Pregnancy has a profound impact on individuals’ lives, yet the subjective experience is often absent from the discourse on reproductive rights and ethics. Although pregnancy is an epistemically transformative experience, phenomenology can help us describe common structures in the many different subjective experiences of pregnancy. Doing so shows us that the effects of pregnancy go beyond the physical symptoms; they invade the experience of the self and the world and transform identity. If someone wants to formulate an argument against abortion, (...) they will have to include the existential impact of pregnancy. In this paper I will further explore the impact of pregnancy through a phenomenological analysis of birth and birthmothers and show that the existential impact of pregnancy does not cease to exist after birth. Giving birth fundamentally changes the world of the pregnant person and leads to irreversible changes in identity. Their world will never return to the way it was before pregnancy. Arguments against abortion would have to take these existential implications into account as well. Finally, I will argue that a similar argument will also become relevant in the discourse on ectogenesis. (shrink)

Body dysmorphic disorder (BDD) poses a significant challenge to an individual’s mental well-being. The obsessive preoccupation with perceived defects in one’s appearance affects individuals’ daily functioning and can result in serious risks, including suicidal ideation and self-surgery. While treatments such as cognitive behavioural therapy and serotonin reuptake inhibitors can provide relief, they do not achieve complete remission. It has been suggested that therapy should not only interrupt the harmful behaviour, but should also address their sense of self, and that after (...) addressing their internalised values, individuals with BDD will be able to incorporate their perceived defect in a manner similar to how individuals with real deformities often do. Phenomenology of psychopathology analyses subjectivity in cases of pathology, and analyses of BDD show that the perceived defect has become a locus of shame. This implies that individuals with BDD have permanently incorporated the gaze of the Other and constantly experience their body as a body-for-others. This paper further explores the sense of self in individuals with BDD through Jenny Slatman’s interpretation of bodily integrity: bodily integrity as a never-ending process of identification. By comparing the experiences of individuals with BDD to those with real deformities and to those who have undergone cosmetic surgery, I will show that re-identification does not occur in individuals with BDD. This suggests that their bodily integrity is fundamentally disturbed and that addressing their internalised values alone will probably not be sufficient for the disorder to go into remission. (shrink)

In this paper I critically reflect on the sustainability potential of biomimetic technologies by focusing on writings of the German philosopher Peter Sloterdijk. Although I agree with Sloterdijk that biomimetic technologies – or, as he calls them, ‘homeotechnologies’ – offer specific opportunities for a more peaceful co-existence of humans and nature, I will argue that his reflections are based on a series of problematic assumptions. I will conclude by arguing that the ‘homeotechnological turn’ can be effected only if it is (...) developed within the context of a different ecological ethos from the technocentric ethos that currently dominates our attitude towards nature. (shrink)

Expanded universal carrier screening (EUCS) entails a population‐wide screening offer for multiple disease‐causing mutations simultaneously. Although there is much debate about the conditions under which EUCS can responsibly be introduced, there seems to be little discussion about its aim: providing carrier couples with options for autonomous reproductive choice. While this links in with current accounts of the aim of foetal anomaly screening, it is different from how the aim of ancestry‐based carrier screening has traditionally been understood: reducing the disease burden (...) in the population. The reasons why the aim of EUCS is presented in terms of ‘autonomy’ rather than ‘prevention’ have not been spelled out in the literature. This paper seeks to fill this gap by considering the morally relevant similarities and dissimilarities between foetal anomaly screening, ancestry‐based carrier screening and EUCS. When carrier screening is performed in the prenatal period, enhancing autonomy appears the most appropriate aim of EUCS, as the alternative of ‘prevention through selective abortion’ would urge women to terminate wanted pregnancies. However, when screening is conducted in the preconception period, carrier couples can avoid the birth of affected children by other means than selective abortion, for instance preimplantation genetic diagnosis. To the extent that this increased control over passing on a genetic disorder raises questions of parental responsibility, it seems necessary that the account of the aims of EUCS is wider than only in terms of enhancing reproductive autonomy. (shrink)

Every field of science, but especially biology, contains particular conceptions of nature. These conceptions are not merely epistemological or ontological, but also have normative dimensions; they provide an ethos, a framework for moral orientation. These normative dimensions, whilst often remaining ‘hidden’ and inarticulate, influence the way in which biologists practice their profession. In this paper, I explore what happens when different versions of these implicit normative frameworks collide. To do so, I will focus on a case study from the field (...) of ecological genomics as it has evolved in one particular country, namely the Netherlands. During an important inaugural meeting, the director of one of the most sizeable Dutch ecogenomics centres gave a presentation in which he introduced the term ‘nature mining’. Part of the audience immediately embraced the term, but others were very reluctant. This mixed response is generally explained as a culmination of growing tension about the future direction of the field: due to new funding demands, a shift had occurred from fundamental research to research more interested in ‘valorisation’. (shrink)

