[1008] Science and Ethics

We investigate moral cognition, judgement and behavior within a science-based philosophical approach.

  • How do people evaluate moral situations? What is the role and functioning of intuition in these evaluations? What primary psychological mechanisms are involved?
  • What motivates people to follow moral standards and sanction deviances?
  • What is altruistic behaviour and how does it work?
  • What are the drivers of availability to others?
  • How can we better communicate, understand others’ needs and provide adequate help?

Based on our ethical analyses and on empirical data, we develop practical solutions to promote respectful behaviour and appropriate communication in a variety of academic and professional contexts.

  • How can students and researchers be nudged towards integrity ?
  • How can communication and interaction between patients and health professionals be optimized to ensure quality of care and mutual respect?

We are interested in the ethical issues generated by new technologies and scientific knowledge.

  • On the basis of what criteria can we evaluate the acceptability of science-based nudging interventions and technologies aimed at orienting people’s behavior?
  • How can we ensure an adequate use of new technologies and medical advances that are available on a large scale?

We work across disciplines and merge knowledge and research methods specific to various disciplines, including philosophy, biology, psychology, sociology, behavioural economics and mathematical modelling.

Advance care planning (ACP) is the process by which patients anticipate and discuss how possible changes in their health state could affect them in the future and, if they wish, negotiate and document their preferences. Well conducted ACP is a complex process that takes time and involves the coordinated activity of multiple stakeholders. Patients need to become aware of the importance of ACP, willing to engage in such a process, and empowered to do so. The process needs to be initiated and conducted under favourable and ethically acceptable conditions, be flexible, take place across different settings (hospital; community; nursing homes), and involve repetitive communication and structured documentation procedures. Thus, to effectively promote ACP, all these levels need to be considered.

Our interdisciplinary team has developed Accordons-nous, a smartphone digital tool to support patients and health care professionals in the advance care planning (ACP) process. The tool raises awareness, facilitates communication, and helps to express values and preferences for care, and to write advance directives (AD).

We conduct studies designed to obtain feedback on the tool from a large population, to evaluate whether it is capable of nudging common patients to engage in an ACP process, and elaborate strategies for implementing the tool in contexts of shared decision-making.

Accordons-nous is freely available in CONCERTO, the official HUG app.

Christine Clavienleads this projet, in collaboration with Céline Schöpfer, Frédéric Ehrler, Antoine Berger, Catherine Bollondi, Thomas Fassier,  Johanna Sommer, Florence Hartheiser,  Francois Pierre Robert, Vincent Clavien, Ines Serre, Pierre Sutter, Camille De La Serna, Laurence Buytaert, and many more people!

The project is supported by the Fondation des HUG, and conducted in collaboration with the centre de l'innovation des HUG.


- 2019: « Prix pour le partenariat avec nos patients » pour Accord au Hackathon des HUG #4

- Schöpfer C, Ehrler F, Berger A, Bollondi Pauly C, Buytaert L, De La Serna C, Hartheiser F, Fassier T, Clavien C. A Mobile App for Advance Care Planning and Advance Directives (Accordons-nous): Development and Usability Study. JMIR Hum Factors. 2022;9(2):e34626. DOI: 10.2196/34626

 - Clavien C, «Un outil pour soutenir l’anticipation des soins», REISO, Revue d'information sociale, mis en ligne le 14 avril 2022, https://www.reiso.org/document/8853

- Schöpfer C, Bollondi Pauly C, Moussa A, Sommer J, Clavien C, Effect of an App for Promoting Advance Care Planning and Motivating Patients to Write their Advance Directives. BMC Health Services Research2023 Jun 1;23(1):566.DOI: 10.1186/s12913-023-09593-3

- Clavien C, Ehlers U, Jox R, Karzig I, Krones T, Loupatzatzis B, Monteverde S, Theile G, Advance Care Planning in Switzerland: Chances and challenges of delivering high-quality ACP in a small high-income, multilingual, federally organized country, ZEFQ, July 11, 2023. DOI:10.1016/j.zefq.2023.04.008

One of the priorities of medicine is to treat patients as closely as possible to their values. The process of advance care planning (ACP) serves this end. It consists of identifying, in discussion with patients, what their priorities in life are, and what care they would (or would not) like to receive in a crisis situation. In the day-to-day reality of care, ACP is often difficult to initiate and to carry out, notably because it is not easy for patients and for care teams, to address the topic of end of life.

To help break the ice and facilitate this discussion process, we have developed Anticip'action. It is a card game that helps to identify what is most important to us in life, to describe and express our values and priorities, and to plan concrete actions based on these reflections. Using this serious game in a hospital context helps to address ACP issues and define which objectives of care or limits to medical interventions correspond to patients' values. 

