A blog from the Centre for Research Ethics & Bioethics (CRB)

Author: Pär Segerdahl (Page 4 of 39)

Keys to more open debates

We are used to thinking that research is either theoretical or empirical, or a combination of theoretical and empirical approaches. I want to suggest that there are also studies that are neither theoretical nor empirical, even though it may seem unthinkable at first. This third possibility often occurs together with the other two, with which it is then interwoven without us particularly noticing it.

What is this third, seemingly unthinkable possibility? To think for yourself! Research rarely runs completely friction-free. At regular intervals, uncertainties appear around both theoretical and empirical starting points, which we have to clarify for ourselves. We then need to reflect on our starting points and perhaps even reconsider them. I am not referring primarily to how new scientific findings can justify re-examination of hypotheses, but to the continuous re-examinations that must be made in the research process that leads to these new findings. It happens so naturally in research work that you do not always think about the fact that you, as a researcher, also think for yourself, reconsider your starting points during the course of the work. Of course, thinking for yourself does not necessarily mean that you think alone. It often happens in conversations with colleagues or at research seminars. But in these situations there are no obvious starting points to start from. The uncertainties concern the starting points that you had taken for granted, and you are therefore referred to yourself, whether you think alone or with others.

This thinking, which paradoxically we do not always think we are doing, is rarely highlighted in the finished studies that are published as scientific articles. The final publication therefore does not give a completely true picture of what the research process looked like in its entirety, which is of course not an objection. On the contrary, it would be comical if autobiographical details were highlighted in scientific publications. There you cannot usually refer to informal conversations with colleagues in corridors or seminar rooms. Nevertheless, these conversations take place as soon as we encounter uncertainties. Conversations where we think for ourselves, even when it happens together. It would hardly be research otherwise.

Do you see how we ourselves get stuck in an unclear starting point when we have difficulty imagining the possibility of academic work that is neither theoretical nor empirical? We then start from a picture of scientific research, which focuses on what already completed studies look like in article form. It can be said that we start from a “façade conception” of scientific work, which hides a lot of what happens in practice behind the façade. This can be hard to come to terms with for new PhD students, who may think that researchers just pick their theoretical and empirical starting points and then elaborate on them. A PhD student can feel bad as a researcher, because the work does not match the image you get of research by reading finished articles, where everything seems to go smoothly. If it did, it would hardly be research. Yet, when seeking funding and ethics approval, researchers are forced to present their project plans as if everything had already gone smoothly. That is, as if the research had already been completed and published.

If what I am writing here gives you an idea of how easily we humans get stuck in unclear starting points, then this blog post has already served as a simple example of the third possibility. In this post, we think together, for ourselves, about an unclear starting point, the façade conception, which we did not think we were starting from. We open our eyes to an assumption which at first we did not see, because we looked at everything through it, as through the spectacles on the nose. Such self-examination of our own starting points can sometimes be the main objective, namely in philosophical studies. There, the questions themselves are already expressions of unclear assumptions. We get entangled in our starting points. But because they sit on our noses, we also get entangled in the illusion that the questions are about something outside of us, something that can only be studied theoretically and empirically.

Today I therefore want to illustrate how differently we can work as researchers. This by suggesting the reading of two publications on the same problem, where one publication is empirical, while the other is neither empirical nor theoretical, but purely philosophical. The empirical article is authored by colleagues at CRB; the philosophical article by me. Both articles touch on ethical issues of embryo donation for stem cell research. Research that in the future may lead to treatments for, for example, Parkinson’s disease.

The empirical study is an interview study with individuals who have undergone infertility treatment at an IVF clinic. They were interviewed about how they viewed leftover frozen embryos from IVF treatment, donation of leftover embryos in general and for cell-based treatment of Parkinson’s disease in particular, and much more. Such empirical studies are important as a basis for ethical and legal discussions about embryonic stem cell research, and about the possibility of further developing the research into treatments for diseases that today lack effective treatments. Read the interview study here: Would you consider donating your left-over embryos to treat Parkinson’s disease? Interviews with individuals who underwent IVF in Sweden.

The philosophical study examines concerns about exploitation of embryo donors to stem cell research. These concerns must be discussed openly and conscientiously. But precisely because issues of exploitation are so important, the debate about them risks being polarized around opposing starting points, which are not seen and cannot be reconsidered. Debates often risk locking positions, rather than opening our minds. The philosophical study describes such tendencies to be misled by our own concepts when we debate medical research, the pharmaceutical industry and risks of exploitation in donation to research. It wants to clarify the conditions for a more thoughtful and open discussion. Read the philosophical study here: The Invisible Patient: Concerns about Donor Exploitation in Stem Cell Research.

