bypass to patients with pulmonary and/or cardiac failure. Most often, these patients are premature neonates. During ECMO, blood is drained from the right atrium, pumped along a membrane where gas exchange takes place, and then redirected to the aorta. To prevent blood clotting, heparin is added. However, with the heparin added, the risk of hemorrhage is considerably increased. (...) Therefore, both the chance of surviving and the chance of severe disability are higher with ECMO than with conventional treatment (i.e., ventilator support). (shrink)

The social and legal implications of forensic DNA are paramount. For this reason, forensic DNA enjoys ample attention from legal, bioethics, and science and technology studies scholars. This article contributes to the scholarship by focusing on the neglected issue of sameness. We investigate a forensic courtroom case which started in the early ’90s and focus on three modes of making similarities: creating equality before the law, making identity, and establishing standards. We argue that equality before the law is not merely (...) a principle but a practice. In the context of DNA research, equality refers to using standardized technology and procedures to identify the criminal suspect. Our case shows the work at stake in introducing a new technology into the courtroom and serves as a lens, magnifying how contingencies and uncertainties are managed and ordered in everyday court practices to arrive at an equal treatment of the suspect. (shrink)

De Vries' mutation theory has not stood the test of time. The supposed mutations of Oenothera were in reality complex recombination phenomena, ultimately explicable in Mendelian terms, while instances of large-scale mutations were found wanting in other species. By 1915 the mutation theory had begun to lose its grip on the biological community; by de Vries' death in 1935 it was almost completely abandoned. Yet, as we have seen, during the first decade of the present century it achieved (...) an enormous popularity. As this paper has tried to suggest, one of the principal reasons for this was that de Vries' theory served as a banner around which a whole crowd of disaffected Darwinians or anti-Darwinians could rally. However, not all of those who favored de Vries did so for quite the same reasons. Underlying the multitude of views ran several common threads: a dissatisfaction with current Darwinian theory born out of misunderstanding natural selection, a general misunderstanding of the nature of species, and a prejudice against speculative, nontestable theories in biology.Supporters of de Vries were not the only opponents of Darwinism, nor was the mutation theory the only alternative to natural selection. In the early twentieth century a number of theories had been proposed to explain away the problems which Darwin had left unsolved. There was the idea of orthogenesis, championed by the American paleontologists Cope, Osborn and others; organic selection (or orthoplasy) was championed by M. M. Baldwin and C. Lloyd Morgan; there were the concepts of convergent evolution proposed by Hermann Friedmann, the theory of physiological selection by John George Romanes, and the concepts of reproductive divergence by H. M. Vernon. Virtually none of these men either accepted or were strong supporters of the de Vriesian theory, for each had his own particular ‘ism” to advocate as the major factor in evolution. The existence of a large number of such theories, each purporting to be the explanation, was characteristic of evolutionary theory at the turn of the century. It is to a large extent the emphasis on such fragmentary concepts that retarded development of the comprehensive theory of evolution which emerged in the 1920's and 1930's. For the historian, however, a study of these alternative theories is instructive in trying to understand the inherent difficulties which Dawwinian theory posed to biologists at the time. De Vries' mutation theory serves historically as a mirror to reflect the critical mood of a generation hostile to the theory of natural selection.It has often been claimed that it was impossible to understand the mechanism of natural selection until it could be placed in genetic and mathematical terms. It is certainly true that great strides have been made in population genetics and the treatment of evolutionary concepts with mathematical tools in the last forty years. But the very people who developed the genetical and mathematical approach to evolution were already convinced of the essential correctness of Darwinian theory before they started. Advances in an understanding of Mendelian heredity aided greatly in solving one important issue for evolutionists: the origin of variations. And the rigor with which selection acted could best be studied by observing changes in gene frequencies (calculated mathematically) over a number of generations. But as this paper has shown, two of the basic problems which biologists faced in evaluating Darwinian theory at the turn of the century-the nature of species, and the criteria of what constituted an acceptable explanation in biological science-could not be answered directly by mathematics. What mathematical and genetical theory did do was to help convince the skeptics of the validity of the Darwinian proposition.The change in explanatory criteria which many hailed as de Vries' most important contribution to evolutionary theory seems to have been part of a general emergence of twentieth-century biology from the domination of theorizers in the nineteenth. It also marked the emergence of America from the domination of biological, and particularly evolutionary, influence of Europeans. The change occurred in three areas: in the kinds of questions asked: testable versus non-testable; in the kind of data sought: quantitative versus qualitative; and in the kinds of theories proposed: analytical and reductive—the attempt to see complex processes in terms of simpler components-as opposed to synthetic and speculative. Although ultimately wrong in his idea, de Vries and his theories rode high on the wave of “experimentalism” which was the harbinger of a new era in evolutionary theory. (shrink)

