Mariëtte van den Hoven

Nudges in Public Health: Paternalism Is Paramount

Open Peer Commentary to Blumenthal-Barby, J. S., and H. Burroughs. 2012. Seeking better health care outcomes: The ethics of using the “nudge.” American Journal of Bioethics 12(2): 1–10.

A Five-Country Survey on Ethics Education in Preservice Teaching Programs

Despite a broad consensus on the ethical dimensions of the teaching profession, and long-standing efforts to align teacher education with wider trends in professional education, little is known about how teacher candidates are being prepared to face the ethical challenges of contemporary teaching. This article presents the results of an international survey on ethics content and curriculum in initial teacher education (ITE). Involving five Organisation for Economic Co-Operation and Development (OECD) countries—the United States, England, Canada, Australia, and the Netherlands—the study’s findings shed light on teacher educators’ perspectives on the contribution of ethics content to the education of future teachers and provide a snapshot of how well existing programs line up with their aspirations. The results showed that 24% of the ITE programs surveyed contain at least one mandatory stand-alone ethics course. The meaning of the results vis-à-vis opportunities for expanding ethics education in preservice teaching programs is also discussed.

Professional Solidarity: The Case of Influenza Immunization

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To dispense or not to dispense? Ethical case decision-making in pharmacy practice

In daily practice, pharmacists are regularly confronted with moral problems in which deciding what to do is not always a straightforward decision. In this contribution we show how the use of a specific method for moral deliberation can (in retrospect or prospective) aid moral judgements. We use the case of dispensing isotretinoin to demonstrate one ethical reflection method, namely the Utrecht Method.

Distance, dialogue and reflection : Interpersonal reflective equilibrium as method for professional ethics education

The method of reflective equilibrium (RE) is well known within the domain of moral philosophy, but hardly discussed as a method in professional ethics education. We argue that an interpersonal version of RE is very promising for professional ethics education. We offer several arguments to support this claim. The first group of arguments focus on a changed practice that is more team-oriented, inter-professional and aims at shared decision-making with patients and clients. The second group of arguments relate to the core aim of professional ethics education, namely to stimulate critical moral reflection. This central aim is a core professional moral competence that entails both a dialogical approach to practice and one’s own moral beliefs as well as a more detached viewpoint on practice, reflection on types of cases and one’s attitude as a professional in practice.

Commentary: The Struggle Against AIDS and the Pharmaceuticals Industry – Are There Limits to the Moral Obligation to Do Good?

Anyone presupposing that pharmaceutical companies have a moral obligation to help curb the AIDS crisis challenges us to think about the outer limits of this obligation and about the substance what can reasonably be obliged. The idea that the outer frontier of the moral obligation to render assistance is reached only when one encounters a threat to the actors’ fundamental interests runs contrary to our healthy common sense. The borderline with the reasonable seems to be much closer. A need to define the boundaries of reasonable moral obligations and to justify the grounds for putting them there lies at the core of the demandingness objection in philosophy. I show that the Roche case is well suited for launching a discussion on the reasonableness of the moral obligation to render assistance. In doing so I present several arguments and how they could be applied to this case. I did not define what would be a tangible and reasonable obligation for Roche. This cannot be done in isolation for Roche or any other company. It must be done in conjunction with the moral community and in the light of normative theories. What I have tried to show in this article is that extreme positions are untenable. The moral obligation to render assistance in curbing AIDS may not elicit an all or nothing answer. The reasonable may perhaps be negotiable.