A student exploration of applied ethics in the Netherlands

Students were given an assignment to explore the field of applied ethics in the Netherlands as part of the master’s program in applied ethics at Utrecht University. This assignment had two educational purposes: to see how the students would explore such a new field and the perspectives on ethics and ethical expertise that arose as a result of this exploration, and to determine what applied ethicists think about the methods used in their field. We found that students used diverse methods to explore this field, and the success of those methods depended mainly on their own methodological skills. We also observed that, even though different methods are clearly being used in the various subfields of applied ethics, a simple high-theory approach was not embraced, and there was a great deal of overlap in the type of methodologies that are used in the subfields of applied ethics.


Introduction
The 2014-2015 cohort of master's students in applied ethics at Utrecht University was asked to explore the field of applied ethics in the Netherlands. In this master's program, students are trained to reflect on ethical issues in various practices and are encouraged to forge a career in any subfield of applied ethics. One of the methods of fostering a practice-oriented attitude is to get the students acquainted with the subfields of applied ethics in the Netherlands, which is done in the first obligatory course in the program. Distinguishing among the various subfields of applied ethics is important not only because these subfields show differences in focus (medical ethics differs from business ethics and environmental ethics) but also because different stakeholders are active in each subfield, and the topics and methods explored in the literature appear to vary depending on the subfield. Students presented their findings in a plenary session and had to write a report that could be used in a joint manuscript. This manuscript reflects the working methods and results that the students found during their assignment, as well as the benefits of such assignments in master's programs.

Subfield(s) of applied ethics
Applied ethics is a subdomain of practical philosophy that has become an increasingly important discipline since the 1980s (Beauchamp 2008). Within this domain, we have seen new subfields develop that not only deal with different topics (e.g., medical, environmental, or business cases) but also seem to use different methodologies. The four principles approach of Beauchamp and Childress is popular in medical domains, while integrity management is much more at the forefront of business ethics. Moreover, as Arras points out, the methodologies used in these various domains of applied ethics are still under construction; ideas about how normative theories and practice should relate differ, and may vary among the various subfields of applied ethics (Beauchamp 2008;Arras 2013). Therefore, getting acquainted with a field necessitates learning more about methods and methodology too.
Students at Utrecht University need a sufficiently strong background in ethical theories and philosophical courses (the minimum is 30 EC) to be admitted to the master's program in applied ethics. As students from all kinds of disciplines-philosophy, social sciences, medicine, accountancy, liberal arts, governance, biomedical sciences, etc.-show interest in the program, their backgrounds and ambitions vary greatly, so their focus in the MA program differs too. Most of them have vague ideas about applied ethics in daily practice, while some already know a few stakeholders in the field. An overarching aim of the assignment, from a teaching perspective, is to bring together their fragmented knowledge on applied ethics in the Netherlands through plenary presentations.

Assignment
The general and broad assignment that is given to students focuses on four aspects: (a) choose a subfield of applied ethics that they are interested in; (b) explore stakeholders in the Netherlands (those who are working in that particular field as applied ethicists); (c) determine the topics that those stakeholders are working on (e.g., projects and publications); (d) find out the perspectives that those stakeholders have on the relation between theory and practice in their work. Last year's group received an additional assignment to work together and prepare a joint manuscript about their findings. One group was appointed to steer the working method that others would use to explore the field.
The assignment is, from an educational point of view, interesting in at least two ways. First, it provides a useful insight into how students search a new field in which they may wish to develop a career. How do students orientate, what tools do they use, and why do they choose these particular tools? Experiences with other groups who have performed similar assignments show that some will use websites of universities to find Bethicists,^some simply use social media such as Facebook, LinkedIn, or Twitter to gather data on applied ethicists in the Netherlands, while others will use a snowball method or turn to PubMed. Learning how to spot ethicists in the field and analyzing how they present themselves in the public sphere helps students to reflect on their own position and options after they have finished the program. BEthicist^is not a registered profession, so anyone can claim expertise. Also, it is not defined by just one type of expertise; being a member of an IRB will require different skills and knowledge than working hands-on in a bank or teaching ethics to non-philosophy students. The methods used by each ethicist in the field can differ, as can their views on how theory and practice are related. For example, in clinical ethics, one rarely makes use of high theory to help physicians with concrete dilemmas, while environmental ethicists frequently use notions such as Bnon-identity^and Bhuman dignity^to discuss our moral responsibilities to future generations. As the assignment represented the students' first encounter with ethical expertise, no further reflections on ethical expertise were expected from them in this assignment, i.e., no definition or taxonomy of ethical expertise was required. A follow-up course addressed the issue of ethical expertise more explicitly. Instead, the assignment highlighted that these different views on the use of theory in practice reflect discussions on various methods associated with applied ethics. Some argue that any reference to Bwhat Kant would say^is unacceptable when confronted with a concrete case (Shalit 1997;Rachels 1991). Yet, applied ethics is also considered a part of practical philosophy, so if consequentialism, virtue ethics, or Kantianism cannot be referenced, what would be a good alternative? In the past, views like casuistry, reflective equilibrium, and others have been developed as an alternative to high theory. Anyone with an ambition to work in the field of applied ethics therefore needs to reflect on how ethical theories and moral practice are related in order to develop their own idea of ethical expertise. Interviewing people in the field of applied ethics and reading their work helps students to address this question.