The question we raise in this paper is, whether patient involvement might be a beneficial way to help determine and achieve the aims of translational research and, if so, how to proceed. TR is said to ensure a more effective movement of basic scientific findings to relevant and useful clinical applications. In view of the fact that patients are supposed to be the primary beneficiaries of such translation and also have relevant knowledge based on their experience, listening to their voice (...) early on in the innovation process might very well increase the effectiveness of the translation. After explaining how the concept of TR emerged and what it entails, this paper shows through a literature review which arguments have been put forward to promote patient involvement in health care research in a more general sense. We examine whether, and if so how, these arguments are relevant for the discourse on TR and we identify pitfalls and dilemmas. Ultimately, we conclude that it may be worthwhile to experiment with patient involvement in TR but that the design of such involvement requires careful consideration. (shrink)

Moral ideals should not be seen as simple and purely personal, but as complex values with a social dimension that transcend attempts to formulate or realize them. Orientation towards ideals needs a realistic component: people should identify with the quest for an ideal, not with the ideal itself, and consider the possibility of negative consequences of their pursuit. Such realism about ideals includes acknowledging that ideals are not the only, nor the most important, motivating force of morality.

The emerging field of ecological genomics promises to bring about a marriage between ecological and laboratory-based, genomic investigations. In this paper, I will reflect on this promise by exploring how ecology and genomics are integrated in the two approaches that currently dominate this field: the organism-centred approach, focusing individual organisms, and the metagenomic approach, concentrating on entire microbial communities composed of a variety of species. I will show that both approaches have already taken some important steps in bridging the gap (...) between genomics and ecology. Since the introduction of next-generation sequencing methodology in 2007, the organism-centred approach does not need to stick to classical model organisms like Arabidopsis anymore. Instead, it is now able to apply genomic tools to ecologically interesting species as well. The metagenomic approach has been able to give ecology a more prominent place in its investigations, in another way. Contrary to classical microbiology, it does not study microbial communities under controlled laboratory settings, but under nature's own conditions. However, in the marriage between genomics and ecology, genomics still appears to be the dominant partner, especially in the case of the organism-centred approach that continues to study the new ecological models in artificial lab environments. Moreover, the organism-centred and metagenomic approaches employ a gene-centred perspective in understanding critical ecological interactions, thus strengthening a reductionist rather than a holistic approach. (shrink)

Conflict framing is key in political communication. Politicians use conflict framing in their online messages (e.g., criticizing other politicians) and journalists in their political coverage (e.g., reporting on political tensions). Conflicts can take a variety of forms and can provoke different reactions. However, the literature still lacks a systematic and theoretically-grounded conceptual framework that accounts for the multi-dimensionality of political conflict frames. Based on literature from political epistemology, political communication, and related fields such as psychology, we present four conceptual dimensions (...) of political conflicts: (1) the style (civil/uncivil); (2) the subject (personal/substantive); (3) whether it is about underlying moral/epistemic principles or not (deep/superficial conflict); and (4) whether it concerns a normative or factual issue. Results of a content analysis of newspaper articles and politicians’ tweets confirm the usage of these conflict dimensions in the Netherlands during a non-election period. Interestingly, most of the conflicts are civil, substantive, and do not highlight deep fundamental clashes. In light of the current societal concerns about the lack of respect in political debates and the deepening of our political divides, these findings can be considered encouraging. (shrink)

The image of “the good nurse” is mainly studied from the perspective of nurses, which often does not match the image held by patients. Therefore, a descriptive study was conducted to examine oncology patients’ perceptions of “the good nurse” and the influence of patient- and context-related variables. A cross-sectional, comparative, descriptive design was used. The sample comprised 557 oncology patients at one of six Flemish hospitals, where they were treated in an oncology day-care unit, oncology hospital ward, or palliative care (...) unit. Data were collected using the Flemish Care-Q instrument. Factor analysis summarised the most important characteristics of “the good nurse”. We reassessed the reliability and construct validity of the Flemish Care-Q and examined the influence of patient- and context-related variables on patient perceptions. Using factor analysis, we grouped the different items of the Flemish Care-Q according to three characteristics: “the good nurse” (I) has a supportive and communicative attitude towards patient and family, (II) is competent and employs a professional attitude, and (III) demonstrates personal involvement towards patient and family. Median factor scores of Factors I, II, and III, respectively, were 8.00, 9.00, and 8.00 (varying from 1, not important, to 10, very important). In order of importance, Factors II, I, and III were identified as valuable characteristics of “the good nurse”. Gender, care setting, and province were influential variables. As perceived by oncology patients, “the good nurse” has a broad range of qualities, of which competence and professionalism are the most valuable. (shrink)

