The concept ‘voluntary return’ is a crucial but often poorly understood part of the procedure for the return of irregularly staying third-country nationals from EU member states, as set out in... Show moreThe concept ‘voluntary return’ is a crucial but often poorly understood part of the procedure for the return of irregularly staying third-country nationals from EU member states, as set out in Directive 2008/115 (the Returns Directive). Through this concept, member states allocate primary responsibility for the return process to individuals. This individual responsibility, however, is only vaguely defined in the Directive, creating the risk that it is used by member states in an almost entirely open-ended and limitless manner, with potentially far-reaching consequences for third-country nationals, including their fundamental rights. This dissertation seeks to clarify the limits of this individual responsibility arising out of the concept of voluntary return in the Directive. It does soby unpacking the two component parts of voluntary return: the obligation to return and the voluntary departure period. This analysis draws on a triangle model that brings into focus the three legal relationships thattogether determine the framework for voluntary return: the individual and the EU member state, the individual and the country of return, and the country of return and the EU member state. The analysis results in the identification of 25 guidelines setting out concrete limits on individual responsibility for voluntary return. Show less
Silven, A.V.; Peet, P.G. van; Boers, S.N.; Tabak, M.; Groot, A. de; Hendriks, D.; ... ; Villalobos-Quesada, M. 2022
Background Implementation of digital health (eHealth) generally involves adapting pre-established and carefully considered processes or routines, and still raises multiple ethical and legal... Show moreBackground Implementation of digital health (eHealth) generally involves adapting pre-established and carefully considered processes or routines, and still raises multiple ethical and legal dilemmas. This study aimed to identify challenges regarding responsibility and liability when prescribing digital health in clinical practice. This was part of an overarching project aiming to explore the most pressing ethical and legal obstacles regarding the implementation and adoption of digital health in the Netherlands, and to propose actionable solutions. Methods A series of multidisciplinary focus groups with stakeholders who have relevant digital health expertise were analysed through thematic analysis. Results The emerging general theme was 'uncertainty regarding responsibilities' when adopting digital health. Key dilemmas take place in clinical settings and within the doctor-patient relationship ('professional digital health'). This context is particularly challenging because different stakeholders interact. In the absence of appropriate legal frameworks and codes of conduct tailored to digital health, physicians' responsibility is to be found in their general duty of care. In other words: to do what is best for patients (not causing harm and doing good). Professional organisations could take a leading role to provide more clarity with respect to physicians' responsibility, by developing guidance describing physicians' duty of care in the context of digital health, and to address the resulting responsibilities. Conclusions Although legal frameworks governing medical practice describe core ethical principles, rights and obligations of physicians, they do not suffice to clarify their responsibilities in the setting of professional digital health. Here we present a series of recommendations to provide more clarity in this respect, offering the opportunity to improve quality of care and patients' health. The recommendations can be used as a starting point to develop professional guidance and have the potential to be adapted to other healthcare professionals and systems. Show less
Silven, A.V.; Peet, P.G. van; Boers, S.N.; Tabak, M.; Groot, A. de; Hendriks, D.; ... ; Villalobos-Quesada, M. 2022
BackgroundImplementation of digital health (eHealth) generally involves adapting pre-established and carefully considered processes or routines, and still raises multiple ethical and legal dilemmas... Show moreBackgroundImplementation of digital health (eHealth) generally involves adapting pre-established and carefully considered processes or routines, and still raises multiple ethical and legal dilemmas. This study aimed to identify challenges regarding responsibility and liability when prescribing digital health in clinical practice. This was part of an overarching project aiming to explore the most pressing ethical and legal obstacles regarding the implementation and adoption of digital health in the Netherlands, and to propose actionable solutions.MethodsA series of multidisciplinary focus groups with stakeholders who have relevant digital health expertise were analysed through thematic analysis.ResultsThe emerging general theme was ‘uncertainty regarding responsibilities’ when adopting digital health. Key dilemmas take place in clinical settings and within the doctor-patient relationship (‘professional digital health’). This context is particularly challenging because different stakeholders interact. In the absence of appropriate legal frameworks and codes of conduct