The historical growth of several applied ethics fields – suchas animal, environmental, business and research ethics – isto a certain extent scandal driven. Moral concern andpublic awareness of ethical problems have triggered thedevelopment of codes, rules and declarations and otherregulatory policies. However, these regulatory instrumentsdo not always effectively address the original concerns.The first paper of this issue is a case in point. David C.Malloy et al. conducted focus groups with physicians fromculturally dissimilar countries. They investigated thephysicians’ level of awareness and the perceived utility ofethical guidelines intended to direct their practice. Theoverall sense was that they were ineffective, despite thecross-cultural nature of the study. Ethical guidelines werevalued only if congruent with existing personal morality.Naturally, this finding questions the relevance of ethicalguidelines when it comes to guidance or education. Hence,the authors suggest further analysis of the purpose, content,and delivery of ethical guidelines in order to improve theireffectiveness in encouraging ethical behaviour.Klaus Lindgaard Hoeyer and Niels Lyno¨e take up thechallenge. When ethics is transformed into policy, the linkbetween problems and solutions is far from simple. Spe-cific policies cannot be explained completely by referenceto the original moral concerns. Other organizational factorssteer the development of concerns into policy. As a resultthe policies adopted may end up addressing other problemsor having other effects than those originally intended.Against this backdrop the authors propose an interestingnew approach to the analysis of history and function ofethics policies and their complex practical implications.In ‘‘Refining deliberation in bioethics’’ Miguel Kottowargues that the rapid growth and the multidisciplinaryorigin of bioethics have made the discipline vulnerable tocriticism. Its discourse has become alarmingly complexand lacks unity. As a result there is a divide betweenacademic bioethics and ordinary citizens and practitionerstrying to cope with ethical problems relying on commonsense and intuitions. Against this backdrop Kottow pro-poses new ways of ongoing, participative and structuredbioethical deliberation.Next, Michael Barilan focuses on Nozick’s famous‘‘refutation of hedonism’’ in his thought experiment of the‘Experience Machine’, a machine that would give one anyexperience one desired by directly stimulating one’s brain.Nozick examined the question of whether one should ‘‘pluginto’’ the experience machine for the rest of one’s life(Nozick 1974). Barilan argues that end-of-life-sufferingthat is resistant to state-of-the-art palliation provides aninteresting analogy to Nozick’s experiment validating hisfindings.Inthefollowingpaper,JosephL.Verheijde,Mohamed Y.Rady andJoan L.McGregoradvancearguments questioningthe validity of the well known and widely accepted HarvardMedical School brain-death criteria to define human death.They argue that there are scientific uncertainties of deter-mining states of impaired consciousness including braindeath that necessitate further debate, claiming that organprocurement from patients with impaired consciousnessmight be seen as a concealed practice of physician-assisteddeath.Joris Gielen, Stef Van den Branden and Bert Broeckaertcontinue the focus on end-of-life issues. They evaluate theoperationalisation of religion and world view in published

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