Moral purism is a commonly held view on moral worthiness and how to identify it in concrete cases. Moral purists long for a moral world in which (business) people—at least sometimes—act morally worthy, but in concrete cases they systematically discount good deeds as grounded in self-interest. Moral purism evokes moral cynicism. Moral cynicism is a problem, both in society at large and the business world. Moral cynicism can be fought by refuting moral purism. This article takes issue with moral purism. (...) The common strategy to tackle moral purism is to reject the exclusion thesis which states that self-interest and the ‘pure’ moral motive (and thus moral worthiness) exclude each other. We develop a different strategy. We argue that moral purists are mistaken in the way they judge moral worthiness in concrete cases. They employ the wrongprocedureand the wrongcriteria.We develop a proper procedure and proper criteria. We build on Kant, who we argue is unfairly regarded as the champion of moral purism. In order to see how Kant can develop a consistent (non-purist) philosophy, the exclusion thesis must be embedded in Kant’s transcendental philosophy. Properly embedded, Kant turns out to be both anti-purist and anti-cynical. (shrink)

For years business ethics has limited the moral duties of enterprises to negative duties. Over the last decade it has been argued that positive duties also befall commercial agents, at least when confronted with large scale public problems and when governments fail. The argument that enterprises have positive duties is often grounded in the political nature of commercial life. It is argued that agents must sometimes take over governmental responsibilities. The German republican tradition argues along these lines as does Nien-Hé (...) Hsieh. Agents in commercial life are bound by positive duties because at some point they become citizens that must take on the responsibilities of the state. In this paper we leave undisputed the claim that corporations must acknowledge positive duties. However, we demonstrate that the political grounding fails, at least in the sense that this theory insufficiently acknowledges a long standing liberal tradition that vindicates apolitical markets and clear borderlines between politics and economics. We carve out an alternative route to the grounding of one specific positive duty—the duty to further justice. Our argument is based on the moral nature of commercial agents and tries to demonstrate that the duty to further justice ensues from liberalism. Taking a Kantian perspective, it conceptualizes the duty to further justice as a moral duty, orientated toward the political domain. It is grounded in the obligation to attain moral autonomy in the civil condition. (shrink)

'Corporate Social Responsibility (CSR) is conceptualized in many ways. We argue that one cannot be indifferent about the issue of its conceptualization. In terms of methodology, our position is that any conceptual discussion must embed CSR in political theory. With regard to substance, we link up with the discussion on whether CSR must be defined on the basis of a tripartite or a quadripartite division of business responsibilities. We share A. B. Carroll's intuition that a quadripartite division is called for (...) as a basis to define CSR. However, defending the quadripartite division of business responsibilities requires that the distinctions between economic, legal, ethical and discretionary business responsibilities be made intelligible. Carroll's account is defective in this respect. We argue that contemporary Neo-Kantian political ethics is able to make sense of these distinctions, because of its specific interpretation of liberalism. Interestingly, from a conventional liberal perspective this interpretation of liberalism is atypical, as it extends public morality beyond the domain of the law. (shrink)

This paper provides an empirical case study of the relationship between corporate social responsibility (CSR) and the new competition regulation in the Netherlands. The leading question in this case study is whether the new institutional arrangement has allowed for the possibility that reasonable exceptions can be made to the principle that inter-firm cooperation is prohibited. That is to say: does the new institutional arrangement allow for the possibility of 'well organized but not 'perfect' markets'? The investigation focuses on the Netherlands, (...) which constitutes an exemplary case as the Dutch are committed to both strengthen the competitiveness of the market and allow for exceptions on behalf of non-economic values such as CSR. The authors expect that the Dutch context will prevent a doctrinal and categorical rejecting of any good argument to make an exception to the rule that inter-firm cooperation must be prohibited. (shrink)