Anticip'action is available to healthcare teams at the HUG in cardboard format, and to patients in printable or digital format via the free HUG Concerto application.

As part of a research project being carried out in the nephrology unit at the HUG, we are currently testing the feasibility of an ACP intervention using Anticip'action as a tool.

Christine Clavien coordinates the différent aspects of this projet in collaboration with Antoine Berger, Catherine Bollondi, Gora Da Rocha, Anne Dufey-Teso, Frédéric Ehrler, Monica Escher, Pascale Lefuel, Virginie Metoukam Bauquis, Céline Schöpfer, Inès Serre, Jelena Stanic.

This projet is supported by the Fondation privée des HUG, and by the direction of care at the HUG.

Outputs :

- 2020 : projet sélectionné dans les highlights par le jury du hackathon national Versus Virus.

-  Clavien CLefuel PBollondi C, Da Rocha G, Escher M, Dufey-Teso A, [conf abstract] Advance care planning with a conversation game: a feasibility and acceptability study. 

Scientific integrity should be a cornerstone of research. Unfortunately, the teaching of Responsible Conduct of Research (RCR) remains fragmented. It too often depends on the personal interest and willingness of teachers who have not had the opportunity to receive a full training themselves. The INTEGRITY project aims at developing pedagogical tools that will then be made available to teachers. It also aims at developing strategies for motivating teachers and students to address RCR topics.

Within this project, our group will design and test nudging interventions for promoting the teaching of RCR topics and for facilitating integer behavior itself.

The project entitled “INTEGRITY: development of innovative, evidence-based tools for teaching research integrity to students and early career researchers” is funded by the European Union, has started in January 2019. It is led by Mariëtte van den Hoven (Utrecht University) and Christine Clavien’s group (involving Abha Saxena, Aurélien Allard, and Céline Schöpfer) is one of the main partners of the consortium.


Mads Paludan Goddiksen, Mikkel Willum Johansen, Anna Catharina Armond, Mateja Centa, Christine Clavien, Eugenijus Gefenas, Roman Globokar, Linda Hogan, Nóra Kovács, Marcus Tang Merit, I.Anna S. Olsson, Margarita Poškutė, Una Quinn, Júlio Borlido Santos, Rita Santos, Céline Schöpfer, Vojko Strahovnik, Orsolya Varga, P. J. Wall, Peter Sandøe & Thomas Bøker Lund (2023) Grey zones and good practice: A European survey of academic integrity among undergraduate students, Ethics & Behavior, DOI: 10.1080/10508422.2023.2187804

Goddiksen MP, Johansen MW, Armond AC, Clavien C, Hogan L, Kovács N, et al. (2023) “The person in power told me to”—European PhD students’ perspectives on guest authorship and good authorship practice. PLoS ONE 18(1): e0280018. https://doi.org/10.1371/journal.pone.0280018

Johansen, M.W., Goddiksen, M.P., Centa, M., Clavien, C., et al. Lack of ethics or lack of knowledge? European upper secondary students’ doubts and misconceptions about integrity issues. Int J Educ Integr 18, 20 (2022). https://doi.org/10.1007/s40979-022-00113-0


An increasing number of organizations invest in biosensors and other wearable computing devices (Internet of Things - IoT) for improving the well-being of their personnel or as means for anticipating potential health and safety risks at work. The use of IoT at the workplace may be useful if purposefully used, but it is not unproblematic, since sensors create a massive data trail that organizations may harness and use for purposes other than occupational health or against the good of the personnel.
Our aim is to investigate, from three perspectives (information systems, legal, and ethical) the opportunities and risks when IoT is introduced in the workplace.
This interdisciplinary project is funded by the Swiss National Science Foundation and led in collaboration with Prof Tobias Mettler (head of the project) and Prof Sophie Weerts, both working at the IDHEAP (Lausanne University). Maeva El Bouchickhi is conducting her PhD on the legal and ethical aspects of this project. Here is the project's website.
- Weerts, S., Naous, D., Bouchikhi, M.E., Clavien, C. (2022). AI Systems for Occupational Safety and Health: From Ethical Concerns to Limited Legal Solutions. In: Janssen, M., et al. Electronic Government. EGOV 2022. Lecture Notes in Computer Science, vol 13391. Springer, Cham. https://doi.org/10.1007/978-3-031-15086-9_32

Nudges are soft interventions designed to influence people’s choices in desired directions while leaving them the choice to do otherwise. These interventions exploit (i.e. eliminate, bypass or elicit) fast automatic and often unconscious decision-making pathways, such as risk aversion, compliance to authority, tendency to stick to default options, or hyperbolic discounting. For example, the risk aversion bias leads patients to underestimate the gains of a drug compared to its possible side effects. This reasoning failure may be corrected by using a framing nudge, that is, by presenting medical information so as to emphasize the risks associated to non-consumption of the drug.