It is easy to see the relevance of the empirical study, as it has results to refer to in the debate. Despite the empirical nature of the study, I dare to suggest that the researchers also “philosophized” about uncertainties that appeared during the course of the work; that they thought for themselves. Perhaps it is not quite as easy to see the relevance of the purely philosophical study, since it does not result in new findings or normative positions that can be referred to in the debate. It only helps us to see how certain mental starting points limit our understanding, if they are not noticed and re-examined. Of what use are such philosophical exercises?

Perhaps the use of philosophy is similar to the use of a key that fits in the lock, when we want to get out of a locked room. The only thing is that in philosophy we often need the “key” already to see that we are locked up. Philosophical keys are thus forged as needed, to help us see our attachments to unclear starting points that need to be reconsidered. You cannot refer to such keys. You must use them yourself, on yourself.

While I was writing this “key” post, diligent colleagues at CRB published another empirical study on the use of human embryonic stem cells for medical treatments. This time an online survey among a random selection of Swedish citizens (reference and link below). The authors emphasize that even empirical studies can unlock polarized debates. This by supplementing the views of engaged debaters, who can sometimes have great influence, with findings on the views of the public and affected groups: voices that are not always heard in the debate. Empirical studies thus also function as keys to more open and thoughtful discussions. In this case, the “keys” are findings that can be referred to in debates.

– Two types of keys, which can contribute in different ways to more open debates.

Pär Segerdahl

Written by…

Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.

Bywall, K.S., Holte, J., Brodin, T. et al. Would you consider donating your left-over embryos to treat Parkinson’s disease? Interviews with individuals that underwent IVF in Sweden. BMC Med Ethics 23, 124 (2022). https://doi.org/10.1186/s12910-022-00864-y

Segerdahl, P. The Invisible Patient: Concerns about Donor Exploitation in Stem Cell Research. Health Care Analysis 30, 240–253 (2022). https://doi.org/10.1007/s10728-022-00448-2

Grauman, Å., Hansson, M., Nyholm, D. et al. Attitudes and values among the Swedish general public to using human embryonic stem cells for medical treatment. BMC Med Ethics 23, 138 (2022). https://doi.org/10.1186/s12910-022-00878-6

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We recommend readings

Predatory conferences

If you are an academic, you have probably noticed that you are getting more and more unexpected invitations via e-mail to participate as a speaker in what are presented as scientific conferences. The invitations can be confusing, as they are often not even in your subject area. But sometimes they get it right and maybe even mention your latest publication, which is praised in general terms. What is happening?

Publication ethics is one of many research areas at CRB. In recent years, we have researched (and blogged about) so-called predatory journals, which can lure academics to publish their studies in them for a considerable fee, which will make the article openly available to readers. Open access is an important trend in science, but here it is exploited for profit without regard for academic values. Predatory journals are often generously multidisciplinary and the promised “effective” peer review is just as generous, in order to capture as many paying authors as possible.

The steady stream of conference invitations to academics reflects the same dubious type of activity, but here the profit comes from conference fees and sometimes also from arranging accommodation. Within publication ethics, one therefore also speaks of predatory conferences. What do we know about these conferences? Is there any research on the phenomenon?

The first systematic scoping review of scholarly peer-reviewed literature on predatory conferences was recently published in BMJ Open. The overview was made by four researchers, Tove Godskesen and Stefan Eriksson at CRB, together with Marilyn H Oermann and Sebastian Gabrielsson.

The review showed that the literature on predatory conferences is small but growing, 20 publications could be included. Almost all of the literature in the review described characteristics that may define predatory conferences. The most cited characteristic was the spam email invitations, with flattering language that could contain grammatical errors and be non-scientific. Another distinguishing feature described was that the organization hosting the conference was unknown and used copied pictures without permission. Finally, high fees, lack of peer review, and multidisciplinary scope were also mentioned.

Why do researchers sometimes attend predatory conferences? Possible reasons cited in the literature were the focus on quantity in academic research dissemination, falling victim to misleading information, or the attractive and exotic locations where these conferences are sometimes held. The easy submission and review process and the opportunity to participate as a chair or invited speaker were also mentioned as possible attractions. Personal characteristics such as inexperience, naivety, ignorance, vanity and indifference were also mentioned.

