
Sigrid SterckxGhent University | UGhent · Department of Philosophy and Moral Sciences
Sigrid Sterckx
PhD
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187
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Introduction
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March 2009 - present
March 1995 - present
Publications
Publications (187)
This paper explores recently emerging challenges in Medical Assistance in Dying on Psychiatric Grounds (MAID-PG), focusing on ethical, clinical, and societal perspectives. Two themes are explored. First, the growing number of young MAID-PG requestors and the public platform given to MAID-PG requests. Ethically, media portrayal, particularly of youn...
Belgium is one of very few countries where euthanasia on the basis of psychiatric illness is legally possible. Three physicians involved in the euthanasia of a 38-year-old woman suffering from psychiatric illness recently faced a criminal trial for “murder by poisoning”, for allegedly having failed to comply with several requirements of the Belgian...
Abstract Background and objectives Defining the optimal moment to start renal replacement therapy (RRT) in acute kidney injury (AKI) remains challenging. Multiple randomized controlled trials (RCTs) addressed this question whilst using absolute criteria such as pH or serum potassium. However, there is a need for identification of the most optimal c...
This article explores whether 'digital pills' that track medication intake should be used to enhance adherence. We concentrate on psychiatric conditions since these pose unique challenges. We analyze two public policies that potentially encourage the development of systems for remote monitoring of intake, namely the granting of patents and marketin...
The combination of “Big Data” and Artificial Intelligence (AI) is frequently promoted as having the potential to deliver valuable health benefits when applied to medical decision-making. However, the responsible adoption of AI-based clinical decision support systems faces several challenges at both the individual and societal level. One of the feat...
Background
Belgium is one of very few countries that legally allow euthanasia for suffering caused by psychiatric illness. In the first criminal trial in Belgium of physicians involved in euthanasia, three physicians recently faced the accusation of “murder by poisoning,” for allegedly having failed to comply with several requirements of the Belgia...
Background
There is increasing interest in incorporating clinical decision support (CDS) into electronic healthcare records (EHR). Successful implementation of CDS systems depends on acceptance of them by healthcare workers. We used a mix of quantitative and qualitative methods starting from Qsort methodology to explore expectations and perceptions...
Research regarding the drivers of acceptance of clinical decision support systems (CDSS) 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 vignette...
Current methods of genome editing have been steadily realising the once remote possibilities of making effective and realistic genetic changes to humans, animals and plants. To underpin this, only 6 years passed between Charpentier and Doudna’s 2012 CRISPR-Cas9 paper and the first confirmed (more or less) case of gene-edited humans. While the tradi...
The use of artificial intelligence (AI) in healthcare comes with opportunities but also numerous challenges. A specific challenge that remains underexplored is the lack of clear and distinct definitions of the concepts used in and/or produced by these algorithms, and how their real world meaning is translated into machine language and vice versa, h...
Access to COVID vaccines
Over the last decades, the face of health care has changed dramatically, with big improvements in what is technically feasible. However, there are indicators that the current approach to evaluating evidence in health care is not holistic and hence in the long run, health care will not be sustainable. New conceptual and normative frameworks for the...
Bedrijven kunnen medische gegevens halen uit verschillende bronnen: Facebook-berichten, aankopen met kredietkaart, inhoud van e-mails of recent bekeken video’s op YouTube. In principe houden deze gegevens geen verband met de gezondheidstoestand van de gebruiker. Kunstmatige intelligentie-instrumenten en “big data”-algoritmen kunnen betekenisloze in...
Digitalisering en artificiële intelligentie (AI) bieden mogelijkheden om de gezondheidszorg te optimaliseren. Vooral machine learning gebaseerd op neurale netwerktechnologie, waaronder deep learning of gebaseerd op beslisboomtechnologie, worden in die context naar voren geschoven. Succesvolle implementatie van dergelijke algoritmes vooronderstelt i...
In 2002 with the passing of the Euthanasia Law, Belgium became one of the few countries worldwide to legalize euthanasia. In the 18 years since the passing of the law, much has changed. We argue that in Belgium a widening of the use of euthanasia is occurring and that this can be ethically and legally problematic. This is in part related to the fac...