This chapter deals with the question to what extent market participants can have moral responsibilities. It starts with a discussion on the nature of responsibility, and then raises the question whether organizations, such as companies can bear responsibility (at all). While some philosophers have been skeptical, we list some reasons to think that companies can be moral agents. Subsequently, we discuss whether companies actually should assume moral responsibilities. There are a number of commonly heard arguments about why companies should or (...) may not be bothered with moral responsibilities: i. the market is an amoral sphere, and ii. the only responsibility that companies have is to increase their profits. We describe the problems with these arguments, and discuss the concept of minimal market morality. This concept describes the minimally required moral responsibilities that companies need to abide by. (shrink)

The Heidelberg Catechism was one of many catechisms that originated during the 16th-centuryReformation. It is also known that the authors of the Heidelberg Catechism made use of existingcatechisms. The content of 16th-century catechisms consisted mainly of the Decalogue, theApostolicum and the Lord’s Prayer. The Heidelberg Catechism starts with the famousintroduction, dealing with man’s only comfort, and in three sections with knowledge of our sinand misery, knowledge of our deliverance, and knowledge of how we should be grateful forour deliverance. This contribution (...) points out that the threefold structure of the HeidelbergCatechism is not unique, but appeared in different ways in different catechisms of prominent16th-century reformers. It is also argued that the Heidelberg Catechism should be read againstLutheran and Calvinistic backgrounds. Finally, it is shown that the Heidelberg Catechismarticulated the basic Christian faith in such a beautiful and poignant manner that it stood thetest of time as a catechism and confession. (shrink)

In latter-day discussions on corporate morality, duties of commission are fiercely debated. Moral institutionalists argue that duties of commission—such as a duty of assistance—overstep the boundaries of moral duty owed by economic agents. " Moral institutionalism" is a newly coined term for a familiar position on market morality. It maintains that market morality ought to be restricted, excluding all duties of commission. Neo-Classical thinkers such as Baumol and Homann defend it most eloquently. They underpin their position with concerns that go (...) to the core of liberalism—the dominant western political theory that sustains the ideals of both the free market and the free, rational person. Those authors claim that liberalism calls for a fully differentiated market because it resents the politicization of the market. Fully differentiated markets exclude duties of commission. They also claim that full differentiation of the market closes the troublesome gap between moral motivation and moral virtue. Full differentiation redeems the promise of "easy virtue". In this paper moral institutionalism will be rejected from a Kantian point of view, mostly inspired by Herman's thesis on the invisibility of morality. Liberalism may perhaps ban the politicization of the market; it does not forbid its moralization. The idea of a fully differentiated market must also be rejected because it is either morally over-demanding (to the morally autonomous person) or morally hazardous (to the person with failing moral motivation). Contrary to what the moral institutionalists claim, right action, morally, is actually quite difficult in fully differentiated markets. (shrink)

Periodic attacks of uncertain origin, where the clinical presentationresembles epilepsy but there is no evidence of a somatic disease, arecalled Pseudo-Epilepsy or Pseudo-Epileptic Attack Disorder (PEAD). PEADmay be called a `non-disease', i.e. a disorder on the fringes ofestablished disease patterns, because it lacks a rationalpathophysiological explanation. The first aim of this article is tocriticize the idea, common in medical science, that diseases are realentities which exist separately from the patient, waiting to bediscovered by the doctor. We argue that doctor and (...) patient construct adisease, and that the construction of the disease PEAD includes manynormative evaluations. The second aim is to provide insight into thesuffering of patients with PEAD. We focus on three aspects of thepatient, identity, autonomy and responsibility. We present somecharacteristic descriptions of (pseudo-)epileptic attacks by FjodorDostoevsky, Gustave Flaubert and Thomas Mann. We argue that diagnosingPEAD reduces a meaningful life event into an insignificant, thoughintriguing, medical phenomenon, and that the patient will not benefitfrom being diagnosed as having PEAD. (shrink)

