Consensus recommendation for prenatal, neonatal and postnatal management of congenital cytomegalovirus infection from the European congenital infection initiative (ECCI).

Congenital cytomegalovirus (cCMV) infection carries a significant burden with a 0.64% global prevalence and a 17-20% chance of serious long-term effects in children. Since the last guidelines, our understanding, particularly regarding primary maternal infections, has improved. A cCMV guidelines group was convened under the patronage of the European Society of Clinical Virology in April 2023 to refine these insights. The quality and validity of selected studies were assessed for potential biases and the GRADE framework was employed to evaluate quality of evidence across key domains. The resulting recommendations address managing cCMV, spanning prevention to postnatal care. Emphasizing early and accurate maternal diagnosis through serological tests enhances risk management and prevention strategies, including using valaciclovir to prevent vertical transmission. The guidelines also strive to refine personalized postnatal care based on risk assessments, ensuring targeted interventions for affected families.

[Don't lose sight of the disadvantages of screening: concerns on proposed amendments of the Dutch Population Screening Act]. / Verlies de nadelen van screening niet uit het oog.

There are more and more possibilities to screen individuals early for health problems or risks thereof. When it comes to screening, it is tempting to think: the sooner a disease (risk) is detected, the better. But screening also has disadvantages, such as distress and fear among participants and the need for further diagnostics in the event of a positive result, with all the related medical risks and burden on the health care system. In short, screening is only useful if the benefits outweigh the disadvantages. In this article we discuss - by means of examples - ethical considerations relevant for weighing the benefits and disadvantages of screening. In closing we reflect on future legislation pertaining to screening that - in our opinion - leaves too much leeway for screening of which the disadvantages outweigh the benefits.

A Quality Checklist for Responsible Conduct of Research (RCR) Education: A proposal to complement the Predictive Modeling Tool.

This article presents a Quality Checklist for Responsible Conduct of Research (RCR) education. The Checklist is a tool for teachers and educational developers in RCR education containing the results of eleven reviews on the impact of RCR education. It makes these data accessible in a layered way, such that users can quickly find the information that they are interested in. The tool can complement the Predictive Modeling Tool , which allows users to fill out information about a course and provides recommendations on how the course's efficacy can be improved. We present our approach to developing the Quality Checklist prototype tool, the tool itself and how it can be used. We compare it to the PMT and discuss the added value of the Quality Checklist prototype tool, as well as its limitations. Finally, we indicate some of the ways in which the prototype tool could be further improved.

The harm principle as a mid-level principle?: three problems from the context of infectious disease control.

Effective infectious disease control may require states to restrict the liberty of individuals. Since preventing harm to others is almost universally accepted as a legitimate (prima facie) reason for restricting the liberty of individuals, it seems plausible to employ a mid-level harm principle in infectious disease control. Moral practices like infectious disease control support - or even require - a certain level of theory-modesty. However, employing a mid-level harm principle in infectious disease control faces at least three problems. First, it is unclear what we gain by attaining convergence on a specific formulation of the harm principle. Likely candidates for convergence, a harm principle aimed at preventing harmful conduct, supplemented by considerations of effectiveness and always choosing the least intrusive means still leave ample room for normative disagreement. Second, while mid-level principles are sometimes put forward in response to the problem of normative theories attaching different weight to moral principles, employing a mid-level harm principle completely leaves open how to determine what weight to attach to it in application. Third, there appears to be a trade-off between attaining convergence and finding a formulation of the harm principle that can justify liberty-restrictions in all situations of contagion, including interventions that are commonly allowed. These are not reasons to abandon mid-level theorizing altogether. But there is no reason to be too theory-modest in applied ethics. Morally justifying e.g. if a liberty-restriction in infectious disease control is proportional to the aim of harm-prevention, promptly requires moving beyond the mid-level harm principle.

Earning points for moral behavior: organ allocation based on reciprocity.

Anticipating the reevaluation of the Dutch organ procurement system, in late 2003 the Rathenau Institute published a study entitled 'Gift or Contribution?' In this study, the author, Govert den Hartogh, carries out a thorough moral analysis of the problem of organ shortage and fair allocation of organs. He suggests there should be a change in mentality whereby organ donation is no longer viewed in terms of charity and the volunteer spirit, but rather in terms of duty and reciprocity. The procurement and allocation of donor organs should be seen as a system of mutually assured help. Fair allocation would imply to give priority to those who recognize and comply with their duty: the registered donors. The idea of viewing organ donation as an undertaking involving mutual benefit rather than as a matter of charity, however, is not new. Notwithstanding the fact that reference to charity and altruism is not required in order for the organ donation to be of moral significance, we will argue against the reciprocity-based scenario. Steering organ allocation towards those who are themselves willing to donate organs is both an ineffective and morally questionable means of attempting to counter organ shortage.