Consequences of attending predatory conferences were described in only one of the publications, an interview study with conference participants. Their stories were marked by disappointments of various kinds. Small overcrowded conference rooms, poorly organized conference facilities, deviations from the conference program that could be reduced by a whole day, reputable keynote speakers announced in the program were absent, and the organizers were hard to reach as if the whole event was remote controlled. Participants were sometimes forced to book their accommodation through the organizers at double cost, and they could also experience that the organizers stole their identities by using their pictures and personal information as if they were part of the conference team. Many participants were so disappointed that they left the conferences early, feeling like they never wanted to attend any conferences again.

The literature also suggested various countermeasures. Among other things, education for all researchers and mentoring of junior academics, published lists of predatory conferences and their organizers, accreditation systems for conferences, and checklists to help identifying predatory conferences. It was also stated that universities and research funders should review their ways of assessing the qualifications of researchers seeking employment, promotion or funding. Attending predatory conferences should not be an asset.

For more details and discussion, read the systematic review here: Predatory conferences: a systematic scoping review.

Another countermeasure mentioned in the literature was more research on predatory conferences. This is also a conclusion of the overview: both empirical and analytical research should be encouraged by funders, journals and research institutions.

Hopefully, these staged conference rooms will soon be empty.

Pär Segerdahl

Written by…

Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.

Godskesen T, Eriksson S, Oermann MH, et al. Predatory conferences: a systematic scoping review. BMJ Open 2022;12:e062425. doi: 10.1136/bmjopen-2022-062425

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We want solid foundations

Does public health need virtue ethics?

So-called virtue ethics may seem too inward-looking to be of any practical use in a complex world. It focuses on good character traits of a morally virtuous person, such as courage, sincerity, compassion, humility and responsibility. It emphasizes how we should be rather than how we should act. How can we find effective guidance in such “heroic” ethics when we seek the morally correct action in ethically difficult situations, or the correct regulation of various parts of the public sector? How can such ancient ethics provide binding reasons for what is morally correct? Humbly referring to one’s superior character traits is hardly the form of a binding argument, is it?

It is tempting to make fun of the apparently ineffective virtue ethics. But it has, in my view, two traits of greatest importance. The first is that it trusts the human being: in actual situations we can see what must be done, and what must be carefully considered. The second is that virtue ethics thus also supports our freedom. A virtuous person does not need to cling to standards of good behavior to avoid bad behavior, but will spontaneously behave well: with responsibility, humility, compassion, etc. So a counter-question could be: What good will it be for someone to gain a whole world of moral correctness, yet forfeit themselves and their own freedom? – This was a personal introduction to today’s post.

In an article in Public Health Ethics, Jessica Nihlén Fahlquist discusses public health as a domain of work where moral virtues may need to be developed and supported in the professionals. Unlike medical care, public health focuses on good and equal health in entire risk groups and populations. Due to this more universal perspective of collective health, there can be a risk that the interests, rights and values ​​of individuals are sometimes overlooked. The work therefore needs to balance the general public health objectives against the values ​​of individuals. This may require a well-developed sensitivity, which can be understood in terms of virtue ethics.

Furthermore, public health is often characterized by a greater distance between professionals and the public than in medical care, where the one-on-one meeting with the patient supports a caring attitude in the clinician towards the individual. Imagination and empathy may therefore be needed in public health to assess the needs of individuals and the effects of the work on individuals. Finally, there is power asymmetry between public health professionals and the people affected by the public health work. This requires responsibility on the part of those who use the resources and knowledge that public health authorities possess. This can also be understood in terms of virtue ethics.

Jessica Nihlén Fahlquist emphasizes three virtues that she argues are needed in public health: responsibility, compassion and humility. She concretises the virtues through three ideals to personally strive for in public health. The ideals are described in short italicized paragraphs, which provide three understandable profiles of how a responsible, compassionate and humble person should be in their work with public health – three clear role models.

The ethical problems are made concrete through two examples, breastfeeding and vaccination, which illustrate challenges and opportunities for virtue ethics in public health work. Read the article here: Public Health and the Virtues of Responsibility, Compassion and Humility.

Jessica Nihlén Fahlquist does not rule out the importance of other moral philosophical perspectives in public health. But the three virtue ethical ideals (and probably also other similar ideals) should complement the prevailing perspectives, she argues. Everything has its place, but finding the right place may require good character traits!

If you would also like to read a more recent and shorter discussion by Jessica Nihlén Fahlquist on these important issues, you will find a reference below.

Pär Segerdahl

Written by…

Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.