As Socially Responsible Investment (SRI) enters the mainstream of professional and institutional investment practice, some perplexities arise. Some SRI market participants are well schooled in finance but are hesitative as to how to apply non-financial criteria in the management of portfolios. Governments too are giving SRI more attention and, in some countries, are discussion whether and how to regulate the SRI market. Advocacy groups are targeting SRI projects through media campaigns using political discourse. Many of the pertinent questions that come (...) with these perplexities are of the philosophical or ethical type and concern legitimisation, demarcation of responsibilities, interpretation of norms and policy formulation. The inclusion of non-financial criteria into investment decision-making leads to a 'puzzle in SRI' for which this article offers a solution. The puzzle arises when the day-to-day implementation of an SRIpolicy coincides with the process of administering justice. Three questions make up that puzzle: (1) what should an investor do when allegations arise about a corporation, (2) what should an investor do when a corporation is brought before a court, (3) what should an investor do when a corporation is found guilty by a court. This article argues, by distinguishing between the rationality of the investor and that of the judge, that allegations, court cases or court verdicts should not be reasons to disinvest from a corporation. This article offers examples from investor practice and points out in which way allegations, court cases and court verdicts make sense for investor behaviour. (shrink)

Many prominent arguments for epistemic relativism take their departure from the observation that a certain kind of epistemic symmetry is present in particular empirical cases. In this paper, we seek to attain further clarity about the kind of symmetry at issue, and the sort of relativism to which such symmetry can reasonably be taken to give rise. The need for such an investigation is made apparent, we believe, by the fact that prominent anti-relativist arguments such as that advanced by Boghossian (...) in his influential book Fear of Knowledge (2006) yield distorted pictures of the matter. Following Boghossian, we present our argument through a detailed consideration of the dispute between Bellarmine and Galileo concerning heliocentrism. Contrary to what Boghossian claims, the relevant sort of symmetry does not concern a difference in fundamental epistemic principles between Bellarmine and Galileo, but rather a much more localized difference in procedures for adjudication between shared principles in the novel epistemic circumstances generated by Galileo's telescopic observations. Bellarmine and Galileo advance fundamentally different procedures of adjudication that are nevertheless equally rational. The upshot is not so much the denial that there are absolute epistemic facts as such, as Boghossian thinks, but rather the denial that there is an absolute fact of the matter as to which was the most rational way to proceed: Bellarmine's or Galileo's. What this gives us, is the denial that there is a certain kind of absolute epistemic fact. (shrink)

One of the essential parts within the transition towards sustainable economies, is the way how higher education prepares its students for their future role in business. In order for them to contribute to corporate social responsibility within the enterprise context, they need specific skills and competences related to sustainable development. Derived from the societal role of business schools in preparing the future business leaders and entrepreneurs, the focus of this paper is the participation in, and the contribution of business schools (...) to the issues of efficiency measures for sustainability. This topic could be wider situated within the context of higher education for sustainable development, which aims at integrating competences for sustainable development into the curriculum, and integrating sustainability measures within campus operations, research and societal role. The paper furthermore looks at a business school context as a case for institutional efficiency measures. The paper describes how business schools could implement efficiency measures and apply instruments within their own context, looking at the campus as a ‘living laboratory’ for sustainability innovation. The paper describes how tools and instruments to foster sustainability integration are applied on campus, its benefits and possible problems. The paper focuses on the application of three instruments: Assessment Instrument for Sustainability in Higher Education; Ecological Footprint Analysis; and Principles for Responsible Management Education. It builds upon the data and results from several action research projects within two Belgian business schools. As a conclusion, the paper will reflect upon the essential characteristics of these initiatives, as a way to enhance efficiency measures for sustainability both within the business school itself, as within a wider business context. (shrink)

Ecological footprint analysis has been used worldwide in a variety of organizations educational institutions) and at different levels organizations, cities, regions, countries). Universities also calculated their ecological footprints, for various reasons: e.g. to answer the societal appeal to integrate sustainability into their core business, to perform a sustainability assessment of their operations, to use as an educational tool with students, to use for policy development. In general, performing an ecological footprint analysis is a way for higher education to ‘practice what (...) they preach’, to monitor sustainability performance and raise awareness among the university's community. This article focuses on the calculation of the ecological footprint and discusses the possibilities to use this tool for campus operations, educational purposes and policy development. (shrink)

