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

Tag: future prospects (Page 1 of 10)

Antimicrobial resistance: bringing the AMR community together

According to the WHO, antibiotic resistance is one of the biggest threats to global health, food security and development. Most of the disease burden is in the global south, but drug resistant infections can affect anyone, in any part of the world. Bacteria are always evolving, and antibiotic resistance is a natural process that develops through mutations. We can slow down the process by using antibiotics responsibly, but to save lives, we urgently need new antibiotics to fight the resistant bacteria that already today threaten our health.

There is a dilemma here: development of new antibiotics is a high-risk business, with very low return of investment, and big pharma is leaving the antibiotics field for precisely this reason. Responsible use of antibiotics means saving new drugs for the most severe cases. There are several initiatives filling the gap this creates. One example is the Innovative Medicines Initiative AMR Accelerator programme, with 9 projects working together to fill the pipeline with new antibiotics, and developing tools and infrastructures that can support antibiotics development.

Antimicrobial resistance (AMR) to antibiotics and other anti-infectives is a community problem. Managing it requires a community coming together to find solutions and work together to develop research infrastructures. For example, assessing the effectiveness of new antibiotics requires standardised high-quality infection models that can become available to projects, companies and research groups that are developing new antibacterial treatments. Recently, the AMR Accelerator COMBINE project announced a collaboration with some of the big players in the field: CARB-X, CAIRD, iiCON and Pharmacology Discovery Services. This kind of collaboration allows key actors to come together and share both expertise and data. The COMBINE project is developing a standardised protocol for an in vivo pneumonia model. It will become available to the scientific community, along with a bank of reference strains of Gram-negative bacteria that are clinically relevant, complete with a framework to bridge the gap between preclinical data and clinical outcomes based on mathematical modelling approaches.

The benefit of a standardised model is to support harmonisation. Ideally, data on how effective new antibiotic candidates are should be the same, regardless of the lab that performed the experiments. The point of the collaboration is to improve quality of the COMBINE pneumonia model. But who are they and what will they do? CARB-X (Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator) is a global non-profit partnership that supports early-stage antibacterial research and development. They will help validation of the pneumonia model. CAIRD (Center for Anti-Infective Research and Development) is working to advance anti-infective pharmacology. They are providing a benchmark by back-translation of clinical data. iiCON has a mission to accelerate and support the discovery and development of innovative new anti-infectives, diagnostics, and preventative products. They are supporting the mathematical modelling to ensure optimal dose selection. And finally, Pharmacology Discovery Services, a contract research organisation (CRO) working with preclinical antibacterial development, will supply efficacy data.

At the centre of this is the COMBINE project, which has a coordinating role in the AMR Accelerator: a cluster of public-private partnership projects funded by the Innovative Medicines Initiative (IMI). The AMR Accelerator brings together academia, pharma industry, patient organisations, non-profits and small and medium sized companies. The aim is to develop a robust pipeline of antibiotics and standardised tools that can be used by others in this community, to help in the fight against antimicrobial resistance.

In parallel, the effort to slow down antibiotic resistance continues. For example, Uppsala University coordinates the COMBINE project, and in 2016, the University founded the Uppsala Antibiotic Center, a multidisciplinary centre for research, education, innovation and awareness. The centre runs the AMR Studio podcast, showcasing some of the multidisciplinary research on antimicrobial resistance around the world. The University is also coordinating the ENABLE-2 antibacterial drug discovery platform funded by the Swedish Research Council, with an open call to support programmes in the early stages of discovery and development of new antibiotics.

Our own efforts at the Centre for Research Ethics & Bioethics are more focused on how we as individuals can help slow down the development of antibiotic resistance, and how we can assess the impact of how you frame antibiotic treatments when you ask patients about their preferences

Josepine Fernow

Written by…

Josepine Fernow, science communications project manager and coordinator at the Centre for Research Ethics & Bioethics, develops communications strategy for European research projects

Do you want to know more?

EurekAlert! News release: Collaboration to improve the quality of in vivo antibiotics testing, 14 November 2023 https://www.eurekalert.org/news-releases/1007971.

Ancillotti M, Nihlén Fahlquist J, Eriksson S, Individual moral responsibility for antibiotic resistance, Bioethics, 2022;36(1):3-9. https://doi.org/10.1111/bioe.12958

Smith IP, Ancillotti M, de Bekker-Grob EW, Veldwijk J. Does It Matter How You Ask? Assessing the Impact of Failure or Effectiveness Framing on Preferences for Antibiotic Treatments in a Discrete Choice Experiment. Patient Prefer Adherence. 2022;16:2921-2936. https://doi.org/10.2147/PPA.S365624

A shorter version of this post in Swedish

Approaching future issues

Encourage children to take responsibility for others?