Jessica Nihlén Fahlquist, Public Health and the Virtues of Responsibility, Compassion and Humility, Public Health Ethics, Volume 12, Issue 3, November 2019, Pages 213–224, https://doi.org/10.1093/phe/phz007

Jessica Nihlén Fahlquist, Individual Virtues and Structures of Virtue in Public Health, Public Health Ethics, Volume 15, Issue 1, April 2022, Pages 11–15, https://doi.org/10.1093/phe/phac004

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We like challenging questions

Data sharing in genomics: proposal for an international Code of Conduct

In genomics, not only individual genes are studied, but the entire genome. Such studies handle and analyse large amounts of data and are becoming increasingly common internationally. One of the challenges is managing the sharing of data between countries around the world. In addition to data protection legislation varying internationally, there are concerns that researchers and research participants from low- and middle-income countries may be exploited or disadvantaged in these exchanges.

Lawyers and bioethicists have therefore called for an international Code of Conduct for data sharing in genomics. A proposal for such a code was recently published in an article in Developing World Bioethics. The article, written by Amal Matar and nine co-authors, describes the process of developing the Code of Conduct and concludes with a nearly 4-page proposal.

The Code of Conduct is intended for researchers and other actors responsible for data management in international genomic research. The code lists ten ethical principles of direct relevance to data sharing. Next, best practices are described in 23 Articles covering seven areas: Data governance system; Data collection; Data storage; Data sharing, transfer and access; Compelled disclosure; Data handling from low- and middle-income countries; Public and community engagement.

Read the article with the proposal for a Code of Conduct here: A proposal for an international Code of Conduct for data sharing in genomics.

Pär Segerdahl

Written by…

Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.

Matar, A., Hansson, M., Slokenberga, S., Panagiotopoulos, A., Chassang, G., Tzortzatou, O., Pormeister, K., Uhlin, E., Cardone, A., & Beauvais, M. (2022). A proposal for an international Code of Conduct for data sharing in genomics. Developing World Bioethics, 1– 14. https://doi.org/10.1111/dewb.12381

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We recommend readings

Patient views on treatment of Parkinson’s disease with embryonic stem cells

Stem cells taken from human embryos very early after fertilization can be grown as embryonic stem cell lines. These embryonic stem cells are called pluripotent, as they can differentiate into virtually all of the body’s cell types (without being able to develop into an individual). The medical interest in embryonic stem cells is related to the possibility of using them to regenerate damaged tissue. One disease one hopes to be able to develop stem cell treatment for is Parkinson’s disease.

In Sweden, it is permitted to use leftover donated embryos from IVF treatment for research purposes. However, not to produce medical products. The path towards possible future treatments is lined with legal and ethical uncertainties. In addition, the moral status of the embryo has been debated for a very long time, without any consensus on the matter being reached.

In this situation, studies of people’s perceptions of the use of human embryonic stem cells for the development of medical treatments become urgent. Recently, the first study of the perceptions of patients, the group that can become recipients, was published. It is an interview study with seventeen patients in Sweden who have Parkinson’s disease. Author is Jennifer Drevin along with six co-authors.

The interviewees were generally positive about using human embryonic stem cells to treat Parkinson’s disease. They did not regard the embryo as a life with human rights, but at the same time they saw the embryo as something special. It was considered that the embryo has great value for the couple who want to become parents and emphasized the importance of the woman’s or the couple’s free and informed consent to donation. As patients, they expressed interest in a treatment that did not limit everyday life through, for example, complicated daily medication. They were interested in better cognitive and communicative abilities and wanted to be more independent: not having to ask family members for support in everyday tasks. The effectiveness of the treatment was considered important and there was concern that stem cell treatment might not be effective enough, or have side effects.

Furthermore, concerns were expressed that donors could be exploited, for example poor and vulnerable groups, and that financial compensation could have negative effects. Allowing donation only of leftover embryos from IVF treatment was considered reassuring, as the main purpose would not be to make money. Finally, there was concern that the pharmaceutical industry would not always prioritize the patient over profit and that expensive stem cell treatments could lead to societal and global injustices. Suspicions that companies will not use embryos ethically were expressed, and some felt that it was more problematic to make a profit on products from embryos than on other medical products. Transparency around the process of developing and using medical stem cell products was considered important.

If you want to see more results, read the study here: Patients’ views on using human embryonic stem cells to treat Parkinson’s disease: an interview study.

It can be difficult to draw general conclusions from the study and the summary above reproduces some of the statements in the interviews. We should, among other things, keep in mind that the interviews were conducted with a small number of patients who themselves have the disease and that the study was conducted in Sweden. The authors emphasize that the study can help clinicians and researchers develop treatments in ways that take into account patients’ needs and concerns. A better understanding of people’s attitudes can also contribute to the public debate and support the development of policy and legislation.

Pär Segerdahl

Written by…

Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.