Perspectives on methods in applied ethics
In the literature, three different positions are often used to describe the relation between practice and theory. We use a distinction that has been made by Beauchamp and Childress (Beauchamp and Childress 2009).
In a top-down approach to applied ethics, one applies a high theory such as deontology, utilitarianism, or virtue ethics to actual cases and then tries to come up with answers or guidelines about correct conduct based on the theoretical concepts and principles that one embraces. Several authors are sceptical of this approach. There is generally a lack of consensus among ethicists about the normative theory or principles to select (Arras 2013). The same goes for the selection of principles. Moreover, ideal theory inherently neglects the nonideal circumstances of everyday reality. For instance, in cases that are nonparadigmatic to high theories, people do not tend to comply with just norms. High theories do not necessarily account for the circumstances of human beings, who have to deal with conflicting emotional and social pressures on a daily basis. Another possibly even more basic issue is that a normative theory is not necessarily the complete, fixed moral framework that it is proclaimed to be.
Bottom-up approaches start with the moral problems people actually encounter in practice, without relying on high theories (Arras 2013: 10). Archetypical bottom-up ethicists are particularists: their approach consists of deliberately avoiding the use of moral principles, which are considered generalized ideas about morality. Examples of particularist reasons for avoiding these principles are that they lack any ultimate justification (Dancy 2009) or that they make us less sensitive to the morally relevant context of a problem. Some particularist positions can be considered anti-theorist, while others are more theory modest (Arras 2013: 41). A serious criticism of bottom-up approaches is that a lack of reference points in theoretical concepts could lead to arbitrary moral judgments.
A third approach is the midlevel approach. An example is the four principle approach developed by Beauchamp and Childress (Beauchamp 2008). Such principles are postulated as commonplace ideas upon which moral decisions can be based. Another well-known method is the method of reflective equilibrium, introduced by Rawls and developed by Norman Daniels and others. The basic idea is that, when deciding which option is be morally justified, one critically examines several ingredients of such a deliberation process. These ingredients can vary in number and type: intuitions, facts, background theories. The result will be a balanced judgement that is justified because of the equilibrium that is found (Arras 2013). Midlevel approaches have also fallen prey to critics; for instance, what determines the credibility of midlevel principles, and hence what status should those principles have? The fact that many people support a certain principle, meaning that it could be considered Bcommon,^is not an argument for its validity.
Students were asked to use these three approaches when investigating their area of interest. Are applied ethicists committing themselves to any of these approaches in practice, and why (or why not)? In the next section, we sketch out the method used by the students. In the third section, we describe the results of their findings, before analyzing and discussing the results in the final section.

Method
The students were split into smaller groups that each inquired into a specific subfield of applied ethics. As the students in the program tended to have different disciplinary backgrounds and different career ambitions, students were free to investigate the subfields they took the greatest interest in. As a result, their inventory may not have been exhaustive, which was not the aim of the assignment anyway. In a group session, all 25 students that enrolled in the class together decided which subareas would be explored and which research questions would be useful. The six most popular subfields among the students were chosen and then used as the basis for groups. Group 1 focused on animal ethics, group 2 on ethics & technology, group 3 on business ethics, group 4 inquired into professional ethics (education), group 5 on environmental ethics, group 6 on public health ethics and group 7 on research ethics. Thus, eight groups were established in all: seven groups investigating various subfields and one group that supervised the search and prepared a draft manuscript (group 8). The Bmanuscript group^formulated guidelines for collective use, so that each group would utilize similar research questions in their inquiries. These guidelines could not be too prescriptive or restrictive on the methodological part of the inquiries. Comments by all groups on a draft of the guidelines were taken into account. The final guidelines (see Table 1) focused in particular on how the results of the research questions were to be presented during a presentation in class as well as in a final paper.
Students had 5 weeks to explore the subfield of their choice and present their results and methods at a joint meeting. The editing group collected the research papers and combined them into a draft manuscript, which was further revised and supervised by the teacher of the class.