It happens that academics write visionary texts that highlight great human challenges. I blogged about such a philosophically visionary article a few years ago; an article in which Kathinka Evers discussed the interaction between society and the brain. In the article, she developed the idea that we have a “proactive” responsibility to adapt our societies to what we know about the brain’s strengths and weaknesses. Above all, she emphasized that the knowledge we have today about the changeability of the brain gives us a proactive responsibility for our own human nature, as this nature is shaped and reshaped in interaction with the societies we build.

Today I want to recommend a visionary philosophical article by Jessica Nihlén Fahlquist, an article that I think has points of contact with Kathinka Evers’ paper. Here, too, the article highlights our responsibility for major human challenges, such as climate and, above all, public health. Here, too, human changeability is emphasized, not least during childhood. Here, too, it is argued that we have a responsibility to be proactive (although the term is not used). But where Kathinka Evers starts from neuroscience, Jessica Nihlén Fahlquist starts from virtue ethics and from social sciences that see children as social actors.

Jessica Nihlén Fahlquist points out that we live in more complex societies and face greater global challenges than ever before in human history. But humans are also complex and can under favorable circumstances develop great capacities for taking responsibility. Virtue ethics has this focus on the human being and on personal character traits that can be cultivated and developed to varying degrees. Virtue ethics is sometimes criticized for not being sufficiently action-guiding. But it is hard to imagine that we can deal with major human challenges through action-guiding rules and regulations alone. Rules are never as complex as human beings. Action-guiding rules assume that the challenges are already under some sort of control and thus are not as uncertain anymore. Faced with complex challenges with great uncertainties, we may have to learn to trust the human being. Do we dare to trust ourselves when we often created the problems?

Jessica Nihlén Fahlquist reasons in a way that brings to mind Kathinka Evers’ idea of a proactive responsibility for our societies and our human nature. Nihlén Fahlquist suggests, if I understand her correctly, that we already have a responsibility to create environments that support the development of human character traits that in the future can help us meet the challenges. We already have a responsibility to support greater abilities to take responsibility in the future, one could say.

Nihlén Fahlquist focuses on public health challenges and her reasoning is based on the pandemic and the issue of vaccination of children. Parents have a right and a duty to protect their children from risks. But reasonably, parents can also be considered obliged not to be overprotective, but also to consider the child’s development of agency and values. The virus that spread during the pandemic did not cause severe symptoms in children. Vaccination therefore does not significantly protect the child’s own health, but would be done with others in mind. Studies show that children may be capable of reasoning in terms of such responsibility for others. Children who participate in medical research can, for example, answer that they participate partly to help others. Do we dare to encourage capable children to take responsibility for public health by letting them reason about their own vaccination? Is it even the case that we should support children to cultivate such responsibility as a virtue?

Nihlén Fahlquist does not claim that children themselves have this responsibility to get vaccinated out of solidarity with others. But if some children prove to be able to reason in such a morally complex way about their own vaccination, one could say that these children’s sense of responsibility is something unexpected and admirable, something that we cannot demand from a child. By encouraging and supporting the unexpected and admirable in children, it can eventually become an expected responsibility in adults, suggests Jessica Nihlén Fahlquist. Virtue ethics makes it meaningful to think in terms of such possibilities, where humans can change and their virtues can grow. Do we dare to believe in such possibilities in ourselves? If you do not expect the unexpected you will not discover it, said a visionary Greek philosopher named Heraclitus.

Jessica Nihlén Fahlquist’s article is multifaceted and innovative. In this post, I have only emphasized one of her lines of thought, which I hope has made you curious about an urgent academic text: Taking risks to protect others – pediatric vaccination and moral responsibility.

In summary, Jessica Nihlén Fahlquist argues that vaccination should be regarded as an opportunity for children to develop their sense of responsibility and that parents, schools, healthcare professionals and public health authorities should include children in debates about ethical public health issues.

Pär Segerdahl

Written by…

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

Jessica Nihlén Fahlquist, Taking Risks to Protect Others – Pediatric Vaccination and Moral Responsibility, Public Health Ethics, 2023;, phad005, https://doi.org/10.1093/phe/phad005

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Approaching future issues

Resolving conflicts where they arise

I believe that many of us feel that the climate of human conversation is getting colder, that it is becoming harder for us to talk and get along with each other. Humanity feels colder than in a long time. At the same time, the global challenges are escalating. The meteorological signs speak for a warmer planet, while people speak a colder language. It should be the other way around. To cool the planet down, humanity should first get warmer.