Most nudging interventions can be applied with little administrative difficulties, and since they preserve freedom of choice, they are often seen as ethical ways to fix problems. Therefore, nudges are increasingly considered as attractive solutions by policy-makers in all sorts of domains.

However, despite their attractive features, nudges may raise difficulties. First, due to their variety and the variety of their application, there is often unclear evidence of the efficiency of particular nudges. Second, while some nudges seem benign, other raise serious ethical concerns. The default organ donation policy discussed and rejected by Swiss politicians in 2015 is an illustration. One persistent question is the extent to which nudges are manipulative and thereby a treat to autonomous decision-making.

Ethical issues raised by the use of nudges have been extensively discussed in moral philosophy circles, but little work has been done in practical ethics. Can we transpose relevant philosophical considerations into workable evaluation procedures that policy-makers could use ahead of their decisions do apply a nudge?

We aim at bridging the gap between theory and practice. Our goal is to help policy-makers (in particular decision-makers in the health care system) to develop effective and ethically acceptable nudging intervention.

This project is conducted by Christine Clavien as external research partner on the ERASME projet "INFLUEnTHICS: Ethique de l’influence", led by Malik Bozzo-Rey at Lille Catholic University (2019-2025).


 - Christine Clavien (2018) Ethics of nudges: A general framework with a focus on shared preference justifications, Journal of Moral Education, 47:3, 366-382, DOI: 10.1080/03057240.2017.1408577

Les progrès impressionnants de la médecine de transplantation ont pour effet d’offrir de nouvelles options de soins. Mais les patients voulant en bénéficier se heurtent au douloureux problème de la pénurie d’organes. En réponse à cette difficulté, les initiatives en faveur de l’option législative du « consentement présumé » sont régulièrement proposées. Elles soulèvent cependant un certain nombre de difficultés, évoquées notamment dans la prise de position de la Commission Nationale d’Ethique.

Dans ce projet, nous examinons les raisons de se prononcer en faveur ou contre différentes politiques du don d’organes. A l’aide d’une étude qualitative, son objectif est de collecter les points de vue des citoyens par rapport à différents modèles de législation du don d’organe (système actuel, système de consentement présumé, système d’incitation, ou système d’obligation de choix). Ses résultats seront utiles pour mener une réflexion éthique informée et pour anticiper les arguments susceptibles de convaincre lors de débats publics sur le sujet.

Recherche conduite par Christine Clavien, l’étudiante de master Janine Kurzen, et Samia Hurst.


- Kurzen J, Clavien C, Hurst S. General public's view on opt-in, opt-out, and mandated choice organ donation policies: a qualitative study involving Swiss French-speaking citizens favourably disposed towards organ donation. Swiss Med Wkly. 2021 Nov 6;151:w30037. 10.4414/smw.2021.w30037

- Clavien, C. Une évaluation éthique du consentement présumé pour le don d'organes en Suisse. In: Revue médicale suisse, 2020, vol. 16, n° 682, p. 370-373. https://archive-ouverte.unige.ch/unige:139355

A l’ère des vérités et contre-vérités dispersées sur la toile, le mouvement des anti-vaccins gagne en importance dans les pays occidentaux. Il s’ensuit une baisse de couverture vaccinale qui génère d’importants problèmes de santé publique, notamment à l’image de l’augmentation des cas de rougeole.

Ce projet vise à identifier les facteurs bloquants ou facilitant la motivation des adultes à contrôler et mettre à jour leur statut vaccinal, et à l’échelle locale de l’Université de Genève, à élaborer des incitations comportementales douces, destinées à augmenter la motivation à le faire.

Recherche conduite par l’étudiant de master Thibaut Papis, sous la supervision de Christine Clavien et en collaboration avec le Projet Vaccins de l'AEMG.


- Papis Thibaut, Clavien Christine. Do Primary Care Physicians Contribute to the Immunization Status of Their Adult Patients? A Story of Patients' Overconfidence Coupled With Physicians' Passivity. Frontiers in Medicine, 8, 2021, DOI=10.3389/fmed.2021.655734



Attempts to bridge evolutionary psychology and ethics generate heated debates. On the one hand, there is the worry that old social-darwinian or eugenic ideas are brought back under the cover of a dubious pseudo-scientific rhetoric. On the other hand, it seems that one cannot reasonably take a stance on what is morally expected and required while ignoring growing knowledge about the human natural (and evolved) faculties involved in social interactions.

We aim at developing a systematic overview of how knowledge and arguments stemming from evolutionary psychology can (and have been) recruited in three main domains of ethics: descriptive ethics, normative ethics, and practical ethics.

