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23Influenza vaccination in Dutch nursing homes: Is tacit consent morally justified?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
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57The Precautionary Principle and the Tolerability of Blood Transfusion RisksAmerican 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
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12There 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
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19The 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
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3The 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
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5In 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
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12Due 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
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13Current 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
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17The 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
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12Given 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
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17Nudges in Public Health: Paternalism Is ParamountAmerican Journal of Bioethics 12 (2): 16-17. 2012.Libertarian paternalism involves the idea that it is justified to shape the context in which people make important choices in a way that they are nudged to options that would be better for them, wh...
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3Public Health Dilemmas Concerning a 2-year old Hepatitis-B Carrier – ResponseJournal of Bioethical Inquiry 5 (1): 87-89. 2008.
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74Donor blood screening and moral responsibility: how safe should blood be?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
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28Maintaining Trust in Newborn ScreeningHastings Center Report 42 (5): 41-47. 2012.Newborn screening consists of taking a few drops of blood from a baby's heel in the first week of life and testing it for a list of disorders. In the United States and most countries in Europe, newborn screening programs began in the 1960s and 1970s with screening for phenylketonuria (PKU), a rare metabolic disease that causes severe and irreversible mental retardation unless treated before problems arise. As knowledge about rare diseases expanded and new screening technologies were introduced—s…Read more
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188Solidarity: a Moral Concept in Need of Clarification (editorial)Public Health Ethics 5 (1): 1--5. 2012.
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67Obligatory precautions against infectionBioethics 19 (4). 2005.ABSTRACT If we have a duty not to infect others, how far does it go? This question is often discussed with respect to HIV transmission, but reflection on other diseases like influenza raises a number of interesting theoretical issues. I argue that a duty to avoid infection not only yields requirements for persons who know they carry a disease, but also for persons who know they are at increased risk, and even for those who definitely know they are completely healthy. Given the numerous ways in w…Read more
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47Health inequities in times of a pandemicPublic Health Ethics 2 (3): 207-209. 2009.(No abstract is available for this citation)
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10Futility without a dichotomy: Towards an ideal physician–patient relationshipBioethics 17 (1). 2003.The futility debate may be considered as an effort to provide a clear and justified borderline between physician and patient decision–making authority. In this paper we argue that the search for a definition of futility that provides physicians with a final argument in discussions about life–prolonging treatment, is misplaced. An acceptable and meaningful criterion of futility that satisfies this effort seems impossible. As a consequence, we reject a dichotomous domain of decision–making power a…Read more
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37Ethics in Public Health: Bloomberg's Battle and BeyondPublic Health Ethics 6 (3): 231-232. 2013.
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52BACKGROUND: The availability of costly safety measures against transfusion-transmissible infections forces Western countries to confront difficult ethical questions. How to decide about implementing such measures? When are such decisions justified? As a preliminary to addressing these questions, we assessed which concerns shape actual donor blood safety policymaking in five Western countries. STUDY DESIGN AND METHODS: Our qualitative study involved determining which issues had been discussed in …Read more
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67Ethics, Prevention, and Public Health (edited book)Oxford University Press. 2009.In these twelve papers notable ethicists use the resources of ethical theory to illuminate important theoretical and practical topics, including the nature of public health, notions of community, population bioethics, the legitimate role of law, the use of cost-effectiveness as a methodology, vaccinations, and the nature of infectious disease.
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71Moral assessment of growth hormone therapy for children with idiopathic short statureJournal of Medical Ethics 23 (5): 305-309. 1997.The prescription of growth hormone therapy for children who are not growth hormone deficient is one of the controversies in contemporary paediatric endocrinology. Is it morally appropriate to enhance the growth, by means of medical treatment, of a child wish idiopathic short stature? The medical, moral, and philosophical questions in this area are many. Data on the effects of human growth hormone (hGH) treatment will not on their own provide us with answers, as these effects have to be evaluated…Read more
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17The Meaning of 'Public' in 'Public Health'In Angus Dawson & Marcel Verweij (eds.), Ethics, Prevention, and Public Health, Clarendon Press. 2007.
Areas of Specialization
Applied Ethics |
Normative Ethics |
Areas of Interest
Applied Ethics |
Normative Ethics |