How can humanity get warmer? How can we deal with the conflicts that make our human climate resemble a cold war on several fronts: between nations, between rich and poor, between women and men, and so on?

Observe what happens within ourselves when the question is asked and demands its answer. We immediately turn our attention to the world and to the actions we think could solve the problem there. A world government? Globally binding legislation? A common human language in a worldwide classless society that does not distinguish between woman and man, between skin colors, between friend and stranger?

Notice again what happens within ourselves when we analyze the question, either in this universalist way or in some other way. We create new conflicts between ourselves as analysts and the world where the problems are assumed to arise. The question itself is a conflict. It incriminates a world that must necessarily change. This creates new areas of conflict between people who argue for conflicting analyses and measures. One peace movement will fight another peace movement, and those who do not take the necessary stand on these enormous issues… well, how should we handle them?

Observe for the third time what happens within ourselves when we have now twice in a row directed our attention towards ourselves. First, we noted our inner tendency to react outwardly. Then we noted how this extroverted tendency created new conflicts not only between ourselves and an incriminated world that must change, but also between ourselves and other people with other analyses of an incriminated world that must change. What do we see, then, when we observe ourselves for the third time?

We see how we look for the source of all conflict everywhere but within ourselves. Even when we incriminate ourselves, we speak as if we were someone other than the one analyzing the problem and demanding action (“I should learn to shut up”). Do you see the extroverted pattern within you? It is like a mental elbow that pushes away a problematic world. Do you see how the conflicts arise within ourselves, through this constant outward reactivity? We think we take responsibility for the world around us, but we are only projecting our mental reflexes.

There was once a philosopher named Socrates. He was likened to an electric ray as he seemed to numb those he was talking to with his unexpected questions, so that they could no longer react with worldly analyses and sharp-witted arguments. He was careful to point out that he himself was equally numbed. He saw the extroverted tendency within himself. Every time he saw it, he became silent and motionless. Sometimes he could stand for hours on a street corner. He saw the source of all conflict in the human mind that always thinks it knows, that always thinks it has the analysis and all the arguments. He called this inner numbness his wisdom and he described it like this: “what I do not know, I do not think I know either.”

Naturally, a philosopher thus numbed could not harbor any conflict, because the moment it began to take shape, he would note the tendency within himself and be numbed. He mastered the art of resolving conflicts where they arise: within ourselves. Free from the will to change an incriminated world, he would thereby have revolutionized everything.

Socrates’ wisdom may seem too simple for the complex problems of our time. But given our three observations of how all conflict arises in the human mind, you see how we ourselves are the origin of all complexity. This simple wisdom can warm a humanity that has forgotten to examine itself.

Pär Segerdahl

Written by…

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

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We care about communication

A new project will explore the prospect of artificial awareness

The neuroethics group at CRB has just started its work as part of a new European research project about artificial awareness. The project is called “Counterfactual Assessment and Valuation for Awareness Architecture” (CAVAA), and is funded for a duration of four years. The consortium is composed of 10 institutions, coordinated by the Radboud University in the Netherlands.

The goal of CAVAA is “to realize a theory of awareness instantiated as an integrated computational architecture…, to explain awareness in biological systems and engineer it in technological ones.” Different specific objectives derive from this general goal. First, CAVAA has a robust theoretical component: it relies on a strong theoretical framework. Conceptual reflection on awareness, including its definition and the identification of features that allow its attribution to either biological organisms or artificial systems, is an explicit task of the project. Second, CAVAA is interested in exploring the connection between awareness in biological organisms and its possible replication in artificial systems. The project thus gives much attention to the connection between neuroscience and AI. Third, against this background, CAVAA aims at replicating awareness in artificial settings. Importantly, the project also has a clear ethical responsibility, more specifically about anticipating the potential societal and ethical impact of aware artificial systems.

There are several reasons why a scientific project with a strong engineering and computer science component also has philosophers on board. We are asked to contribute to developing a strong and consistent theoretical account of awareness, including the conceptual conceivability and the technical feasibility of its artificial replication. This is not straightforward, not only because there are many content-related challenges, but also because there are logical traps to avoid. For instance, we should avoid the temptation to validate an empirical statement on the basis of our own theory: this would possibly be tautological or circular.

In addition to this theoretical contribution, we will also collaborate in identifying indicators of awareness and benchmarks for validating the cognitive architecture that will be developed. Finally, we will collaborate in the ethical analysis concerning potential future scenarios related to artificial awareness, such as the possibility of developing artificial moral agents or the need to extend moral rights also to artificial systems.