This project is conducted by Christine Clavien in collaboration with Florian Cova


Christine Clavien & Florian Cova, “Evolutionary Psychology and Ethics”, in T. K. Shackelford (ed.), The SAGE Handbook of Evolutionary Psychology, SAGE Publications, 2021, pp. 379-402

Humans and non-human animals are capable of spectacular as well as ordinary helping actions. Can these actions or their underlying behavioural tendencies be described as altruistic? Some will and some won’t, and the answer will greatly depend on one’s definition of altruism.

Altruism, broadly conceived as unilateral giving behaviour, has been investigated by disciplines as different as psychology, philosophy, sociology, neurosciences, economics, or biology. However, a close analysis readily shows that these disciplines conceive the phenomenon of altruism very differently. As a consequence, the same action or behaviour may fall under the altruism category in one research area but not in the other, which leads to major misunderstandings across disciplines. Do these disciplinary specificities impede a full understanding of the general phenomenon of human altruism or do they each shed an original and irreplaceable light on the phenomenon? In this project, we aim at investigating the latter hypothesis.

Conceptual work is needed in order to find a "workable" concpet of altruism that may be used in interdisciplinary reserach. For this, we have developed the notion of  “ordinary altruism”, which is close to the common sense and moral use of the term. Human ordinary altruistic actions fulfil the three following conditions:

  • They result from actors’ intention to help: i.e. the helping does not come about as an unplanned incidental effect while the actors are doing something else.
  • They are produced voluntarily: i.e. actors can choose between various options (e.g. to help or no to help) and are not pressured by obvious external constraints while forming their intention to help (e.g. threat of punishment against non-helpers).
  • They are “prima facie disinterested”: i.e. there is no obvious evidence that actors help only as a mean to obtain external rewards such as personal reputation or expected benefits from future cooperation.

We recruit interdisciplinary knowledge in order to highlight the phenomenon of ordinary altruism from (1) an evolutionary ultimate point of view, (2) a mechanistic proximate point of view, and (3) a phenomenological points of view.

On the basis of this conceptual work, futur lines of research may be envisaged. In which areas of action is ordinary altruism most likely to occur? Which environmental and psychological features do facilitate (or impede) the production of altruistic actions? Is it ethically appropriate to promote altruism? What practical measures could be applied in order to promote altruism in contemporary societies? More particularly, how could altruism be encouraged in medical contexts?

This project is conducted by Christine Clavien


- Clavien, Christine (2018), «Altruisme (A)», dans Maxime Kristanek (dir.), l'Encyclopédie philosophique, consulté le ..., https://encyclo-philo.fr/11925-2

The importance of being open and present to another, or, as Gabriel Marcel calls it, being available, is widely acknowledged, both in and outside academia. This attitude is taken to be important to develop a non-conflictual relationship where the other feels understood and valued. However, it is usually not explained what it means to be open and present.

While the affective side of our relationships with others has attracted a lot of academic attention, especially empathy and compassion, the role that our cognitive attitude towards the other plays in our relationship has not raised as much interest. Being open and present seems indeed to be related to the way we pay attention to the other and try to understand her, but it is not clear what type of attention or understanding is at stake and what its impact on our relationships with others is.

There was a burst of interest in this question in the first half of the 20th century and authors such as Martin Buber, Gabriel Marcel and Simone Weil discussed it. But none of them provided a systematic account of this attitude and attention to it remained marginal. However, if availability toward others play the important role it is taken to have in our relationships with others, it deserves more attention and it needs to be more precisely studied.

The aim of this research project is first to describe more precisely the attitude of availability in order to get a good grasp of the phenomenon and understand what is meant when we speak about being open and present. This will enable us to clarify the role that this attitude plays in our relationships with others. Second, if the importance of availability for successful relationships is confirmed, we will see how the new understanding of availability its impacts can be used to teach and promote this attitude more effectively. For this project we will look at one context in which availability seems especially important: the relationship between patients and health care professionals.

This project was conducted by Elodie Malbois and co-supervised by Christine Clavien. It was funded by the Swiss National Science Foundation.


 Elodie Malbois' PhD completed in 2020

  • Elodie Malbois & Christine Clavien. “Overcoming the Limits of Empathic Concern: The Case for Availability and Its Application to the Medical Domain”, Medicine, Health Care and Philosophy 23, 191–203 (2020).
  • Elodie Malbois & Nicolas Foureur, “La contention nocturne en gériatrie : faut-il toujours l’éviter ou oser se poser la question au cas par cas ? ” Bioethica Forum, Bioethica Forum, 12:3/4 (2019).
  • Elodie Malbois “Gabriel Marcel: Intersubjectivity as Reciprocal Availability”, in Phenomenological Approaches to Intersubjectivity and Values, Luis Aguiar de Sousa and Ana Falcato eds., Cambridge Scholar Publishing: Cambridge, 2019