Findings
Each group had to decide how to explore the subfield assigned to it, which led to a huge variety of approaches. In this section, we focus on the methods used by the groups and the findings they came up with (Table 2).

Methods used to investigate the subfield
Most groups used a two-step approach to explore their particular subfield of applied ethics. The first step was to find the key figures working in the field of applied ethics; the second was to answer the research questions. For some groups, this implied that they had to make further choices regarding the subfield in question. For example, the professional ethics group decided to focus on the teaching of ethics, and not, for example, on the ethics of teaching or on views on professional ethics as such. The research ethics group defined their subfield as relating to moral issues surrounding Bhuman-subject research^and not research ethics in general, as that would have included research integrity or IRBs as well.
Some groups defined a key figure as someone who had published at least one article relevant to the subfield (public health group), while others decided that only professors or head of departments would count as an expert (technology group). The business ethics group was the only one who explicitly searched outside of academia and found examples of business ethics in practice. The environmental ethics group searched for experts who effectively presented themselves as being an environmental ethicist/expert. They ignored experts who were less visible online. As a result, they ended up finding several key figures who were self-employed (i.e., not employed at universities).   Despite using different criteria to define a key figure, most of the groups used quite similar working strategies to explore their subfields. Most of the students limited their search to people working within academia, and therefore used websites of universities or looked in journals to see who published on certain topics. Network websites were also used. The research ethics group, for example, used the website of the Association for Ethicists in the Netherlands [Vereniging voor Ethici in Nederland], and the group focusing on ethics and technology consulted the Rathenau Institute. The public health ethics group used a snowball method starting with LinkedIn, while the animal ethics group simply asked one experienced applied ethicist to identify key figures in their subfield (this was a very pragmatic strategy because the number of key figures was limited).
Different methods were also used with regards to the second research question. Most groups read articles from the scholars they had identified and conducted interviews with one or more of those professionals in order to find out more about their working methods and their views on the relation between ethical theory and practice. Some used open interviews, others semi-structured interviews. The research ethics group explicitly searched for papers that had a clear description of the methods used. The professional ethics group used an online survey, which they spread among the members of the Network of Ethics Teachers. The key figures interviewed by the groups who held interviews were-due to the limited time frame-mostly chosen pragmatically according to availability. An online survey has advantages, namely that more people can be questioned (n = 29), but it also has disadvantages, as the questions need to be precise enough to obtain sufficient information. Written and online surveys will generally lead to staccato answers.

