About
44
Publications
13,314
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
465
Citations
Introduction
I am a public/ digital health ethicist, with a background in philosophy. I am specifically interested in how institutional structures relate to the exercise of personal autonomy. I have worked on the ethics of mobile health, genome sequencing, antibiotic resistance and screening.
Publications
Publications (44)
There is growing interest in contact tracing apps (CT apps) for pandemic management. It is crucial to consider ethical requirements before, while, and after implementing such apps. In this paper, we illustrate the complexity and multiplicity of the ethical considerations by presenting an ethical framework for a responsible design and implementation...
Mobile vaccination teams visiting long-term care homes will have an important role in providing vaccination coverage for some of the most vulnerable population subgroups. However, based on the experiences of German mobile diagnostic teams during the first COVID-19 pandemic wave, the deployment of mobile vaccination teams to care homes for older adu...
Effectiveness is a key criterion in assessing the justification of antibiotic resistance interventions. Depending on an intervention’s effectiveness, burdens and costs will be more or less justified, which is especially important for large scale population-level interventions with high running costs and pronounced risks to individuals in terms of w...
This chapter charts and critically analyses the ethical challenge of assessing how much (and what kind of) evidence is required for the justification of interventions in response antibiotic resistance (ABR), as well as other major public health threats. Our ambition here is to identify and briefly discuss main issues, and point to ways in which the...
The COVID-19 pandemic presents unprecedented challenges to public health decision-making. Specifically, the lack of evidence and the urgency with which a response is called for, raise the ethical challenge of assessing how much (and what kind of) evidence is required for the justification of interventions in response to the various threats we face....
There is a growing interest in contact tracing apps (CT apps) for pandemic man- agement. These apps raise significant moral concerns. It is therefore crucial to consider ethical requirements before and while implementing such apps.
• Public trust is of major importance for population uptake of contact tracing apps. Hasty, ill-prepared or badly comm...
Effectiveness is a key criterion in assessing the justification of antibiotic resistance interventions. Depending on an intervention’s effectiveness, burdens and costs will be more or less justified, which is especially important for large scale population-level interventions with high running costs and pronounced risks to individuals in terms of w...
Following publication of the original article [1], the author explained that there are multiple errors in the original article.
In this perspective, we discuss non-experts’ beliefs about the complex and ‘messy' problem of antibiotic resistance (ABR). First, we explain what we mean by complex and messy problems and why ABR fits that description. We then suggest that the attitudes of non-experts are particularly relevant to these problems. This gives rise to social epistemic...
Background:
Emissions of high concentrations of antibiotics from manufacturing sites select for resistant bacteria and may contribute to the emergence of new forms of resistance in pathogens. Many scientists, industry, policy makers and other stakeholders recognize such pollution as an unnecessary and unacceptable risk to global public health. An...
Guest editorial to a special issue of Bioethics on the ethics of antibiotic resistance.
Antibiotic resistance, arising when bacteria develop defences against antibiotics, creates a public health threat of massive proportions. This raises challenging questions for standard notions in bioethics when suitable policy is to be characterised and justified. We examine the particular proposal of expediting innovation of new antibiotics by cut...
Question
Emissions of high concentrations of antibiotics from manufacturing sites select for resistant bacteria and may contribute to the emergence of new forms of resistance in pathogens. Many scientists, industry, policy makers and other stakeholders recognize such pollution as an unnecessary and unacceptable risk to global public health. An atte...
THIS PAPER HAS BEEN PUBLISHED IN THE JOURNAL ENVIRONMENTAL HEALTH. SEE FURTHER NEW ARTICLE PAGE: https://www.researchgate.net/publication/336145559_Managing_pollution_from_antibiotics_manufacturing_charting_actors_incentives_and_disincentives
Background
Emissions of high concentrations of antibiotics from manufacturing sites select for resistant...
