The rise of ethics in the Netherlands
In the end of the 90’s of the past century and the early years of the twentieth century an ethical debate arose on the future of health care in the Netherlands. The ethical debate is about a lot of topics regarding health care. The debate about euthanasia and abortion are about done in the Netherlands. In the Netherlands the main topics are:
• About the boundaries of technology. Although technological a lot is possible, not everything is acceptable. Think of transplantation, when is someone dead, cloning of human beings, but also of genetic modification
• the just distribution of the scarce health resources. Think of lung transplantation to smokers, but also extra insurance premiums for people who live an unhealthy life
• About solidarity and the bandwidth of the collectively insured package, e.g. are physiotherapy, general practitioner, health transportation mandatory or free of choice insured?
• About the social responsibility of organizations working in health care. E.g. the debate about the possibility to make a profit as a hospital organization and salaries of CEO’s of hospitals
The debate has a tendency towards a more conservative ethical society in which common values are highly appraised. The best place to see the first signs of this shift is in the Dutch parliament. In the BBC documentary “the power of nightmares” the rise of the neo-conservative movement in the US is described.
o The increase of health care cost will urge the government to limit the collective health insurance. Individuals will be free to get an additional health insurance, but this puts a pressure on the welfare state as we know it
o Every technological breakthrough will create its own debate. Think of the controversial first successful cloning operation in South Korea.
o The debate about profit and salaries will make that the sector will not be that attractive for the best management in the future. Bad management will result in bad organizational results
o Ethics can slowdown and guide technological innovation. When something becomes possible people just want to have it, no matter what.
There is a shift going in the Netherlands as well as in the rest of western society from a autonomous, liberal individualistic perspective to a more conservative ethical revival. In this new paradigm common values and equality are highly appraised. The community will regain its respect again.
Ministry of health (www.minvws.nl),
already going on