In the end, there are several potential contributions that philosophy can provide to the scientific attempt to replicate biological awareness in artificial systems. Part of this possible collaboration is the fundamental and provoking question: why should we try to develop artificial awareness at all? What is the expected benefit, should we succeed? This is definitely an open question, with possible arguments for and against attempting such a grand accomplishment.

There is also another question of equal importance, which may justify the effort to identify the necessary and sufficient conditions for artificial systems to become aware, and how to recognize them as such. What if we will inadvertently create (or worse: have already created) forms of artificial awareness, but do not recognize this and treat them as if they were unaware? Such scenarios also confront us with serious ethical issues. So, regardless of our background beliefs about artificial awareness, it is worth investing in thinking about it.

Stay tuned to hear more from CAVAA!

Written by…

Michele Farisco, Postdoc Researcher at Centre for Research Ethics & Bioethics, working in the EU Flagship Human Brain Project.

Part of international collaborations

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

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

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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We recommend readings

Self-confidence in the midst of uncertainty

Feeling confident is natural when we have the knowledge that the task requires. However, self-confidence can be harmful if we think that we know what we do not know. It can be really problematic if we make a habit of pretending that we know. Perhaps because we demand it of ourselves.

There is also another kind of self-confidence, which can seem unnatural. I am thinking of a rarely noticed form of self-confidence, which can awaken just when we are uncertain about how to think and act. But how can self-confidence arise precisely when we are uncertain? It sounds not only unnatural, but also illogical. And was it not harmful to exhibit self-confidence in such situations?

I am thinking of the self-confidence to be just as uncertain as we are, because our uncertainty is a fact that we are certain of: I do not know. It is easy to overlook the fact that even uncertainty is a reality that can be ascertained and investigated in ourselves. Sometimes it is important to take note of our uncertainty. That is sticking to the facts too!

What happens if we do not trust uncertainty when we are uncertain? I think we then tend to seek guidance from others, who seem to know what we do not know. It seems not only natural, but also logical. It is reasonable to do so, of course, if relevant knowledge really exists elsewhere. Asking others, who can be judged to know better, also requires a significant measure of self-confidence and good judgment, in the midst of uncertainty.

But suppose we instinctively seek guidance from others as soon as we are uncertain, because we do not dare to stick to uncertainty in such moments. What happens if we always run away from uncertainty, without stopping and paying attention to it, as if uncertainty were something impermissible? In such a judgmental attitude to uncertainty, knowledge and certainty can become a demand that we feel must be met, towards ourselves and towards each other, if only as a facade. We are then back where we started, in pretended knowledge, which now might become a collective high-risk game and not just an individual bad habit.

Collective knowledge games can of course work, if sufficiently many influential players have the knowledge that the tasks require and knowledge is disseminated in a well-organized manner. Maybe we think that it should be possible to build such a society, a secure knowledge society. The question I wonder about is how sustainable this is in the long run, if the emphasis on certainty does not simultaneously emphasize also uncertainty and questioning. Not for the sake of questioning, but because uncertainty is also a fact that needs attention.

In philosophy and ethics, it is often uncertainty that primarily drives the work. This may sound strange, but even uncertainty can be investigated. If we ask a tentative question about something we sincerely wonder about, clearer questions can soon arise that we continue to wonder about, and soon the investigation will begin. The investigation comes to life because we dare to trust ourselves, because we dare to give ourselves time to think, in the midst of uncertainty, which can become clarity if we do not run away from it. In the investigation, we can of course notice that we need more knowledge about specific issues, knowledge that is acquired from others or that we ourselves develop through empirical studies. But it is not only specific knowledge that informs the investigation. The work with the questions that express our uncertainty clarifies ourselves and makes our thinking clearer. Knowledge gets a well-considered context, where it is needed, which enlightens knowledge.

A “pure” game of knowledge is hardly sustainable in the long run, if its demands are not open also to the other side of knowledge, to the uncertainty that can be difficult to separate from ourselves. Such openness requires that we trust not only the rules of the game, but also ourselves. But do we dare to trust ourselves when we are uncertain?

I think we dare, if we see uncertainty as a fact that can be investigated and clarified, instead of judging it as something dangerous that should not be allowed to be a fact. That is when it can become dangerous.

Pär Segerdahl

Written by…

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

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Thinking about thinking

Can consumers help counteract antimicrobial resistance?