Ideals are important in social reality, but they have been neglected in theories of law, politics, and morality. This book has the role of ideals as its central theme. More specifically, it argues that ideals are necessary to understand pluralism, that they are key elements in controversy and debate, and that they enable development. It combines theoretical analysis of the concept of ideals with discussion of concrete debates and cases, including philosophical debates about politics and equality, sociological studies of the (...) diverse interpretations of the rule of law, and accounts of the development of environmental law and privacy law. Thus, the functioning of ideals is critically examined, showing the merits and limitations of an ideal-oriented approach. (shrink)

This article describes the findings of a mixed method literature review that examined the perceptions of elderly patients and residents of a good nurse in nursing homes, hospitals and home care. According to elderly patients and residents, good nurses are individuals who have the necessary technical and psychosocial skills to care for patients. They are at their disposal, promptly recognising the patients' needs. Good nurses like their job and are sincere and affectionate. They are understanding and caring. They do not (...) hesitate to enter into a trust-based relationship with their patients. Knowing and understanding how elderly patients and nursing home residents perceive ‘the good nurse’ is crucial for providing quality care and for promoting better patient outcomes in geriatric care. (shrink)

Biomedical research policy in recent years has often tried to make such research more ‘translational’, aiming to facilitate the transfer of insights from research and development to health care for the benefit of future users. Involving patients in deliberations about and design of biomedical research may increase the quality of R&D and of resulting innovations and thus contribute to translation. However, patient involvement in biomedical research is not an easy feat. This paper discusses the development of a method for involving (...) patients in biomedical research aiming to address its main challenges.After reviewing the potential challenges of patient involvement, we formulate three requirements for any method to meaningfully involve patients in biomedical research. It should enable patients to put forward their experiential knowledge, to develop a rich view of what an envisioned innovation might look like and do, and to connect their experiential knowledge with the envisioned innovation. We then describe how we developed the card-based discussion method ‘Voice of patients’, and discuss to what extent the method, when used in four focus groups, satisfied these requirements. We conclude that the method is quite successful in mobilising patients’ experiential knowledge, in stimulating their imaginaries of the innovation under discussion and to some extent also in connecting these two. More work is needed to translate patients’ considerations into recommendations relevant to researchers’ activities. It also seems wise to broaden the audience for patients’ considerations to other actors working on a specific innovation. (shrink)

Bowman-Smart and colleagues (2023) argue that techniques to screen and analyze the fetal genome are rapidly evolving, and are sometimes already offered commercially. These new developments will all...

New agrifood technologies are often difficult to grasp for the public, which may lead to resistance or even rejection. Insight into which technology features determine public acceptability of the technology could offer guidelines for responsible technology development. This paper systematically assesses the relative importance of specific technology features for consumer response in the agrifood domain in two consecutive studies. Prominent technology features were selected from expert judgment and literature. The effects of these features on consumer evaluation were tested in a (...) consumer study. Fictitious technologies were used to avoid any uncontrollable contextual influences that existing new technologies may evoke. Results show that technologies that were seen as more natural and newer were perceived less risky, more beneficial, and were evaluated more positively. Technologies applied to food were judged to be more beneficial, but also more risky than those applied to non-food. Technologies used in the production process were perceived to be less risky and evaluated more positively than those used in the product. Technologies owned by the market leader were perceived to be more beneficial, and evaluated more positively than those that were freely available. In a next study, effects of the technology features on consumer response were tested for existing new agrifood technologies. This study replicated the results for perceived naturalness, perceived newness, and place in the production process where the technology is applied. However, in contrast to the first study, we did not find an effect of application area and technology ownership. (shrink)

Lower levels of news use are generally understood to be associated with less political engagement among citizens. But while some people simply have a low preference for news, others avoid the news intentionally. So far little is known about the relationship between active news avoidance and civic engagement in society, a void this study has set out to fill. Based on a four-wave general population panel survey in the Netherlands, conducted between April and July 2020 (N = 1,084) during a (...) crisis situation, this research-in-brief investigates the development of news avoidance and pro-social civic engagement over time. Results suggest that higher news topic avoidance results in higher levels of civic engagement. The study discusses different explanations for why less news can mean more engagement. (shrink)