Several attempts to conceptualize farm animal welfare have been criticized for diverging reasons, among them often the failure to incorporate the public concern and opinion. This paper’s objective is to develop a conception of farm animal welfare that starts from the public’s perception and integrates the opinion of different stakeholder representatives, thus following a fork-to-farm approach. Four qualitative citizen focus group discussions were used to develop a quantitative questionnaire, which has been completed by a representative sample of Flemish citizens ( (...) n = 459). Exploratory and confirmatory factor analyses were applied to develop a conception of farm animal welfare starting from an extended list of aspects that relate to animal production and associate with farm animal welfare in the public’s perception. In depth interviews with stakeholder representatives were used to match and adapt the structure of the animal welfare conception model. The resulting conception revealed seven dimensions grouped in two different levels. Three dimensions were animal-based: “Suffering and Stress,” “Ability to Engage in Natural Behavior,” and “Animal Health.” Four dimensions were resource-based: “Housing and Barn climate,” “Transport and Slaughter,” “Feed and Water,” and “Human-Animal Relationship.” This conception is distinct from earlier attempts since it is based on public perceptions; it addresses the opinion of different stakeholders, and it distinguishes empirically between animal-based and resource-based dimensions in the conceptualization of farm animal welfare. The relevancy of a popular definition is supported by the present demand oriented economy, in which animal welfare is a non-trade concern, and mainly left to the market where consumers still mainly act as individuals who calculate and weigh pros and cons. (shrink)

Research regarding the drivers of acceptance of clinical decision support systems by physicians is still rather limited. The literature that does exist, however, tends to focus on problems regarding the user-friendliness of CDSS. We have performed a thematic analysis of 24 interviews with physicians concerning specific clinical case vignettes, in order to explore their underlying opinions and attitudes regarding the introduction of CDSS in clinical practice, to allow a more in-depth analysis of factors underlying acceptance of CDSS. We identified three (...) general themes from the results. First, ‘the perceived role of the AI’, including items referring to the tasks that may properly be assigned to the CDSS according to the respondents. Second, ‘the perceived role of the physician’, referring to the aspects of clinical practice that were seen as being fundamentally ‘human’ or non-automatable. Third, ‘concerns regarding AI’, including items referring to more general issues that were raised by the respondents regarding the introduction of CDSS in general and/or in clinical medicine in particular. Apart from the overall concerns expressed by the respondents regarding user-friendliness, we will explain how our results indicate that our respondents were primarily occupied by distinguishing between parts of their job that should be automated and aspects that should be kept in human hands. We refer to this distinction as ‘the division of clinical labor.’ This division is not based on knowledge regarding AI or medicine, but rather on which parts of a physician’s job were seen by the respondents as being central to who they are as physicians and as human beings. Often the respondents’ view that certain core parts of their job ought to be shielded from automation was closely linked to claims concerning the uniqueness of medicine as a domain. Finally, although almost all respondents claimed that they highly value their final responsibility, a closer investigation of this concept suggests that their view of ‘final responsibility’ was not that demanding after all. (shrink)

Bundel essays over de invloed van de Duitse filosoof (1844-1900) op diverse cultuuruitingen.

The European Corporate Sustainability Framework (ECSF) is, among other concepts, based on a phase-wise development approach as described by Clare Graves' Levels of Existence Theory. As much as corporate sustainability has a sequence of adequate interpretations, aligned with each development level, also the notion of business excellence can be defined at multiple levels, as this paper demonstrates. Furthermore, the authors analyze the current EFQM Excellence Model for particular biases towards various development levels and suggest a new and innovative two-step approach (...) to assessing organizational performance with respect to organizational excellence (OE) and corporate sustainability. According to the organization's ambition, the assessment is either limited to a shareholder approach, mainly focusing at optimal usage of resources, or it also includes an additional assessment format based on the stakeholder approach, with specific reference to the organization's performance on the financial, social and ecological bottom line. This paper demonstrates the need and feasibility of an EFQM-Based assessment tool with a combined focus on corporate sustainability and OE. (shrink)

Thematisch of per periode geordend overzicht van de westerse filosofieën vanaf de 15e eeuw.

