Publications
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The ‘thousand-dollar genome’: an ethical exploration (2010)
Sequencing an individual’s complete genome is expected to be possible for a relatively low sum (‘one thousand dollars’) within a few years. Sequencing is determining the order of base pairs that make up the genome.
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So far away and yet so near? (2010)
The demand for care will increase in the years ahead and yet the number of care professionals will decrease. One way of solving this problem is to use ‘telecare’.
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He who pays the piper calls the tune? (2009)
This advisory report examines the influence of financiers (especially industrial financiers) on the development of medical knowledge, and the ethical questions to which this gives rise.
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Ethical considerations in healthcare-related TV programmes (2009)
Health care is a popular theme in TV programmes. Informative as well as entertaiment programmes are keen to provide coverage on health and sickeness, and on filming patients and doctors in their natural habitat: the consultation room or the emergency department.
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Dilemmas of nurses and carers (2009)
On November 26th (2009) the Centre for Ethics and Health published a report on moral dilemmas in daily care that nurses and carers are confronted with. These dilemmas are related to institutional requirements, such as achieving targets, meeting performance requirements and dealing with new financial structures.
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Care for the unborn child (2009)
Since the Health Council published its report on ‘invasive diagnosis and treatment of the fetus’ in 1990, significant developments have taken place in this field, mainly as a result of the new options now available in non-invasive (drug) and minimally invasive fetal therapy.
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Dilemmas on the doorstep (2008)
On September 25th, the Centre for Ethics and Health published Dilemmas on the doorstep – Reading early warning signs and intervention by professionals in parenting situations. In English, we have prepared a summary of the report.
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Farewell to non-commitment (2008)
Discussions on post-mortem organ donation usually centre on four decision systems: the consent system, the classic no-objection system, the compulsory-choice system and the Active Donor Registration System (ADR system). Within these systems, citizens can choose one or more options: whether they wish to be donors, whether they object to this, or whether they (explicitly) leave the decision to their next of kin.
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Financial incentives of organ donors (2007)
The lack of organ donations has recentrly received a great deal of attention in the Netherlands. The reason for this is the persistent lack of kidney donors. In 2006 more than 1000 people were on a waiting list for a kidney, whereas the number of available post-mortem organs decreased by 14 percent in 2006.
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Economisation of health care and professional ethics (2007)
The term ‘economisation’ is often used to describe the growing dominance of economic motives and interests in the organisation and provision of healthcare.
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Considerations pertaining to neonatal life termination (2007)
Life termination causing or hastening death by the administration of a substance intended to have that effect – is a criminal offence in the Netherlands, which may constitute manslaughter or murder.
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Appropriate evidence. Ethical questions concerning the use of evidence in health care policy (2007)
Scientific evidence is playing an increasingly important role in both health care and health care policy. Yet is this emphasis on scientific rigour appropriate for every form of care? That is the key question posed in the monitoring report Appropriate evidence.
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Confidence in responsible care? (2006)
The effects of performance indicators and moral issues associated with their use.
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Should blood donors be tested for Variant Creutzfeldt-Jakob disease? (2006)
Since it has become clear that variant Creutzfeldt-Jakob disease is transmissible via blood transfusions, major efforts have been made to develop a test that allows for the detection of abnormal prion proteins in the blood.
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Performance indicators and public reporting in health care (2006)
Performance indicators are measurable elements of healthcare provision that act as a possible pointer to the quality of care. They act as signals: low scores signal that something might be going wrong, and that further analysis is needed to find out whether this is indeed the case.
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Embryonic stem cells without moral pain? (2005)
This spring, Korean researchers announced that they had succeeded in obtaining stem cells from embryos produced by cloning. This involved introducing the nucleus of human skin cells into egg cells from which the nucleus had been removed. It is hoped that in the long term this method can be used to culture patient-specific cell material for autologous transplantation that might prove effective in the treatment of a wide range of complaints.
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Ethics in health-care institutions and in the education of care professionals (2005)
Since health-care work involves so many moral questions, it is important that health-care professionals should possess the skills needed to deal with these questions. The present report reveals, however, that many health-care workers lack the necessary basic knowledge of ethics and ethical skills. Moreover, many health-care workers are not aware of the moral implications of such simple activities as washing and dressing patients. This can lead in practice to misunderstandings, moral and communication problems and a less than optimal quality of care
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Health care professional and police informant? (2005)
Imagine that shortly after the murder of the controversial Dutch politician Pim Fortuyn, Volkert van der G. (the person charged and ultimately convicted of the crime) was not arrested, but sought the assistance of a psychiatrist to deal with his feelings of guilt. Should the psychiatrist pass this information on to the police? According to current Dutch legislation he should not: he is bound by his duty of confidentiality towards his patients.
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Tracking down threats to health: screening in GP practice (2005)
More and more methods are becoming available for early detection of diseases, aimed at prevention of these complaints by timely treatment or changes in lifestyle. This report considers the role of the GP in this development.
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Now with extra bacteria! Food products with health claims (2005)
Unhealthy eating habits damage the health of the public. People eat too much and they eat the wrong kinds of foods, which leads to a growth in the prevalence of many diseases. A new trend in supermarkets is the stocking of food products that come with health claims, such as bread with added fish oil to reduce blood cholesterol levels or yoghurt drinks containing healthy bacteria which are supposed to promote healthy intestinal flora. It is possible that these new food products do help to combat the problem of food-related disease.
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Ethical aspects of cost-utility analysis (2005)
Monitoring of the expenditure on health care involves the need to make choices about which treatments are to be included in the health-care package made available to the public. Specific cost-utility analysis (CUA) methods have been developed to provide a uniform quantitative basis for the making of such decisions over the whole range of health services. An important criterion in this connection is the QALY (quality-adjusted life year).
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Advanced home care technology: moral questions associated with an ethical ideal (2004)
Patients suffering from a range of severe and less severe conditions are increasingly being treated at home using ever more sophisticated medical technology. Some examples of this trend, which is expected to continue, include intravenous treatment of infections, haemodialysis, respiratory support and telemonitoring. The trend has some clear benefits, but also raises ethical questions.
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Terminal sedation (2004)
Terminal sedation is the procedure whereby a patient is placed into a deep sleep with the expectation that this will be maintained until he or she dies. Artificial administration of food and fluid is often withdrawn at the same time. This leads to a marked decline in the patient’s consciousness up till death, and may also shorten his or her life. It is important that fundamental values and norms are not violated during this process, and that the patient continues to be treated with due care.
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Advanced home care technology: moral issues surrounding a new healthcare practice (2004)
An increasing number of types of medical technology are becoming appropriate for home application. In addition, developments in demand for and supply of healthcare are leading to an increased use of home care technology.
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Human enhancement (2003)
Under the influence of scientific and technological developments, the theme of ‘engineering people’ is receiving increasing attention. The health care system also, to an increasing degree, has to deal with the possibilities provided by the biomedical sciences for perfecting healthy people in accordance with their own preferences. In medical ethics, this theme is known as ‘enhancement’: the use of genetic, biomedical or pharmacological knowledge to make improvements in human characteristics.