We consider the implications for the ethical evaluation of research programs of two fundamental changes in the revised research ethical guideline of the Council for International Organizations of Medical Sciences. The first is the extension of scope that follows from exchanging “biomedical” for “health-related” research, and the second is the new e...
PUBLISHED IN the Journal of Argumentation in Context (ISSN 2211-4742).
This article explores ethical aspects of using open argumentation in person centered care (PCC), where health professionals (HPs) openly criticize or contradict factual claims, assumptions, preferences or value commitments of patients. We argue that such disputing may be claime...
The paper explores the room, both conceptually and ethically, for questioning, contradicting and adapting positions to patients in three specific areas: care of patients with vulnerable cpapcities for taking responsibility (adolescents and psychiatry), contexts of constrained autonomy (forensic care), and public health (antobiotic resistance stewar...
The recently revised CIOMS guidelines radically broaden both that scope of the guidelines from medical to all kinds of health research), and the basis on which such research may be assessed ethically, not least what is called ”social value” of research. This makes these guidelines less on a par with the WMA’s Declaration of Helsinki principles for...
The debate on the ethics of screening programmes in recent years has developed into one of the largest and most complex fields within public health ethics. This chapter unravels and discusses some of the basic themes within this debate, such as the criteria of screening, the role of consent and the public dimension of screening activities, as well...
New developments in genetics and genomics offer a constant challenge to ethical reflection. One such development is the application of whole genome sequencing (WGS) as a diagnostic tool. The use of WGS in clinical practice carries with it the promise of personalized medicine, which will likely enable more efficient care and tailored prevention. How...
The debate on the 'right (not) to know' has simmered on for over 30 years. New examples where a right to be informed is contrasted to a right to be kept in ignorance occasionally surface and spark disagreement on the extent to which patients and research subjects have a right to be self-determining concerning the health related information they rec...
The advent of new genetic and genomic technologies may cause friction with the principle of respect for autonomy and demands a rethinking of traditional interpretations of the concept of informed consent. Technologies such as whole-genome sequencing and micro-array based analysis enable genome-wide testing for many heterogeneous abnormalities and p...
In their article, Dees and Kwon (2013) describe the case of newborn screening for Krabbe disease and argue compellingly that a mandatory newborn screening program for this disease is problematic in several respects. Therefore, they submit, testing on Krabbe disease should only be offered on a voluntary basis, under a research protocol. In my opinio...
The arrival of new genetic technologies that allow efficient examination of the whole human genome (microarray, next-generation sequencing) will impact upon both laboratories (cytogenetic and molecular genetics in the first instance) and clinical/medical genetic services. The interpretation of analytical results in terms of their clinical relevance...
The bonds between applied ethics and social science seem to become increasingly tight. This does not only manifest itself
by social scientists and ethicists working together, but also by an increasing attention, from both sides, to the very nature
of their cooperation. The debate on this topic has been ongoing for more than twenty years, but in the...
Advances in genomics will open up opportunities in the fields of genetic testing, early diagnosis and disease treatment. While neonatal screening is the field of application par excellencefor these developments, the debate on its potential benefits and drawbacks is mainly theoretically driven and based on the opinions of professionals.
We conducted...
Since decades, neonatal screening has been considered an uncontroversial public health programme. Most industrialised countries screen for some diseases like phenylketonuria (PKU) and congenital hypothyroidism. These conditions can be relatively well treated, either in the form of dietary restrictions, or by supplementing the children with the subs...
The current neonatal screening program ("the heel prick") involves taking a few drops of blood from almost every newborn in the Netherlands to determine whether the child is suffering from one of three congenital disorders: phenylketonuria, congenital hypothyroid, or adrenogenital syndrome. This study investigated the preferences and views of paren...
Part I offers the context to the claim that informed consent requirements need to be strengthened to the extent that newborn screening conveys more disadvantages relative to the advantages. This includes a discussion of the Dutch debate on expanding newborn screening. From this discussion it becomes apparent that the interpretation and application...