Findings on the relation between theory and practice
On the question what how ethicists in each subfield view the relation between normative theory and applied practice, the findings showed that the methodology used varied among the subfields. However, in most subfields, such as in business ethics, animal ethics, health ethics, as well as in ethics and technology, a practice-oriented approach was considered of utmost importance. Only one stakeholder in the field of environmental ethics said that they utilized high theory, although they actually seemed to use a midlevel approach. In the professional ethics group, a survey was conducted among some members of a network of ethics teachers. The survey was sent via mail to the network. 65.5 % (19/29) of the respondents indicated that they used ethical theory when teaching ethics to students. On the question of how professional ethics teachers perceive the relation between theory and practice, only two respondents replied that there was no explicit role for theory in education, while 9/24 answered that they are closely related, and 9/24 also answered that theory should serve practical reflection (inspire, help to justify, help to understand). So a majority did see a role for ethical theory. On the question of whether a certain theory is dominant, answers were less unified: no theory is dominant was the answer given by 12.5 % of respondents; among the theories, utilitarianism was stated by the highest number of respondents (21 %), while virtue ethics scored 17 %.
In other subfields, experts indicated that, in most cases, theories helped to nuance or explain empirical data. The group that investigated the ethics of technology pointed out how developments in practice are used to develop theories, and how these theories in turn are used in discussions of and reflections on these new developments. The group exploring the subfield of business ethics concluded that empirical data were mostly used to bridge the gap between the ethicist and the business man. At the same time, the dominant focus was on practical cases in the subfield of business ethics. In business ethics, legitimacy was not gained from high theory but by its practical application. Thus, codes of conduct, Bmoresprudence,^and casuistry were frequently mentioned methods. Moresprudence is a new methodology that is equivalent to jurisprudence in law; it aims to offer a framework for practice using reflections and advice based on earlier cases. All of these examples seem to fit with a bottom-up approach in applied ethics. In the field of animal ethics, theory played a greater role. Theoretical frameworks offer concepts and arguments that can be used to reflect on actual cases; for example, on the moral status of animals, what integrity or dignity of animals implies. The environmental ethics group mentioned that all stakeholders embraced high theory and the relevance of empirical data.
A comparison of the data obtained by all of the groups seems to favor midlevel approaches above other methods in applied ethics. For example, in the field of public health ethics, midlevel principles are used to analyze concrete problems. A description of practice is a starting point in the development of the main normative structures, policies, and regulations. In one example, the harm principle was analyzed in relation to high theory. Interestingly, no student or expert mentioned the relevance of cultural and societal influences in applied ethics debates in the Netherlands and how this relates to moral debate and methodology in applied ethics.
In the field of animal ethics, research ethics, and public health ethics, so-called reflective equilibrium methods were found to be particularly popular.
The ethics and technology group observed that stakeholders want to be flexible in applying different methods. Technology touches upon every part of our lives and is therefore interdisciplinary by nature. In this field, different methods were used to examine the relations between values, people, and technology.
In the field of professional ethics (which is about teaching), midlevel approaches and bottom-up approaches were used; various types of moral case deliberation were employed, such as the Utrecht method (Bolt et al. 2015).

How to find stakeholders
The assignment was designed to be broad and general in nature because the field of applied ethics in the Netherland is-as it probably is in many countries-very diverse, and there are only a few associations that people working in this field join by membership. Ethicists work freelance, for institutions, and within academia. To get an overview of them is not easy. It is interesting that many groups decided to focus solely on searching universities for applied ethicists. The only group that explicitly reached out to nonacademic fields was the business ethics group: they actually expected that business ethics would mainly be addressed within companies rather than in academia. However, they noticed that ethical jargon or ethical theory is not used when ethics is applied in the corporate setting; ethics has to be used pragmatically within corporate organizations.
Another observation is that the methods used by the students to identify stakeholders differed in quality. Using social media (e.g., LinkedIn) to explore ethical expertise was not a successful strategy; nor was simply performing a Google search. To give an example, the public health ethics group used social media and found a professor who had published only one article on population health. The group decided to consider him a key player and also interviewed him. In the final report he is quoted as expert, while other-more obvious-experts were not quoted. This is a clear mistake, and the group was not able to critically review its findings. The mistake is probably related to the way academics and ethicists present themselves via social media and the web: if they do not add appropriate keywords to their profiles, their expertise could be overlooked. A search of the literature could correct for such distorted social media findings. Another complicating factor is that not all ethicists explicitly state their expertise. It is helpful, therefore, to use the strategy that the animal ethics group used, i.e., to simply ask an applied ethicist to provide the names of key players in the subfield of animal ethics. Moreover, ethical expertise is linked to the line of work of the stakeholder, not necessarily to their educational background. Some self-supporting individuals identified themselves as ethical experts in the subfield of environmental ethics, yet the same group of students ignored the academics that also work in the field. So who should be considered an expert: those publishing on the topic and being invited to conferences, or those who advise organizations and develop a methodology for using ethics in practice?
Some subfields proved difficult to explore. The number of people working in the subfield of animal ethics in the Netherlands is well defined, and all stakeholders work closely together. Thus, identifying key players proved to be quite simple. The same was true of the group focusing on research ethics, as only two academic hospitals in the Netherlands specifically focus on research ethics. However, the group investigating environmental ethics found it very difficult to get an overview of stakeholders, not only because it is a relatively new field in applied ethics, but also because there are hardly any ethicists working solely on that topic, and they do not present themselves as experts on the web. The professional ethics group had a relatively easy job, as a network of Dutch ethics teachers gave them access to a huge number of teachers (>100).
A third observation is that explorations of the subfields were sometimes hampered by a lack of training in empirical research. Even though a similar strategy was used to probe practices, the results varied greatly. The inexperience of the students in finding effective methods of identifying and contacting people partly explains their level of success. For example, if you are inexperienced in composing questionnaires, fewer respondents will be motivated to participate (due to how the questions are formulated) or will not offer the type of data that you are interested in. Sending an email questionnaire with open questions proved less successful than creating a SurveyMonkey survey online. During the plenary sessions, it became clear to the students just how successful each strategy had been. It was part of the assignment to explore their own thresholds and competences in this respect.
An important related issue is that ethical expertise is not well defined. Students tried to come up with their own criteria, such as Bpublished at least one article in the field^or Bworking in a company and being involved in ethics^or Bonly academics can be ethicists.^Reflections on what ethical expertise exactly entails, and who should (or should not) rightfully be considered an applied ethicist, were beyond the reach of this assignment. Simply exploring the field and getting a sneak preview of the topics and methods used in it were the main aims of this assignment. The findings of the different groups certainly gave rise to reflections in the plenary session.