Euthanasia and physician assisted suicide (E/PAS) in the context of unbearable psychological or emotional suffering related to psychiatric disorders (psychiatric E/PAS) is a highly debated topic. In Belgium and The Netherlands, the law allows for psychiatric E/PAS since 2002. The aim of this article is to give an overview of the Belgian and Dutch e...
The European Patent Office Enlarged Board of Appeal was asked in April 2019 to answer two questions regarding the exclusions from patentability under Art. 53 European Patent Convention (EPC), the dominant patent law in Europe. The first related to the manner in which EPC Articles should be interpreted, and the second to whether Art. 53 EPC excluded...
23andMe not only sells genetic testing but also uses customer data in its R&D activities and commercial partnerships. This raises questions about transparency and informed consent. Based on a online survey conducted in 2017-18, we examine attitudes of 368 customers of 23andMe toward the company's use of their data. Our findings point at divides in...
In the context of debates on (forensic) psychiatry issues pertaining to moral dimensions of (forensic) psychiatric health care are frequently discussed. These debates invite reflection on the question whether forensic practitioners have a role in stimulating patients’ moral development and moral growth in the context of forensic psychiatric and psy...
A wide variety of medications and neuromodulation techniques are being investigated to manage risk factors for deviant behavior. If certain neurointerventions can restore impaired moral decision-making and behavior in offenders, should the criminal justice system be permitted to use such neurointerventions and, if so, under which conditions? In thi...
In 2017, regulatory approval was given in the US for a ‘digital pill’, a pill for which actual ingestion could be remotely monitored. The pill, Abilify Mycite is marketed by Otsuka but the monitoring system derives from Proteus Digital Health. In this paper, we focus on this digital pill and another equivalent system from AiCure which relies on fac...
We seek to clarify and assess the underlying moral reasons for opposing all medically unnecessary genital cutting of female minors, no matter how severe. We find that within a Western medicolegal framework, these reasons are compelling. However, they do not only apply to female minors, but rather to non-consenting persons of any age irrespective of...
Background:
Notwithstanding fears of overly permissive approaches and related pleas to refuse euthanasia for psychological suffering, some Belgian hospitals have declared that such requests could be admissible. However, some of these hospitals have decided that such requests have to be managed and carried out outside their walls.
Main text:
Ghen...
Background:
Since Belgium legalised euthanasia, the number of performed euthanasia cases for psychological suffering in psychiatric patients has significantly increased, as well as the number of media reports on controversial cases. This has prompted several healthcare organisations and committees to develop policies on the management of these req...
Although climate change jeopardizes the fundamental human rights of current as well as future people, current actions and ambitions to tackle it are inadequate. There are two prominent explanations for this motivational gap in the climate ethics literature. The first maintains that our conventional moral judgement system is not well equipped to ide...
In 2012, a new and promising gene manipulation technique, CRISPR-Cas9, was announced which seems likely to be a foundational technique in healthcare and agriculture. However, patents have been granted. As with other technological developments, there are concerns of social justice regarding inequalities in access. Given the technologies’ ‘foundation...
Care.data and the 100000 genomes project
The right to access and use one's personal genetic details
Hippocrates famously advised doctors, 'it is far more important to know what person the disease has than what disease the person has'. Yet 2500 years later, 'personalised medicine', based on individual genetic profiling and the achievements of genomic research, claims to be revolutionary. In this book, experts from a wide range of disciplines criti...
Advancements in the field of biotechnology have accelerated the development of drugs that are manufactured from cultures of living cells, commonly referred to as 'biologics'. Due to the complexity of the production process, generic biologics are unlikely to be chemically identical to the reference product, and accordingly are referred to as 'biosim...
Data exclusivity is a temporary exclusive user right on the clinical data that need to be submitted to the regulatory authorities to prove that a new drug is safe and effective. For the pharmaceutical industry, data exclusivity is an important addition to the patent system, as data exclusivity will de facto delay the market entry of generic drugs u...
In 2014, the Belgian Euthanasia Law was amended so as to extend the possibility of obtaining euthanasia to minors who have the capacity for discernment. The amendment led to considerable debate among Belgian legal experts, health care professionals and ethicists, in large part due to concerns about the scope and assessment of the minor's 'capacity...