tailored to digital health, physicians’ responsibility is to be found in their general duty of care. In other words: to do what is best for patients (not causing harm and doing good). Professional organisations could take a leading role to provide more clarity with respect to physicians’ responsibility, by developing guidance describing physicians’ duty of care in the context of digital health, and to address the resulting responsibilities.ConclusionsAlthough legal frameworks governing medical practice describe core ethical principles, rights and obligations of physicians, they do not suffice to clarify their responsibilities in the setting of professional digital health. Here we present a series of recommendations to provide more clarity in this respect, offering the opportunity to improve quality of care and patients’ health. The recommendations can be used as a starting point to develop professional guidance and have the potential to be adapted to other healthcare professionals and systems. Show less
Objective: Healthcare providers' (HCPs) perceptions of smokers' responsibility for smoking may affect implementation of smoking cessation care (SCC), but are understudied. This study examined Dutch... Show moreObjective: Healthcare providers' (HCPs) perceptions of smokers' responsibility for smoking may affect implementation of smoking cessation care (SCC), but are understudied. This study examined Dutch HCPs' perceptions of smokers' responsibility for smoking, and how many and which subgroups exist with regard to these perceptions.Methods: Observational cross-sectional study among physicians and other HCPs (N = 570). Latent class analysis was used to analyse data.Results: Results showed two latent classes of HCPs: a majority (77 %) that appeared to hold smokers themselves more accountable for their smoking, and a minority (23 %) that seemed more inclined to believe that people smoked as a consequence of factors such as addiction, and smoking initiation when people were young and could not foresee consequences. The two-class model showed excellent certainty in classification. Class membership was associated with age, working experience, and smoking status. The majority class experienced more barriers to SCC than the minority class and provided SCC tasks to fewer patients.Conclusions: HCPs' perceptions of smokers' responsibility for smoking relate to HCP background characteristics, barriers to SCC and implementation of SCC.Practice Implications: New approaches to improving SCC might be needed that take HCP's perceptions of smokers' responsibility into account. (C) 2020 The Author(s). Published by Elsevier B.V. Show less
This dissertation explores the relationship between autonomous weapon systems, the concept of human dignity, and international law. The thesis focuses on four branches of international law ... Show moreThis dissertation explores the relationship between autonomous weapon systems, the concept of human dignity, and international law. The thesis focuses on four branches of international law (international humanitarian law, human rights law, criminal law and the law of state reponsibility) and discusses whether autonomous weapon systems can be used in compliance with these bodies of law. The foundational notion of human dignity in international law provides a theoretical framework for the research and writing. The thesis argues that there are certain kinds of decision-making responsibilities that humans should not delegate to autonomous machines. More specifically, it argues that the transfer of decisions involving complex (and often contradictory) values to artificial intelligence software violates human dignity and, therefore, international law. Nevertheless, as the speed of autonomous weapon systems increases, the opportunities for human involvement and intervention in such decisions will inevitably decrease. Thus, to preserve the principle of human dignity (and ultimately international law), autonomous weapons should have a ‘co-active’ design that ensures teamwork and interdependence between humans and the computer software that directs these weapons. Show less
The thesis deals with the question as to whether international organisations could be jointly responsible for violations of international law committed by peacekeepers deployed in a peacekeeping... Show moreThe thesis deals with the question as to whether international organisations could be jointly responsible for violations of international law committed by peacekeepers deployed in a peacekeeping operation. The study starts by exploring the development of the concept of peacekeeping operations and the relations between the UN and four specific regional organisations (NATO, EU, AU and ECOWAS) on the basis of the applicable dispositions of the UN Charter. This examination as well as the following analysis of relations among these organisations, illustrate the evolution of a division of labour and an increase of cooperation between the UN and these organisations. It justifies the formulation of a presumption that international organisations could be jointly responsible as well as the formulation of a new criterion of attribution (normative control). The case-studies of specific peacekeeping operations confirm that in certain circumstances the UN and regional organisations have to be considered jointly responsible. Show less