Relation between theory and practice
To answer the second research question, regarding the views of applied ethicists on the relation between ethical theories and actual practice, we found that some strategies were less successful than others. Stakeholders will not necessarily explicitly address their views on applied ethics methodology in their articles, so reading those articles will not necessarily shed light on their views. Thus, the research ethics group, who focused on the articles published by six key figures, did not necessarily discover the stance of each author regarding applied ethics in general, never mind the methodology they favor. Interviewing stakeholders appears to be a useful complementary strategy for obtaining a better overview of the subfield of interest.
Interviews proved to be very helpful, as most of the ethicists could then explain their views. Many applied ethicists do not explain their views regarding high theory in every article they publish. Instead, those manuscripts often deal with a specific item, such as genomics, animal integrity, or climate change. It was possible to uncover the methods used by an ethicist by reading an article written by them, but an interview seemed necessary to determine how they viewed the relation between theory and practice in general and the type of methods they usually tended to use. Finally, the oral presentations to fellow students helped all course participants to get an idea of the overall views of applied ethicists on the topic. It provided them with a more comprehensive, albeit still limited, understanding of the field of applied ethics in the Netherlands.
The wide variety of methods used by the various groups in the assignment suggests that the guidelines were too vague; they were not as well tailored to their purpose as initially expected. Either the guideline should have been much more prescriptive or the expectations were not realistic. The guidelines were discussed with all groups and agreed upon. However, each group requested some leeway in how they pursued their inquiries, so the manuscript group did not insist on strict guidelines. Most of the groups also considered the final paper they had to deliver to be too restrictive. That paper served two purposes: it was required to get a grade, and it served as input for the draft manuscript, hence the tension that the students felt when preparing their paper is understandable. Moreover, the manuscript group found it difficult to transform the 750-word document into the draft manuscript due to the rather limited information offered by the students. To fully understand the working strategies of each group and to finish the manuscript, the manuscript group had to go back and forth between student groups and even check the online survey.

Conclusion
The assignment to explore the field of applied ethics in the Netherlands served two educational purposes. The first was to see which methods are used by students to tackle the challenge of exploring a subfield of applied ethics. The second aim was to help students reflect on the relation between philosophical ethics and applied ethics in context.
The assignment was successful in the following ways: all students were introduced to various subfields of applied ethics; it offered them a chance to explore possible future career areas; and it provided them with an opportunity to get acquainted with some expert ethicists in their subfields of interest. For some students, this was an excellent opportunity to take their first steps towards an internship or a thesis topic. They also learned how to use different methods, to identify people who work in the various subfields, and to deliberate on their success or failure in identifying experts. They were encouraged to reflect on their different approaches during the presentations. The assignment successfully highlighted the wide variety in methods used in applied ethics and the lack of debate about those methods. Interviews proved useful as they allowed the students to ask the experts how they view the relation between philosophical ethics (ethical theory) and applied ethics. Some ethicists were not explicit about the relation between theory and practice, or simply did not need to consider ethical theory in practice (e.g., in corporate ethics committees). This raised the issues of what ethical expertise consists of, whether it varies in different contexts, and who should be considered an ethical expert. The program of applied ethics encourages students to pursue a career as an ethicist in a subfield, or at least to reflect on the expertise that appears necessary to work in each subfield. It offers reflection on topics such as Bwhat is ethical expertise^and Bhow is ethical theory related to practice^in order to foster a critical approach in the students when they debate these topics. Not every example of applied ethics in the field is of high quality or is appropriate to context in which it is used. This, however, goes beyond the focus of this course and the assignment, and is food for thought in another course in the program.