Rapid advances in microarray and sequencing technologies are making genotyping and genome sequencing more affordable and readily available. There is an expectation that genomic sequencing technologies improve personalized diagnosis and personalized drug therapy. Concurrently, provision of direct-to-consumer genetic testing by commercial providers h...
The introduction of Web 2.0 technology, along with a population increasingly proficient in Information and Communications Technology (ICT), coupled with the rapid advancements in genetic testing methods, has seen an increase in the presence of participant-centred research initiatives. Such initiatives, aided by the centrality of ICT interconnection...
Neurobiological and behavioural genetic research gives rise to speculations about potential biomedical interventions to prevent, contain, or treat violent and antisocial behaviour. These developments have stirred considerable ethical debate on the prospects, threats, and limitations of integrating neurobiological and behavioural genetic interventio...
http://www.tandfonline.com/eprint/cm9bgBQwvAjy5GUU5qMz/full
The inclusion of an investment chapter in the Comprehensive Economic and Trade Agreement (CETA) and the Transatlantic Trade and Investment Partnership (TTIP) has encountered significant opposition, especially in relation to Investor-State Dispute Settlement (ISDS). In this context, the EU...
In 2012, Eli Lilly, a US pharmaceutical corporation, initiated an investor-state arbitral claim against the Canadian government after the Canadian courts invalidated two of Eli Lilly's Canadian patents, claiming that the application of the so-called ‘promise doctrine’ violates international patent law agreements. Even though this is not the first i...
Examining the evidence from Belgium – one of only five countries where euthanasia is practised legally – an international panel of experts considers the implications of legalised euthanasia and assisted suicide. Looking at the issue from an international perspective, the authors have written an invaluable in-depth analysis of the ethical aspects of...
In this piece, we comment on the article by Pearce earlier in this journal. As Pearce correctly points out, what is fundamentally at issue in ESHRE et al's opposition to Stanford University's European patent on time-lapse microscopy is whether an exclusion from patentability, here of methods of medical diagnosis, should be interpreted narrowly or n...
In 2013, a European Patent for the time-lapse microscopy was granted by the European Patent Office (EPO) to Stanford University and was subsequently opposed by Unisense FertiliTech A/S and by the European Society for Human Reproduction and Embryology (ESHRE), Sigrid Sterckx, Julian Cockbain and Guido Pennings. ESHRE et al.'s opposition was based on...
This chapter examines continuous sedation as a way to relieve unbearable suffering in patients at the end of life. After considering consensus and guidelines on continuous sedation, it looks at the debate over terminology and definition. It then discusses the practice of continuous sedation in various countries and how it is performed, along with t...
In this chapter we review recent developments in patent law in the US and Europe in relation to the patenting of ‘isolated’ human body materials, noting the tension in patent law between its general aspiration of promoting the (bio) economy while at the same time ring-fencing products of nature from effective monopolisation by patentees. Central to...
Whether living tissue and donation by minors is acceptable is the subject of considerable debate. In view of the vulnerable position of minors, the risks involved in the medical procedure, and the possible conflict of interests on the part of the parents, the legal approach in Europe has traditionally been very restrictive. However, this approach m...
Background
Continuous deep sedation at the end of life is a practice that has been the topic of considerable ethical debate, for example surrounding its perceived similarity or dissimilarity with physician-assisted dying. The practice is generally considered to be legal as a form of symptom control, although this is mostly only assumed. France has...
Background:
The language of "participant-driven research," "crowdsourcing" and "citizen science" is increasingly being used to encourage the public to become involved in research ventures as both subjects and scientists. Originally, these labels were invoked by volunteer research efforts propelled by amateurs outside of traditional research instit...
This paper explores whether the Clean Development Mechanism (CDM), a flexibility mechanism under the Kyoto Protocol, has contributed to poverty alleviation in countries that host CDM projects. We argue that the CDM should deliver pro-poor benefits to the communities in which projects are established, since poverty alleviation is integral to sustain...
An ‘Information Centre’ has recently been
established by law which has the power to collect, collate and
provide access to the medical information for all patients
treated by the National Health Service in England, whether in
hospitals or by General Practitioners. This so-called ‘care.-
data’ scheme has given rise to major and ongoing controversies...