Drevin, J., Nyholm, D., Widner, H. et al. Patients’ views on using human embryonic stem cells to treat Parkinson’s disease: an interview study. BMC Med Ethics 23, 102 (2022). https://doi.org/10.1186/s12910-022-00840-6

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In dialogue with patients

A charming idea about consciousness

Some ideas can have such a charm that you only need to hear them once to immediately feel that they are probably true: “there must be some grain of truth in it.” Conspiracy theories and urban myths probably spread in part because of how they manage to charm susceptible human minds by ringing true. It is said that even some states of illness are spread because the idea of ​​the illness has such a strong impact on many of us. In some cases, we only need to hear about the diagnosis to start showing the symptoms and maybe we also receive the treatment. But even the idea of diseases spread by ideas has charm, so we should be on our guard.

The temptation to fall for the charm of certain ideas naturally also exists in academia. At the same time, philosophy and science are characterized by self-critical examination of ideas that may sound so attractive that we do not notice the lack of examination. As long as the ideas are limited hypotheses that can in principle be tested, it is relatively easy to correct one’s hasty belief in them. But sometimes these charming ideas consist of grand hypotheses about elusive phenomena that no one knows how to test. People can be so convinced by such ideas that they predict that future science just needs to fill in the details. A dangerous rhetoric to get caught up in, which also has its charm.

Last year I wrote a blog post about a theory at the border between science and philosophy that I would like to characterize as both grand and charming. This is not to say that the theory must be false, just that in our time it may sound immediately convincing. The theory is an attempt to explain an elusive “phenomenon” that perplexes science, namely the nature of consciousness. Many feel that if we could explain consciousness on purely scientific grounds, it would be an enormously significant achievement.

The theory claims that consciousness is a certain mathematically defined form of information processing. Associating consciousness with information is timely, we are immediately inclined to listen. What type of information processing would consciousness be? The theory states that consciousness is integrated information. Integration here refers not only to information being stored as in computers, but to all this diversified information being interconnected and forming an organized whole, where all parts are effectively available globally. If I understand the matter correctly, you can say that the integrated information of a system is the amount of generated information that exceeds the information generated by the parts. The more information a system manages to integrate, the more consciousness the system has.

What, then, is so charming about the idea that ​​consciousness is integrated information? Well, the idea might seem to fit with how we experience our conscious lives. At this moment you are experiencing multitudes of different sensory impressions, filled with details of various kinds. Visual impressions are mixed with impressions from the other senses. At the same time, however, these sensory impressions are integrated into a unified experience from a single viewpoint, your own. The mathematical theory of information processing where diversification is combined with integration of information may therefore sound attractive as a theory of consciousness. We may be inclined to think: Perhaps it is because the brain processes information in this integrative way that our conscious lives are characterized by a personal viewpoint and all impressions are organized as an ego-centred subjective whole. Consciousness is integrated information!

It becomes even more enticing when it turns out that the theory, called Integrated Information Theory (IIT), contains a calculable measure (Phi) of the amount of integrated information. If the theory is correct, then one would be able to quantify consciousness and give different systems different Phi for the amount of consciousness. Here the idea becomes charming in yet another way. Because if you want to explain consciousness scientifically, it sounds like a virtue if the theory enables the quantification of how much consciousness a system generates. The desire to explain consciousness scientifically can make us extra receptive to the idea, which is a bit deceptive.

In an article in Behavioral and Brain Sciences, Björn Merker, Kenneth Williford and David Rudrauf examine the theory of consciousness as integrated information. The review is detailed and comprehensive. It is followed up by comments from other researchers, and ends with the authors’ response. What the three authors try to show in the article is that even if the brain does integrate information in the sense of the theory, the identification of consciousness with integrated information is mistaken. What the theory describes is efficient network organization, rather than consciousness. Phi is a measure of network efficiency, not of consciousness. What the authors examine in particular is that charming feature I just mentioned: the theory can seem to “fit” with how we experience our conscious lives from a unified ego-centric viewpoint. It is true that integrated information constitutes a “unity” in the sense that many things are joined in a functionally organized way. But that “unity” is hardly the same “unity” that characterizes consciousness, where the unity is your own point of view on your experiences. Effective networks can hardly be said to have a “viewpoint” from a subjective “ego-centre” just because they integrate information. The identification of features of our conscious lives with the basic concepts of the theory is thus hasty, tempting though it may be.

