Utrecht University
Department for Philosophy and Religious Studies
PhD, 1998
Areas of Specialization
Applied Ethics
Normative Ethics
Areas of Interest
Applied Ethics
Normative Ethics
  •  19
    Influenza vaccination in Dutch nursing homes: Is tacit consent morally justified?
    with M. A. Van den Hoven
    Medicine, Health Care and Philosophy 8 (1): 89-95. 2005.
    Objectives: Efficient procedures for obtaining informed (proxy) consent may contribute to high influenza vaccination rates in nursing homes. Yet are such procedures justified? This study’s objective was to gain insight in informed consent policies in Dutch nursing homes; to assess how these may affect influenza vaccination rates and to answer the question whether deviating from standard informed consent procedures could be morally justified. Design: A survey among nursing home physicians. Settin…Read more
  •  50
    The Precautionary Principle and the Tolerability of Blood Transfusion Risks
    with Koen Kramer and Hans L. Zaaijer
    American Journal of Bioethics 17 (3): 32-43. 2017.
    Tolerance for blood transfusion risks is very low, as evidenced by the implementation of expensive blood tests and the rejection of gay men as blood donors. Is this low risk tolerance supported by the precautionary principle, as defenders of such policies claim? We discuss three constraints on applying the precautionary principle and show that respecting these implies tolerating certain risks. Consistency means that the precautionary principle cannot prescribe precautions that it must simultaneo…Read more
  •  7
    Maternal immunisation : Ethical issues
    with Philipp Lambach, Justin R. Ortiz, and Andreas Reis
    There has been increased interest in the potential of maternal immunisation to protect maternal, fetal, and infant health. Maternal tetanus vaccination is part of routine antenatal care and immunisation campaigns in many countries, and it has played an important part in the reduction of maternal and neonatal tetanus. Additional vaccines that have been recommended for routine maternal immunisation include those for influenza and pertussis, and other vaccines are being developed. Maternal immunisa…Read more
  •  3
    The curious philosopher often answers questions by raising further, more fundamental questions. How can this be fruitful and practical in the context of Wageningen University? Philosophy offers critical reflection on conceptual and normative assumptions in science and society, and that is necessary for responsible practices. I illustrate this by analyzing the concept of quality of life – a key value in the mission of our university – and by questioning current debates about responsibility for he…Read more
  •  11
    The idea of the rule of rescue is that special weight should be given to protecting lives of assignable individuals in need now even if protecting others in the future would be more cost-effective. How can this be justified? One way to cast the problem is to see it as a conflict between a collectivist approach that emphasizes protecting groups or populations versus an approach that boils down to protecting individuals. This chapter argues that one individual-oriented approach to ethics, namely c…Read more
  •  2
    In spite of the fact that in recent years many steps have been taken in the control of zoonotic diseases, we are still confronted with recent outbreaks of, for example Ebola and Avian Flu and with public debates on the preferred way to deal with zoonoses. Such debates can easily get polarised. Therefore, we argue that a more integrated approach is needed. In this paper we propose an integration on three levels. First, the One Health initiative could serve a fruitful approach to take the interrel…Read more
  •  12
    Due to its emphasis on experiential interests, animal ethics tends to focus on individuals as the sole unit of moral concern. Many issues in animal ethics can be fruitfully analysed in terms of obligations towards individual animals, but some problems require reflection about collective dimensions of animal life in ways that individualist approaches can’t offer. Criticism of the individualist focus in animal ethics is not new; it has been put forward in particular by environmental ethics approac…Read more
  •  10
    Current thinking on the development of molecular microbial characterisation techniques in public health focuses mainly on operational issues that need to be resolved before incorporation into daily practice can take place. Notwithstanding the importance of these operational challenges, it is also essential to formulate conditions under which such microbial characterisation methods can be used from an ethical perspective. The potential ability of molecular techniques to show relational patterns b…Read more
  •  13
    The growing prevalence of obesity and related conditions such as Type II diabetes is held by many to be a major public health problem in developed countries, and increasingly in developing countries as well. If we wish to tackle this problem, it will be a major task. Individuals will have to change their consumption and exercise patterns, companies will have to improve the products they make and how they market them, nutrition experts and communities will have to redefine what is acceptable and …Read more
  •  8
    Given the ethical aspects of vaccination policies and current threats to public trust in vaccination, it is important that governments follow clear criteria for including new vaccines in a national programme. The Health Council of the Netherlands developed such a framework of criteria in 2007, and has been using this as basis for advisory reports about several vaccinations. However, general criteria alone offer insufficient ground and direction for thinking about what the state ought to do. In t…Read more
  •  10
    Nudges in Public Health: Paternalism Is Paramount
    American Journal of Bioethics 12 (2): 16-17. 2012.