Living organ donation (LD) is an increasingly established practice. Whereas in the United States and Canada LD by minors has occasionally been reported, LD by minors seems to be largely absent in the European Union (EU). It is currently unclear whether this is the result of a different legal approach. This study is the first to systematically analy...
The characterisation of anthropogenic climate change as a violation of basic human rights is gaining wide recognition. Many people believe that tackling this problem is exclusively the job of governments and supranational institutions (especially the United Nations Framework Convention on Climate Change). This argument can be traced back to the del...
Since the adoption of the WTO‐TRIPS Agreement in 1994, there has been significant controversy over the impact of pharmaceutical patent protection on the access to medicines in the developing world. In addition to the market exclusivity provided by patents, the pharmaceutical industry has also sought to further extend their monopolies by advocating...
Although emissions trading is embraced as a means to curb carbon emissions and to incentivize the use of renewable energy, it is also heavily contested on ethical grounds. We will assess the main fundamental objections and possible counterarguments. Although we sympathize with some of these arguments, we argue that they are unpersuasive when an emi...
Rationale, aims and objectives:
Continuous sedation at the end of life is an end-of-life practice that has gained considerable attention in the international literature. Nevertheless, significant confusion persists, even on how to label or define the practice. Several different terms and definitions exist, and these are often non-neutral and indic...
The ethical (un)acceptability of euthanasia for severe physical suffering is undoubtedly one of the most controversial topics of our time. Perhaps even more controversial is the debate on whether euthanasia could also be justified for cases of mental suffering, which we understand as suffering without an underlying diagnosable condition or cause. V...
An ‘Information Centre’ has recently been established by law
which has the power to collect, collate and provide access to the medical information for
all patients treated by the National Health Service in England, whether in hospitals or by General Practitioners. This so-called ‘care.data’ scheme has given rise to major and ongoing controversies....
In order to develop a model of equitable and sustainable distribution, this paper advocates integrating the ecological space paradigm and the capabilities approach. As the currency of distribution, this account proposes a hybrid of capabilities and ecological space. Although the goal of distributive justice should be to secure and promote people’s...
The capabilities approach of Amartya Sen and Martha Nussbaum has become an influential viewpoint for addressing issues of social justice and human development. It has not yet, however, given adequate theoretical consideration to the requirements of environmental sustainability. Sen has focussed on the instrumental importance of human development fo...
In this article, the question is addressed as to whether European patent law discriminates against medical devices and in favor of pharmaceuticals, and, if so, whether such discrimination is unfair to the medical devices sector. Three forms of discrimination are identified: the availability of Supplementary Protection Certificates for pharmaceutica...
With the recent transposition of Directive 2010/53/EU into the transplant regulation of EU Member States, the time is right to have a closer look at its implications for living organ donation practice. We first discuss the relevance of the Action Plan which forms the basis for the policy of the European Commission in the field of organ donation and...
18 H uman organs and tissues differ in regard to their clinical and research uses and the regulatory legislation controlling their use. Organs such as livers and hearts are usually taken from donors who are brain-dead; in addition, kidneys can also come from live volunteers. Organs decay rapidly and need to be transplanted quickly. Surgeons and coo...
Human body material removed post mortem is a particularly valuable resource for research. Considering the efforts that are currently being made to study the biochemical processes and possible genetic causes that underlie cancer and cardiovascular and neurodegenerative diseases, it is likely that this type of research will continue to gain in import...
Although transplant professionals have initially been reluctant to perform transplants after public solicitation of organs from living donors, nowadays these transplants are increasingly being performed and reported. After clarifying the existing terminology, we elaborate an operational definition of public solicitation that is consistent with the...
Although transplant professionals have initially been reluctant to perform transplants after public solicitation of organs from living donors, nowadays these transplants are increasingly being performed and reported. After clarifying the existing terminology, we elaborate an operational definition of public solicitation that is consistent with the...
Human body material removed post mortem is a particularly valuable resource for research. Considering the efforts that are currently being made to study the biochemical processes and possible genetic causes that underlie cancer and cardiovascular and neurodegenerative diseases, it is likely that this type of research will continue to gain in import...