Handboek over de rol van betekenisgeving in organisaties en sociale relaties.

Over the past 20 years business ethics in Europe witnessed a remarkable growth. Today business ethics is faced with two challenges. The first comes from the social sciences and consultants who have both reclaimed the topics of business ethics, regretfully often at the loss of the proper ethical perspective. The second comes from the remarkable rise of corporate social responsibility which has pushed aside the mainstream business ethics methodology with its emphasis on moral deliberation by the individual. These challenges can (...) be tackled by an institutional transformation in business ethics that links up to the long-standing European tradition of institutional analysis of the market. The second remedy is an enlargement of the research agenda in business ethics by coming closer to other parts of applied ethics where the business ethics view is at this moment grossly neglected. (shrink)

BackgroundA patient who fulfils the due diligence requirements for euthanasia, and is medically suitable, is able to donate his organs after euthanasia in Belgium, the Netherlands and Canada. Since 2012, more than 70 patients have undergone this combined procedure in the Netherlands. Even though all patients who undergo euthanasia are suffering hopelessly and unbearably, some of these patients are nevertheless willing to help others in need of an organ. Organ donation after euthanasia is a so-called donation after circulatory death (DCD), (...) Maastricht category III procedure, which takes place following cardiac arrest, comparable to donation after withdrawal of life sustaining therapy in critically ill patients. To minimize the period of organ ischemia, the patient is transported to the operating room immediately after the legally mandated no-touch period of 5 min following circulatory arrest. This means that the organ donation procedure following euthanasia must take place in the hospital, which appears to be insurmountable to many patients who are willing to donate, since they already spent a lot of time in the hospital. Case presentationThis article describes the procedure of organ donation after euthanasia starting at home (ODAEH) following anesthesia in a former health care professional suffering from multiple system atrophy. This case is unique for at least two reasons. He spent his last conscious hours surrounded by his family at home, after which he underwent general anaesthesia and was intubated, before being transported to the hospital for euthanasia and organ donation. In addition, the patient explicitly requested the euthanasia to be performed in the preparation room, next to the operating room, in order to limit the period of organ ischemia due to transport time from the intensive care unit to the operating room. The medical, legal and ethical considerations related to this illustrative case are subsequently discussed.ConclusionsOrgan donation after euthanasia is a pure act of altruism. This combined procedure can also be performed after the patient has been anesthetized at home and during transportation to the hospital. (shrink)

Many authors have argued that the core of evolutionary biology as represented by the catchphrase 'The fittest survive' is tautological. Concerning the fitness concept of population genetics it is easy to rebut this charge by a proper explication of the term 'survival'. In biology and in the philosophy of biology, various fitness concepts over and above that of population genetics have been elaborated. These concepts, which are called 'supervenient' by some philosophers, have a limited usefulness. On some interpretations they do (...) lead to unacceptable tautologies and circular reasoning. The so-called propensity concept of fitness is problematic in this respect. If interpreted in a proper way, supervenient concepts appear not to allow the formulation of highly general explanations and theories; at best they reveal common patterns among diverse non-general explanations and theories. Philosophers cherishing supervenient fitness concepts are apparently motivated by a mistaken search for general theory. The fitness concept of population genetics may play a role in relatively general theories and explanations. Supervenient concepts cannot play such a role. They should rather help us recognize the value of natural history in biology. (shrink)

Transparency is a crucial condition to implement a CSR policy based on the reputation mechanism. The central question of this contribution is how a transparency policy ought to be organised in order to enhance the CSR behaviour of companies. Governments endorsing CSR as a new means of governance have different strategies to foster CSR transparency. In this paper we discuss the advantages and disadvantages of two conventional policy strategies: the facilitation policy and the command and control strategy. Using three criteria (...) (efficiency, freedom and virtue) we conclude that both strategies are defective. Most attention is paid to the facilitation strategy since governments nowadays mainly use this. In evaluating this strategy we analyse the Dutch case. As an alternative we introduce a third government policy: the development of a self-regulating sub-system. By construing an analogy with the historical development of corporate financial disclosure, we point out that the vital step in the creation of a self-regulating subsystem is the creation of strong informational intermediate organisations. (shrink)