Antimicrobial resistance (AMR) occurs when microorganisms (bacteria and viruses, etc.) survive treatments with antimicrobial drugs, such as antibiotics. However, the problem is not only caused by unwise use of such drugs on humans. Such drugs are also used on a large scale in animals in food production, which is a significant cause of AMR.

In an article in the journal Frontiers in Sustainable Food Systems, Mirko Ancillotti and three co-authors discuss the possibility that food consumers can contribute to counteracting AMR. This is a specific possibility that they argue is often overlooked when addressing the general public.

A difficulty that arises when AMR needs to be handled by several actors, such as authorities, food producers, consumers and retailers, is that the actors transfer the responsibility to the others. Consumers can claim that they would buy antibiotic-smart goods if they were offered in stores, while retailers can claim that they would sell such goods if consumers demanded them. Both parties can also blame how, for example, the market or legislation governs them. Another problem is that if one actor, for example the authorities, takes great responsibility, other actors feel less or no responsibility.

The authors of the article propose that one way out of the difficulty could be to influence consumers to take individual responsibility for AMR. Mirko Ancillotti has previously found evidence that people care about antibiotic resistance. Perhaps a combination of social pressure and empowerment could engage consumers to individually act more wisely from an AMR perspective?

The authors make comparisons with the climate movement and suggest digital innovations in stores and online, which can inform, exert pressure and support AMR-smarter food choices. One example could be apps that help consumers see their purchasing pattern, suggest product alternatives, and inform about what is gained from an AMR perspective by choosing the alternative.

Read the article with its constructive proposal to engage consumers against antimicrobial resistance: The Status Quo Problem and the Role of Consumers Against Antimicrobial Resistance.

Pär Segerdahl

Written by…

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

Ancillotti, Mirko; Nilsson, Elin; Nordvall, Anna-Carin; Oljans, Emma. The Status Quo Problem and the Role of Consumers Against Antimicrobial Resistance. Frontiers in Sustainable Food Systems, 2022.

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Approaching future issues

Fact resistance, human nature and contemplation

Sometimes we all resist facts. I saw a cyclist slip on the icy road. When I asked if it went well, she was on her feet in an instant and denied everything: “I did not fall!” It is human to deny facts. They can hurt and be disturbing.

What are we resisting? The usual answer is that fact-resistant individuals or groups resist facts about the world around us, such as statistics on violent crime, on vaccine side effects, on climate change or on the spread of disease. It then becomes natural to offer resistance to fact resistance by demanding more rigour in the field of knowledge. People should learn to turn more rigorously to the world they live in! The problem is that fact-resistant attitudes do just that. They are almost bewitched by the world and by the causes of what are perceived as outrageous problems in it. And now we too are bewitched by fact resistance and speculate about the causes of this outrageous problem.

Of course, we believe that our opposition is justified. But who does not think so? Legitimate resistance is met by legitimate resistance, and soon the conflict escalates around its double spiral of legitimacy. The possibility of resolving it is blocked by the conflict itself, because all parties are equally legitimate opponents of each other. Everyone hears their own inner voices warning them from acknowledging their mistakes, from acknowledging their uncertainty, from acknowledging their human resistance to reality, as when we fall off the bike and wish it had never happened. The opposing side would immediately seize the opportunity! Soon, our mistake is a scandal on social media. So we do as the person who slipped on the icy road, we deny everything without thinking: “I was not wrong, I had my own facts!” We ignore the fact that life thereby becomes a lie, because our inner voices warn us from acknowledging our uncertainty. We have the right to be recognized, our voices insist, at least as an alternative to the “established view.”

Conflicts give us no time for reflection. Yet, there is really nothing stopping us from sitting down, in the midst of conflict, and resolving it within ourselves. When we give ourselves time to think for ourselves, we are freer to acknowledge our uncertainty and examine our spirals of thought. Of course, this philosophical self-examination does not resolve the conflict between legitimate opponents which escalates around us as increasingly impenetrable and real. It only resolves the conflict within ourselves. But perhaps our thoughtful philosophical voice still gives a hint of how, just by allowing us to soar in uncertainty, we already see the emptiness of the conflict and are free from it?

If we more often dared to soar in uncertainty, if it became more permissible to say “I do not know,” if we listened more attentively to thoughtful voices instead of silencing them with loud knowledge claims, then perhaps fact resistance also decreases. Perhaps fact resistance is not least resistance to an inner fact. To a single inner fact. What fact? Our insecurity as human beings, which we do not permit ourselves. But if you allow yourself to slip on the icy road, then you do not have to deny that you did!

A more thoughtful way of being human should be possible. We shape the societies that shape us.

Pär Segerdahl

Written by…

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

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