The European Union Emissions Trading System (EU ETS) is in dire straits. Prone to design problems and suffering from the effects of the economic crises the scheme is criticised for its poor achievements. In this paper we will analyse some of the features of this situation from an ethical perspective. The major part is dedicated to the complications...
This book discusses the agency and responsibility of individuals in climate change, and argues that these are underemphasized, enabling individuals to maintain their consumptive lifestyles without having to accept moral responsibility for their luxury emissions. © Wouter Peeters, Andries De Smet, Lisa Diependaele and Sigrid Sterckx 2015. All rights...
In this paper we examine to what extent globalization has altered responsibilities for human rights. We give priority to negative human rights and take the violation of these rights as the baseline for determining harm and injustice. We will focus on the global economic order and on climate change and examine whether these aspects of globalization...
In addition to highlighting the main conclusions of our discussion in the preceding chapters, we emphasize that the lack of a more robust approach regarding people’s rights and responsibilities does not imply that we are unable to make any judgement at all. On the basis of moral responsibility for their luxury emissions, emitters can at least be as...
In this chapter, we tentatively suggest some strategies to increase emitters’ motivation to accept moral responsibility for the consequences of their luxury emissions, and to accordingly acknowledge their remedial responsibility for tackling climate change. First, emitters’ motivation can be increased by enhancing their moral judgement on the basis...
This chapter explores two complementary explanations for the motivational gap. We argue that the first explanation — referring to the inadequacy of our moral framework to capture climate change as an important moral problem — remains incomplete, since individuals can effectively be identified as morally responsible for their luxury emissions. Secon...
Most objections against holding individual emitters responsible for climate change are closely related to the characteristic way in which people experience themselves as agents with causal powers. Within this phenomenology of agency, acts have primacy over omissions; near effects have primacy over remote effects; and individual effects have primacy...
This chapter sketches the problems of climate change and allocation of the responsibility for tackling it. In view of the threats to key human rights posed by observed and projected climatic changes, climate change is conceptualized as a moral harm. We explore how the burdens involved in remedying the problem should be allocated, focusing on the pr...
The application of ethically controversial medical procedures may differ from one place to another. Drawing on a keyword and text-mining analysis of 156 interviews with doctors and nurses involved in end-of-life care ('care providers'), differences between countries in care providers' ethical rationales for the use of sedation are reported. In the...
Background
The debate on the ethical aspects of moral bioenhancement focuses on the desirability of using biomedical as opposed to traditional means to achieve moral betterment. The aim of this paper is to systematically review the ethical reasons presented in the literature for and against moral bioenhancement.
Discussion
A review was performed a...
Continuous sedation at the end-of-life is a practice that has attracted much attention. An increasing number of guidelines on the proposed correct performance of the practice have been drafted. All guidelines stress the importance of using sedation proportionally to the severity of the symptoms the patient is suffering from, and thus to reduce the...
Extensive debate surrounds the practice of continuous sedation until death to control refractory symptoms in terminal cancer care. We examined reported practice of United Kingdom, Belgian and Dutch physicians and nurses.
Methods: Qualitative case studies using interviews.
Setting: Hospitals, the domestic home and hospices or palliative care units...
Doping scandals can reveal unresolved tensions between the meritocratic values of equal opportunity + reward for effort and
the “talentocratic” love of hereditary privilege. Whence this special reverence for talent? We analyze the following arguments:
(1) talent is a unique indicator of greater potential, whereas doping enables only temporary boost...
The UK National Health Service (the ‘NHS’), encouraged by the 2011 report Innovation Health and Wealth, Accelerating Adoption and Diffusion in the NHS, and empowered by the Health and Social Care Act 2012, is in the process of adopting a new agenda for stimulating innovation
in healthcare. For this, the bodies, body materials, and confidential heal...
To the Editor:Patients nearing death often experience distressing symptoms that cannot be alleviated by conventional treatments. In these situations palliative sedation, i.e. the use of sedative drugs to relieve intolerable and refractory distress by reducing the patient’s consciousness, can be an option of last resort [1]. In their recent publicat...