An important approach to understand how the brain gives rise to consciousness is to probe the depth of unconscious processing, thus to define the key features that cause conscious awareness. Here, we investigate the possibility for subliminal stimuli to shape the context for unconscious processing. Context effects have generally been assumed to require consciousness. In the present experiment, unconscious context processing was investigated by looking at the impact of the context on the response activation elicited by a subliminal prime. We (...) compared the effects of the same subliminal prime on target processing when the prime was embedded in different unconscious contexts. Results showed that the same prime can evoke opposite responses depending on the unconscious context in which it is presented. Taken together, the results of this study show that context effects can be unconscious. (shrink)

Cosmopolitanism is an emerging movement in global ethics. This book provides cutting edge essays by leading scholars on cosmopolitanism.

Food and life are intimately entangled. To grasp the underlying complexity of this seemingly simple statement, this article first introduces the approach to food/eating as an assemblage enacted by various heterogeneous components, and further develops it by engaging with actor network theory and material semiotics. Thereafter the focus turns to ‘entanglement’, as inspired by quantum physics, to elicit the basic dynamics of the entanglement of food and more-than-human beings, conceived of as involving mutual and differential becomings within and among assemblages. (...) The article illustrates these entangled becomings by drawing upon examples from Sri Lanka, which in an intercultural philosophical fashion serve to establish an articulation (in the sense of a connection) between the proposed abstract approach to food and some basic premises of Buddhism and Ayurveda, a South Asian health system. Overall, the article crafts a conceptual toolbox and performs ontological groundwork wherein food and human beings as entangled assemblages provide a productive, refined, and sensitive research apparatus for the intimate study of more-than-human life and organization while also spurring novel theorizations through food/eating. (shrink)

Wim van der Steen charts conceptual foundations of evolutionary biology and, on the basis of this, he evaluates applications of evolutionary theory outside biology. Philosophical analysis shows that key notions of the theory such as fitness, adaptation, selection, and optimality are empty place-holder concepts that call for context-dependent specifications of meaning. For example, as he points out, the notion of optimality is empty without a specification of constraints. Hence, the controversial thesis that animals perform optimal behaviors as a result of (...) natural selection is meaningless rather than true or false. Analysis shows that many other controversies in evolutionary biology are spurious. Thus, the thesis of genic selectionism, which puts genes at center stage in evolutionary theory, is best reconstructed as an arbitrary conceptualization without substance. Disagreements over the thesis are futile. They reflect preferences for different conceptualizations which are ultimately equivalent. As concepts are properly specified, van der Steen asserts evolutionary theory turns out to be a body of interesting natural history at a low level of generality. General laws of evolution do not exist. Hence, evolutionary approaches do not allow sweeping claims about human nature. Unfortunately, in disciplines outside biology such claims are often defended with evolutionary approaches. Evolutionary theory also cannot serve as a foundation for normative views in ethics or epistemology. This is an important and controversial work for scholars and advanced researchers in biology and the philosophy of biology. (shrink)

Philosophical theories about reduction and integration in science are at variance with what is happenign in science. A realistic approach to science show that possibilities for reduction and integration are limited. The classical ideal of a unified science has since long been rejected in philosophy. But the current emphasis on interdisciplinary integration in philosophy and in science shows that it survives in a different guise. It is necessary to redress the balance, specifically in biology. Methodological analysis shows that many of (...) the grand interdisciplinary theories involving biology actually represent pseudo-integration covered up by inappropriate, overgeneral concepts. Integrationism is not bad, but it must be kept within reasonable bounds. If the present analysis is appropriate, there will have to be fundamental changes in research strategy both in science and in the philosophy of science. (shrink)