It is argued that de Vries did not see Mendel's paper until 1900, and that, while his own theory of inheritance may have incorporated the notion of independent units, this pre-Mendelian formulation was not the same as Mendel's since it did not apply to paired hereditary units. Moreover, the way in which the term ‘segregation’ has been applied in the secondary literature has blurred the distinction between what is explained and the law which facilitates explanation.

SummaryIt is argued that Hugo de Vries's conversion to Mendelism did not agree with his previous theoretical framework. De Vries regarded the number of offspring expressing a certain character as a hereditary quality, intrinsic to the state of the pangene involved. His was a shortlived conversion since after the ‘rediscovery’ he failed to unify his older views with Mendelism. De Vries was never very much of a Mendelian. The usual stories of the Dutch ‘rediscovery’ need, therefore, a (...) considerable reshaping. (shrink)

A great deal is known about the technical issues surrounding the introduction of Hugo De Vries's mutation theory and the subsequent development of the modern genetical theory of natural selection. But so far little has been done to relate these events to the wider issues of the time. This article suggests that extra-scientific factors played a significant role, and substantiates this by comparing De Vries's respect for the original Darwinian spirit with Thomas Hunt Morgan's use of the mutation (...) theory as part of an attack on the whole philosophy of Darwinism. In particular, it is argued that Morgan's attitude was dictated by his moral objections to the picture of a world dominated by struggle. (shrink)

The Dutch philosopher of religion Hent de Vries has explored and complicated the boundaries between religion and modern thought in order to create the space for an innovative “minimal theology.” This article reconstructs de Vries's interpretation of the changes in Theodor W. Adorno's thought between Dialectic of Enlightenment and Negative Dialectics in order to demonstrate its fecundity for a philosophical account of otherness. It also examines and defends de Vries's own rhetorical mode of reading texts as an (...) exemplary approach to philosophical dialogue. Finally, however, the essay challenges de Vries's privileging of the religious as the site of ethical relationality and his intentional bracketing of Adorno's critical social theory. (shrink)

Hugo de Vries claimed that he had discovered Mendel's laws before he found Mendel's paper. De Vries's first ratios, published in 1897, for the second generation of hybrids were 2/3:1/3 and 80%:20%. By 1900, both of these ratios had become 3:1. These changing ratios suggest that as late as 1897 de Vries had not discovered the laws, although he asserted, from 1900 on, that he had found the laws in 1896. An Appendix details de Vries's Mendelian (...) experiments as described in the original edition of volume two of Die Mutationstheorie, but omitted entirely from the English translation. (shrink)

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)

The Dutch philosopher of religion Hent de Vries has explored and complicated the boundaries between religion and modern thought in order to create the space for an innovative “minimal theology.” This article reconstructs de Vries's interpretation of the changes in Theodor W. Adorno's thought between Dialectic of Enlightenment and Negative Dialectics in order to demonstrate its fecundity for a philosophical account of otherness. It also examines and defends de Vries's own rhetorical mode of reading texts as an (...) exemplary approach to philosophical dialogue. Finally, however, the essay challenges de Vries's privileging of the religious as the site of ethical relationality and his intentional bracketing of Adorno's critical social theory. (shrink)

Love, sex, and physical intimacy are some of the most desired goods in life and they are increasingly being sought on dating apps such as Tinder, Bumble, and Badoo. For those who want a leg up in the chase for other people’s attention, almost all of these apps now offer the option of paying a fee to boost one’s visibility for a certain amount of time, which may range from 30 min to a few hours. In this article, I argue (...) that there are strong moral grounds and, in countries with laws against unconscionable contracts, legal ones for thinking that the sale of such visibility boosts should be regulated, if not banned altogether. To do so, I raise two objections against their unfettered sale, namely that it exploits the impaired autonomy of certain users and that it creates socio-economic injustices. (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.