The authors do not deny that the brain integrates information in accordance with the theory. The theory mathematically describes an efficient way to process information in networks with limited energy resources, something that characterizes the brain, the authors point out. But if consciousness is identified with integrated information, then many other systems that process information in the same efficient way would also be conscious. Not only other biological systems besides the brain, but also artifacts such as some large-scale electrical power grids and social networks. Proponents of the theory seem to accept this, but we have no independent reason to suppose that systems other than the brain would have consciousness. Why then insist that other systems are also conscious? Well, perhaps because one is already attracted by the association between the basic concepts of the theory and the organization of our conscious experiences, as well as by the possibility of quantifying consciousness in different systems. The latter may sound like a scientific virtue. But if the identification is false from the beginning, then the virtue appears rather as a departure from science. The theory might flood the universe with consciousness. At least that is how I understand the gist of ​​the article.

Anyone who feels the allure of the theory that consciousness is integrated information should read the careful examination of the idea: The integrated information theory of consciousness: A case of mistaken identity.

The last word has certainly not been said and even charming ideas can turn out to be true. The problem is that the charm easily becomes the evidence when we are under the influence of the idea. Therefore, I believe that the careful discussion of the theory of consciousness as integrated information is urgent. The article is an excellent example of the importance of self-critical examination in philosophy and science.

Pär Segerdahl

Written by…

Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.

Merker, B., Williford, K., & Rudrauf, D. (2022). The integrated information theory of consciousness: A case of mistaken identity. Behavioral and Brain Sciences, 45, E41. doi:10.1017/S0140525X21000881

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We like critical thinking

Responses of Italian residents to public health measures during the 2020 pandemic spring

Italy was the first country in Europe to be hit hard by the Covid-19 pandemic. It started mainly in the northern regions, but soon the same public health measures were introduced throughout the country. Commercial and social activities were closed, as were schools and universities. Only points of sale that were deemed necessary were allowed to remain open, such as pharmacies, grocery stores and newsstands. It became forbidden to move outdoors except for certain purposes.

How did people react to the measures? During the late spring and early summer of 2020, an in-depth interview study was conducted with a number of Italian residents of different gender, age, education and home region. The study was recently published as an article by Virginia Romano, Mirko Ancillotti, Deborah Mascalzoni and Roberta Biasiotto. The interviews touched on everyday life during the lockdown as well as perceptions of the public health measures, but also possible priority-setting criteria in intensive care were discussed, as well as views on how the media and information worked.

Several participants described how, after an initial difficulty in understanding and accepting the changes, they soon adapted. Their fear decreased and routines for working from home were established. They began to appreciate increased time with family and a lifestyle with less travel and stress. On the other hand, it was perceived that the public health measures, with their many rules to follow, created a distinction between “us” and “them.” Participants expressed that they began to observe and blame others for not following the rules, while at the same time feeling themselves observed and blamed. This fragmentation was met with disappointment, as the interviewees had hoped that the pandemic would, on the contrary, unite society and increase solidarity and tolerance. However, some experienced just such positive effects. The use of a face mask, for example, was perceived as respectful behaviour towards others.

In general, participants were positive about the public health measures, which were considered necessary to control the pandemic. On the other hand, suspicions were directed at economic interests to maintain productivity. It was perceived that lobbyists were pushing to postpone the lockdown and to speed up the easing of restrictions. Furthermore, it was considered that the pandemic revealed a need to better organize healthcare in Italy. The restrictions also increased the interviewees’ awareness of inequalities in society, for example regarding living space, access to garden and proximity to nature, as well as opportunities to work from home with stable income.

The participants also discussed hypothetical inclusion and exclusion criteria in intensive care, and described their impressions of how information and media functioned during the pandemic spring. The first question was of course difficult to handle for the participants. It was easier to admit that trust in information and the media had decreased. Some participants reported that they developed more critical attitudes towards the sources of information in the media.

If you want more results and the authors’ own discussion, read the article here: Italians locked down: people’s responses to early COVID-19 pandemic public health measures

Pär Segerdahl

Written by…

Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.

Romano, V., Ancillotti, M., Mascalzoni, D. et al. Italians locked down: people’s responses to early COVID-19 pandemic public health measures. Humanit Soc Sci Commun 9, 342 (2022). https://doi.org/10.1057/s41599-022-01358-3

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Ethics needs empirical input

Attitudes, norms and values ​​that can influence antibiotic resistance

Human use of antibiotics creates an evolutionary pressure that drives the development of antibiotic-resistant bacteria. If antibiotics lose their effectiveness, simple infections can become life-threatening and it becomes more difficult to treat infections in hospitals in connection with surgical interventions or other treatments. We should therefore reduce the use of antibiotics and use them more wisely.

Greece is at the top among European countries when it comes to antibiotics consumption. Nevertheless, studies have shown that Greeks are aware of the connection between the overuse of antibiotics and antibiotic resistance. It is not as surprising as it may sound. Other research shows that information alone is not enough to change people’s behaviour.