This paper explores semi‐formal interactions between SRI‐investors that take the governance route rather than deploy a best‐in‐class logic or exclusionary screening. On the basis of a stakeholder typology of the investor and of the chosen topic of interaction, namely compliance with the core ILO labour conventions, the paper formulates 10 expectations about management reactions to the concerns raised by investors. These expectations cover responsiveness, acknowledgment of positions and general attitude. The expectations are then related to the factual discourse by management (...) responding to such concerns raised by investors. Based on data obtained from the Portfolio21‐correspondence, which is a joint initiative of European investors, it is found that management is very willing to discuss cases but at the same time denies the truth‐value of the allegations. Here, the problem of information asymmetry comes to the fore. (shrink)

This textbook not only provides the student with a solid foundation in ethics, but introduces students to the most important themes relevant to business today. Issues such as human rights violation down in the supply chain, the effect business has on nature and the environment, and inclusiveness are each discussed in separate chapters, which discuss their importance, but also their challenges. While there are numerous business ethics textbooks, few take a philosophical approach to business ethics. However, without introducing philosophical ethics, (...) discussions about business ethics are bound to get stuck in fallacies and paradoxes. This textbook therefore fills an important societal gap by providing an introduction to profound philosophical issues in clear language at a philosophically high, but accessible level. (shrink)

Industrial melanism, according to the traditional explanation, amounts to niche construction since it involves changes in predation pressure. Indeed, it would be difficult to imagine selection without niche construction. This cannot be what Laland, Odling-Smee & Feldman mean. They offer convincing examples, but they should provide a better definition of “niche construction” to indicate how their view supplements traditional evolutionary biology.

As thousands of healthy research participants are being included in small and large imaging studies, it is essential that dilemmas raised by the detection of incidental findings are adequately handled. Current ethical guidance indicates that pathways for dealing with incidental findings should be in place, but does not specify what such pathways should look like. Building on an interview study of researchers’ practices and perspectives, we identified key considerations for the set-up of pathways for the detection, management and communication of (...) incidental findings in imaging research. We conducted an interview study with a purposive sample of researchers at research facilities across the Netherlands. Based on a qualitative analysis of these interviews and on existing guidelines found in the literature, we developed a prototype ethical framework, which was critically assessed and fine-tuned during a two-day international expert meeting with bioethicists and representatives from large population-based imaging studies from the United Kingdom, Germany, Sweden and Belgium. Practices and policies for the handling of incidental findings vary strongly across the Netherlands, ranging from no review of research scans and limited feedback to research participants, to routine review of scans and the arrangement of clinical follow-up. Respondents felt that researchers do not have a duty to actively look for incidental findings, but they do have a duty to act on findings, when detected. The principle of reciprocity featured prominently in our interviews and expert meeting. We present an ethical framework that may guide researchers and research ethics committees in the design and/or evaluation of appropriate pathways for the handling of incidental findings in imaging studies. The framework consists of seven steps: anticipation of findings, information provision and informed consent, scan acquisition, review of scans, consultation on detected abnormalities, communication of the finding, and further clinical management and follow-up of the research participant. Each of these steps represents a key decision to be made by researchers, which should be justified not only with reference to costs and/or logistical considerations, but also with reference to researchers’ moral obligations and the principle of reciprocity. (shrink)

Science is not value-free and ethics is not fact-free. Science and ethics should be similar, but they are not. The author indicates how research in ethics is to change in the face of this. Ethicists should accommodate empirical work in their programs and they should take heed of methodologies developed in science and philosophy of science. They should abandon the search for a single overarching theory of morality. Controversies in ethics are often spurious for lack of articulate methodological key concepts. (...) For example, disagreements over the value of general theories are misguided since disputants implicitly use different notions of generality and different notions of theory. An appropriate methodology does not suffice for the resolution of controversies but it is indispensable for consensus. The book argues these theses in a general way and applies them to the subject of egoism and altruism in ethics. Further case studies concern the environment and psychiatric disorders. (shrink)