ABSTRACTIn 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 , 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)

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)

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)

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)

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)

The almost simultaneous and overlapping discoveries of Mendel's forgotten work by Hugo de Vries, Carl Correns, and Erik von Tschermak gave rise to an intense rivalry, some jealousy, and more than a little illfeeling. De Vries, the first to announce the discovery, has been subjected to the charge that he wished to conceal his discovery and to obtain for himself the credit for having discovered what we now call Mendelism. This charge involves the statement that de Vries (...) gave credit to Mendel only after he had found that others had also read Mendel's papers. The evidence on which this charge is based is sketchy, and we can now show that at least that portion of it that is based on supposed alteration in the proof of de Vries' paper in the Berichte is without foundation. Unfortunately, de Vries gave three different accounts of how he was led to Mendel's work. Two of these involve Liberty Hyde Bailey.Bailey had listed Mendel's papers in a bibliography that he published in 1892 in The Rural Library. Bailey did not include this bibliography in the first edition (1895) of Plant Breeding or in its reprinting in 1896 and 1897. He did include the bibliography in the second edition (1902), but this was after de Vries and others had called attention to Mendel. In 1899, both Bailey and de Vries gave papers at the Hybrid Conference held at Chiswick, England, but we have no record of their having discussed Mendel. What evidence we have indicates that, at this time, neither of them had read Mendel's papers.De Vries wrote to Bailey that it was Bailey's listing of Mendel in the bibliography published in The Rural Library that led to his discovery of Mendel. Later, de Vries wrote to H. F. Roberts that he had first found a reference to Mendel in Bailey's Plant Breeding of 1895, where the bibliographic reference to Mendel's papers was not published. Finally, de Vries told Th. J. Stomps, who succeeded him at the University of Amsterdam, that he had first learned of Mendel early in 1900 from a reprint of Mendel's paper sent him by his friend Professor M. W. Beyerinck. Our present evidence favors Stomp's account as it shows that de Vries had not read Mendel's papers in 1899 but had early in 1900.Attempts to pinpoint de Vries' discovery of Mendel are aided in part, and in part confused, by the fact that he published five relevant papers in 1900. These papers were in press simultaneously, and some of them were altered in proof. Further confusion is due to the fact that at least three of them were published in the reverse order of their acceptance for publication. Unfortunately we do not have the crucial dates for all of the papers.J. Roy. Hort. Soc. 24: 69–75. A definitely pre-Mendelian paper given on 11 July 1899, and published in 1900 (possibly in April). The evidence for an alteration in proof after de Vries had read Mendel is shown by the fact that de Vries described a ratio of 99 to 54 as a 3 to 1 ratio.Rev. gén. botan. 12: 129–137. A Mendelian paper, giving the 3 to 1 ratio in the F2 generation of a cross between starchy and sugary corn. The paper is not dated by de Vries but it was published in the volume, 128 pages ahead of a paper de Vries dated 19 March. In a footnote, de Vries cites a paper by Correns that was published on 25 January, so we can tell that it was written or corrected in proof after this date. Here Correns showed de Vries that he had already read Mendel's paper. Any attempt by de Vries to ignore Mendel or get credit for Mendelism after 25 January would have been senseless. This date was nearly two months before de Vries' Berichte paper was submitted for publication.Ber. deut. botan. Ges. 18: 83–90. Accepted for publication 14 march, published 25 April. This paper gives Mendel full credit and stimulated the publications of Correns and von Tschermak. As de Vries was aware that Correns already knew of Mendel when the paper was first submitted, there was no occasion to alter it in proof.Rev. gén. botan. 12: 257–271. Dated by de Vries 19 March, but the proof was read after June. De Vries cites von Tschermak's paper in the Berichte that was published in June. The Revue paper is a Mendelian paper, and Mendel is cited on the last page.C. R. Acad. Sci. (Paris) 130: 845–847. Accepted for publication 26 March 1900. Reprint received by Correns 21 April. Mendel is not mentioned but de Vries' use of terms told Correns that de Vries had read Mendel's paper. First of the papers to be published, it caused Correns to assume that de Vries wanted the credit that was due Mendel.The three discoverers of Mendel did not form a mutual admiration society. (shrink)