  •  3
    Public Health Dilemmas Concerning a 2-year old Hepatitis-B Carrier – Response
    with Jim Steenbergen
    Journal of Bioethical Inquiry 5 (1): 87-89. 2008.
  •  65
    Donor blood screening and moral responsibility: how safe should blood be?
    with Koen Kramer
    Journal of Medical Ethics 44 (3): 187-191. 2018.
    Some screening tests for donor blood that are used by blood services to prevent transfusion-transmission of infectious diseases offer relatively few health benefits for the resources spent on them. Can good ethical arguments be provided for employing these tests nonetheless? This paper discusses—and ultimately rejects—three such arguments. According to the ‘rule of rescue’ argument, general standards for cost-effectiveness in healthcare may be ignored when rescuing identifiable individuals. The …Read more
  •  15
    Editorial: Public Health Ethics—10 Years On
    Public Health Ethics 11 (1): 1-5. 2018.
  •  1537
    The rule of rescue holds that special weight should be given to protecting the lives of assignable individuals in need, implying that less weight is given to considerations of cost-effectiveness. This is sometimes invoked as an argument for funding or reimbursing life-saving treatment in public healthcare even if the costs of such treatment are extreme. At first sight one might assume that an individualist approach to ethics—such as Scanlon’s contractualism—would offer a promising route to justi…Read more
  •  20
    You eat what you are: Moral dimensions of diets tailored to one's genes
    Journal of Agricultural and Environmental Ethics 16 (6): 557-568. 2003.
    Thanks to developments in genomics,dietary recommendations adapted to genetic riskprofiles of individual persons are no longerscience fiction. But what are the consequencesof these diets? An examination of possibleimpacts of genetically tailor-made diets raisesmorally relevant concerns that are analogous to(medical-ethical) considerations aboutscreening and testing. These concerns oftengive rise to applying norms for informedconsent and for the weighing of burdens andbenefits. These diets also h…Read more
  •  245
    Ethical Promises and Pitfalls of OneHealth
    Public Health Ethics 9 (1): 1-4. 2016.
    Emerging infectious diseases such as Ebola, Hendra, SARS, West Nile, Hepatitis E and avian influenza have led to a renewed recognition of how diseases in human beings, wildlife and livestock are interlinked. The changing prevalence and spread of such infections are largely determined by human activities and changes in environment and climate—where the latter are often also caused by human activities. Since the beginning of the 21st century, these insights have been brought together under the hea…Read more
  •  61
    Public health ethics: A manifesto
    Public Health Ethics 1 (1): 1--2. 2008.
  •  24
    (No abstract is available for this citation)
  •  162
    Moral principles for allocating scarce medical resources in an influenza pandemic
    Journal of Bioethical Inquiry 6 (2): 159--169. 2009.
    One of the societal problems in a new influenza pandemic will be how to use the scarce medical resources that are available for prevention and treatment, and what medical, epidemiological and ethical justifications can be given for the choices that have to be made. Many things may become scarce: personal protective equipment, antiviral drugs, hospital beds, mechanical ventilation, vaccination, etc. In this paper I discuss two general ethical principles for priority setting (utility and equity) a…Read more
  •  29
    Vaccination Policies
    In Hugh LaFollette (ed.), The International Encyclopedia of Ethics, Blackwell. 2013.
    Vaccination involves priming the immune system with an antigenic agent that mimics a virus or bacterium, which results in immunity against the “real” microorganism. Collective vaccination policies have played an important role in the control of infectious disease worldwide. They can serve the utilitarian aim to protect public health – hence welfare – and also promote fairness: making essential vaccines accessible to all members of the public. Yet as more and more vaccines are developed, societie…Read more
  •  38
    The Steward of the Millian State
    Public Health Ethics 1 (3): 193-195. 2008.
  •  926
    The curious philosopher often answers questions by raising further, more fundamental questions. How can this be fruitful and practical in the context of Wageningen University? Philosophy offers critical reflection on conceptual and normative assumptions in science and society, and that is necessary for responsible practices. I illustrate this by analyzing the concept of quality of life – a key value in the mission of our university – and by questioning current debates about responsibility for he…Read more
  •  45
    Public Health: Beyond the Role of the State
    Public Health Ethics 8 (1): 1-3. 2015.
  •  31
    Personal Health Monitoring and Human Interaction
    American Journal of Bioethics 12 (9): 47-48. 2012.
    The American Journal of Bioethics, Volume 12, Issue 9, Page 47-48, September 2012