Since ignorance about the problem cannot explain the overuse of antibiotics in Greece, other factors should be investigated. In an article in BMC Public Health, Dimitrios Papadimou, Erik Malmqvist and Mirko Ancillotti present an interview study (focus groups) in which other possible explanations were examined, such as attitudes, norms and values ​​among Greeks.

The Greek participants saw overconsumption of antibiotics as an entrenched habit in Greece. It is easy to get access to antibiotics, they are often used without a doctor’s prescription, sometimes even as a precaution. In addition, doctors frequently prescribe antibiotics as a reliable remedy, participants said. Although critical of this Greek pattern of antibiotic consumption, participants considered it morally questionable to restrict individual access to potentially beneficial antibiotic treatments in the name of the greater good. Nor did they want to place the responsibility for handling antibiotic resistance on the individual. The whole of society must take responsibility, it was argued, perhaps above all government actors, healthcare staff and food producers. Finally, participants expressed doubts about the possibility of effectively managing antibiotic resistance in Greece.

There certainly seem to be more factors than limited awareness of the problem behind the overuse of antibiotics in Greece (and in other countries). If you would like more details and discussion, read the study here: Socio-cultural determinants of antibiotic resistance: a qualitative study of Greeks’ attitudes, perceptions and values

Hopefully, the study motivates future quantitative investigations of attitudes, norms and values, with more participants. Changing the use of antibiotics is probably like changing the course of a huge ship. Simply being aware of the necessary change is not enough.

Pär Segerdahl

Written by…

Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.

Papadimou, D., Malmqvist, E. & Ancillotti, M. Socio-cultural determinants of antibiotic resistance: a qualitative study of Greeks’ attitudes, perceptions and values. BMC Public Health 22, 1439 (2022). https://doi.org/10.1186/s12889-022-13855-w

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Approaching future issues

Does the brain make room for free will?

The question of whether we have free will has been debated throughout the ages and everywhere in the world. Can we influence our future or is it predetermined? If everything is predetermined and we lack free will, why should we act responsibly and by what right do we hold each other accountable?

There have been different ideas about what predetermines the future and excludes free will. People have talked about fate and about the gods. Today, we rather imagine that it is about necessary causal relationships in the universe. It seems that the strict determinism of the material world must preclude the free will that we humans perceive ourselves to have. If we really had free will, we think, then nature would have to give us a space of our own to decide in. A causal gap where nature does not determine everything according to its laws, but allows us to act according to our will. But this seems to contradict our scientific world view.

In an article in the journal Intellectica, Kathinka Evers at CRB examines the plausibility of this choice between two extreme positions: either strict determinism that excludes free will, or free will that excludes determinism.

Kathinka Evers approaches the problem from a neuroscientific perspective. This particular perspective has historically tended to support one of the positions: strict determinism that excludes free will. How can the brain make room for free will, if our decisions are the result of electrochemical processes and of evolutionarily developed programs? Is it not right there, in the brain, that our free will is thwarted by material processes that give us no space to act?

Some authors who have written about free will from a neuroscientific perspective have at times explained away freedom as the brain’s user’s illusion: as a necessary illusion, as a fictional construct. Some have argued that since social groups function best when we as individuals assume ourselves to be responsible actors, we must, after all, keep this old illusion alive. Free will is a fiction that works and is needed in society!

This attitude is unsound, says Kathinka Evers. We cannot build our societies on assumptions that contradict our best knowledge. It would be absurd to hold people responsible for actions that they in fact have no ability to influence. At the same time, she agrees that the notion of free will is socially important. But if we are to retain the notion, it must be consistent with our knowledge of the brain.

One of the main points of the article is that our knowledge of the brain could actually provide some room for free will. The brain could function beyond the opposition between indeterminism and strict determinism, some neuroscientific theories suggest. This does not mean that there would be uncaused neural events. Rather, a determinism is proposed where the relationship between cause and effect is variable and contingent, not invariable and necessary, as we commonly assume. As far as I understand, it is about the fact that the brain has been shown to function much more independently, actively and flexibly than in the image of it as a kind of programmed machine. Different incoming nerve signals can stabilize different neural patterns of connections in the brain, which support the same behavioural ability. And the same incoming nerve signal can stabilize different patterns of connections in the brain that result in the same behavioural ability. Despite great variation in how individuals’ neural patterns of connections are stabilized, the same common abilities are supported. This model of the brain is thus deterministic, while being characterized by variability. It describes a kind of kaleidoscopically variable causality in the brain between incoming signals and resulting behaviours and abilities.