Unconsented episiotomies and other procedures during labour are commonly reported by women in several countries, and often highlighted in birth activism. Yet, forced caesarean sections aside, the ethics of consent during labour has received little attention. Focusing on episiotomies, this paper addresses whether and how consent in labour should be obtained. We briefly review the rationale for informed consent, distinguishing its intrinsic and instrumental relevance for respecting autonomy. We also emphasise two non-explicit ways of giving consent: implied and opt-out consent. (...) We then discuss challenges and opportunities for obtaining consent in labour and birth, given its unique position in medicine.We argue that consent for procedures in labour is always necessary, but this consent does not always have to be fully informed or explicit. We recommend an individualised approach where the antenatal period is used to exchange information and explore values and preferences with respect to the relevant procedures. Explicit consent should always be sought at the point of intervening, unless women antenatally insist otherwise. We caution against implied consent. However, if a woman does not give a conclusive response during labour and the stakes are high, care providers can move to clearly communicated opt-out consent. Our discussion is focused on episiotomies, but also provides a useful starting point for addressing the ethics of consent for other procedures during labour, as well as general time-critical medical procedures. (shrink)

One major way of arguing for the moral attractiveness of luck egalitarianism is indirect; it consists in showing that the view follows from competing views on distributive justice which one actually endorses. Kasper Lippert-Rasmussen (KLR) claims that luck egalitarianism is indirectly supported in this way by Rawls’s intuitive argument for the difference principle. That argument begins by asserting that the impact of social and natural contingencies on distributive shares is unjust. After clarifying the notion of indirect support, I argue against (...) KLR’s claim. Whether the argument goes on to support luck egalitarianism is a matter of interpretation which can only be decided by looking closer at what Rawls has to say about the difference principle than KLR’s own treatment of the argument allows. In its most plausible reading, the intuitive argument veers away from luck egalitarianism in favor of a non-egalitarian view of the difference principle as a principle of compensating advantage. On this view, inequality due to bad luck is not in any respect unjust when the least advantaged cannot be made better off under alternative arrangements. In conclusion I explain why there are good reasons of fairness to understand the difference principle in this way. (shrink)

The quincentenary of the Protestant Reformations creates a challenge. With reference to Protestant churches in South Africa, the ambiguity inherent in this challenge is considered in the first part of the essay. In the second part, Martin Luther’s famous discovery is investigated in light of his earlier theology leading up to 31 October 1517. It is argued that Luther’s earlier theology is characterised by a hermeneutic rediscovery. In the third part, Dietrich Bonhoeffer’s theology is brought into conversation with Luther. It (...) is asked how Bonhoeffer received Luther’s theology – more specifically, how he re-appropriated the hermeneutic inherent in Luther’s earlier theology. In the final part, it is asked what the theological hermeneutic inherent in Luther’s earlier theology – re-appropriated by Bonhoeffer – can mean for South African churches commemorating the Protestant Reformations. (shrink)

The next World Congress of Bioethics will be held in Doha, Qatar. Although this location provides opportunities to interact with a more culturally diverse audience, to advance dialogue between cultures and religions, offer opportunities for mutual learning, there are also huge moral concerns. Qatar is known for violations of human rights ‐ including the treatment of migrant workers and the rights of women ‐ corruption, criminalization of LGBTQI+ persons, and climate impact. Since these concerns are also key (bio)ethical concern we (...) call for a broad debate within the bioethics community whether organizing and attending the World Congress in Qatar is ethically problematic and how ethical concerns should be dealt with. (shrink)

Prima facie, we make successful decisions as we act on and intervene in the world day-to-day. Epistemologists are often concerned with whether rationality is involved in such decision-making practices, and, if so, to what degree. Some, particularly in the post-structuralist tradition, argue that successful decision-making occurs via an existential leap into the unknown rather than via any determinant or criterion such as rationality. I call this view radical voluntarism (RV). Proponents of RV include those who subscribe to a view they (...) call Critical Complexity (CC). In this paper, I argue that CC presents a false dichotomy when it conceives of rationality in Cartesian – i.e. ideal and transcendental – terms, and then concludes that RV is the proper alternative. I then outline a pragmatist rationality informed by recent work in psychology on bounded rationality, ecological rationality, and specifically embodied rationality. Such a pragmatist rationality seems to be compatible with the tenets of post-structuralism, and can therefore replace RV in CC. (shrink)

Several complexity theorists draw a sharp and ontologically robust distinction between (merely) complicated systems and (genuinely) complex systems. I argue that this distinction does not hold. Upon fine-grained analysis, ostensibly complicated systems turn out to be complex systems. The purported boundary between the complicated and the complex appears to be vague rather than sharp. Systems are complex by degrees.

Critical Concepts for the Creative Humanities is the first book to outline and define the specific and evolving field of the creative humanities and provides the field's nascent bibliography.

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