Suicide is considered a global public health issue and compulsory admission is a commonly used measure to prevent suicide. However, the practice has been criticised since several studies indicate that the measure lacks empirical support and may even increase suicide risk. This paper investigates whether the practice has enough empirical support to be considered proportionate. To that end, arguments supporting compulsory admission as a suicide-preventive measure for most suicidal patients are scrutinized. The ethical point of departure is that the expected (...) benefits of compulsory admission should outweigh the potential harms of the measure to be proportionate and defensible. It is concluded that, for most suicidal patients, suicide-preventive compulsory admission cannot be presumed to be a proportionate measure. To be so, the expected medical benefits of the measure should be greater than the potential increase in suicide risk and other harms that compulsory admission could entail. Instead of using compulsory admission as a suicide-preventive measure, extra safety measures may be needed during and after compulsory admission to prevent the risk of hospitalisation-induced suicide. (shrink)

Patients with borderline personality disorder (BPD) are overrepresented in compulsory inpatient care for suicide-protective reasons. Still, much evidence indicates negative effects of such care, including increased suicide risk. Clinical guidelines are contradictory, leaving clinicians with difficult ethical dilemmas when deciding on compulsory care. In this study, we analyse the arguments most commonly used in favour of compulsory care of BPD patients, to find out in what situations such care is ethically justified. The aim is to guide clinicians when deciding on (...) compulsory care for BPD patients and reduce the use of potentially harmful care. The arguments analysed are (a) the patients lack decision competence, (b) the patients lack authenticity, (c) compulsory care saves the patient from suicide, (d) compulsory care safeguards against litigation, complaints, or doctor's anxiety, (e) compulsory care is a practical solution in emergencies, and (f) it is better for the caregiver to ‘err on the safe side’. We conclude that compulsory care is not ethically justified in most cases unless the clinician has probable reason to believe that the patient lacks decision capacity by suffering from a severe mental co-morbidity and stands to benefit from such care. (shrink)

This paper focuses on the ethical justifiability of patents on Genetically Modified (GM) crops. I argue that there are three distinguishing features of GM crops that make it unethical to grant patents on GM crops, even if we assume that the patent system is in general justified. The first half of the paper critiques David Resnik’s recent arguments in favor of patents on GM crops. Resnik argues that we should take a consequentialist approach to the issue, and that the best (...) way to do so is to apply the Precautionary Principle, and that the Precautionary Principle, in this case, supports patents on GM crops. I argue that his argument in favor of a consequentialist treatment is invalid; his Precautionary Principle in any case appears to be incompatible with consequentialism; and his conception of reasonable precautions is too ill-defined to have any argumentative purchase. In the second half of the paper, I argue against GM crop patents, on three grounds. First, there is insufficient evidence to say whether allowing patents on GM crops will make research go faster than not having patents, whilst there is a good reason to think that, other things being equal, a society that allows patents on GM crops will be less just than one that does not. Second, even assuming that patents on GM crops will increase the pace of GM crop research, there is no social need to do so. Third, patents on GM crops will frequently have ethically unacceptable side effects. (shrink)

This open access book provides the first explicit case study for an application of the method of reflective equilibrium (RE), using it to develop and defend a precautionary principle. It thereby makes an important and original contribution to questions of philosophical method and methodology. The book shows step-by-step how RE is applied, and develops a methodological framework which will be useful for everyone who wishes to use reflective equilibrium. With respect to precautionary principles, the book demonstrates how a rights-based precautionary (...) principle can be constructed and defended. The case study succeeds in demonstrating that RE can be successfully applied and puts real constraints on the justification process. This is all the more remarkable as the case study was designed as an open-ended process, without presupposing any specific results. This book will be highly relevant both to people interested in philosophical methodology and epistemology, as well as to researchers who are interested in using philosophical methods and tools and applying them to practical problems. (shrink)