Kathinka Evers thus hypothetically suggests that this variability in the brain, if real, could provide empirical evidence that free will is compatible with determinism.

Read the philosophically exciting article here: Variable determinism in social applications: translating science to society

Although Kathinka Evers suggests that a certain amount of free will could be compatible with what we know about the brain, she emphasizes that neuroscience gives us increasingly detailed knowledge about how we are conditioned by inherited programs, for example, during adolescence, as well as by our conditions and experiences in childhood. We should, after all, be cautiously restrained in praising and blaming each other, she concludes the article, referring to the Stoic Epictetus, one of the philosophers who thought about free will and who rather emphasized freedom from the notion of a free will.

Pär Segerdahl

Written by…

Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.

Evers Kathinka (2021/2). Variable Determinism in Social Applications: Translating Science to Society. In Monier Cyril & Khamassi Mehdi (Eds), Liberty and cognition, Intellectica, 75, pp.73-89.

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Artificial intelligence: augmenting intelligence in humans or creating human intelligence in machines?

Sometimes you read articles at the intersection of philosophy and science that contain really exciting visionary thoughts, which are at the same time difficult to really understand and assess. The technical elaboration of the thoughts grows as you read, and in the end you do not know if you are capable of thinking independently about the ideas or if they are about new scientific findings and trends that you lack the expertise to judge.

Today I dare to recommend the reading of such an article. The post must, of course, be short. But the fundamental ideas in the article are so interesting that I hope some readers of this post will also become readers of the article and make a serious attempt to understand it.

What is the article about? It is about an alternative approach to the highest aims and claims in artificial intelligence. Instead of trying to create machines that can do what humans can do, machines with higher-level capacities such as consciousness and morality, the article focuses on the possibility of creating machines that augment the intelligence of already conscious, morally thinking humans. However, this idea is not entirely new. It has existed for over half a century in, for example, cybernetics. So what is new in the article?

Something I myself was struck by was the compassionate voice in the article, which is otherwise not prominent in the AI ​​literature. The article focuses not on creating super-smart problem solvers, but on strengthening our connections with each other and with the world in which we live. The examples that are given in the article are about better moral considerations for people far away, better predictions of natural disasters in a complex climate, and about restoring social contacts in people suffering from depression or schizophrenia.

But perhaps the most original idea in the article is the suggestion that the development of these human self-augmenting machines would draw inspiration from how the brain already maintains contact with its environment. Here one should keep in mind that we are dealing with mathematical models of the brain and with innovative ways of thinking about how the brain interacts with the environment.

It is tempting to see the brain as an isolated organ. But the brain, via the senses and nerve-paths, is in constant dynamic exchange with the body and the world. You would not experience the world if the world did not constantly make new imprints in your brain and you constantly acted on those imprints. This intense interactivity on multiple levels and time scales aims to maintain a stable and comprehensible contact with a surrounding world. The way of thinking in the article reminds me of the concept of a “digital twin,” which I previously blogged about. But here it is the brain that appears to be a neural twin of the world. The brain resembles a continuously updated neural mirror image of the world, which it simultaneously continuously changes.

Here, however, I find it difficult to properly understand and assess the thoughts in the article, especially regarding the mathematical model that is supposed to describe the “adaptive dynamics” of the brain. But as I understand it, the article suggests the possibility of recreating a similar dynamic in intelligent machines, which could enhance our ability to see complex patterns in our environment and be in contact with each other. A little poetically, one could perhaps say that it is about strengthening our neural twinship with the world. A kind of neural-digital twinship with the environment? A digitally augmented neural twinship with the world?

I dare not say more here about the visionary article. Maybe I have already taken too many poetic liberties? I hope that I have at least managed to make you interested to read the article and to asses it for yourself: Augmenting Human Selves Through Artificial Agents – Lessons From the Brain.

Well, maybe one concluding remark. I mentioned the difficulty of sometimes understanding and assessing visionary ideas that are formulated at the intersection of philosophy and science. Is not that difficulty itself an example of how our contact with the world can sometimes weaken? However, I do not know if I would have been helped by digital intelligence augmentation that quickly took me through the philosophical difficulties that can arise during reading. Some questions seem to essentially require time, that you stop and think!

Giving yourself time to think is a natural way to deepen your contact with reality, known by philosophers for millennia.

Pär Segerdahl

Written by…

Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.

Northoff G, Fraser M, Griffiths J, Pinotsis DA, Panangaden P, Moran R and Friston K (2022) Augmenting Human Selves Through Artificial Agents – Lessons From the Brain. Front. Comput. Neurosci. 16:892354. doi: 10.3389/fncom.2022.892354

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