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

Tag: risk

Proceed carefully with vaccine against covid-19

Pharmaceutical companies want to quickly manufacture a vaccine against covid-19, with human testing and launch in the market as soon as possible. In a debate article, Jessica Nihlén Fahlquist at CRB warns of the risk of losing the larger risk perspective: “Tests on people and a potential premature mass vaccination entail risks. It is easy to forget about similar situations in the past,” she writes.

It may take time for side effects to appear. Unfortunately, it therefore also takes time to develop new safe vaccines. We need to develop a vaccine, but even with new vaccines, caution is needed.

The article is in Swedish. If you want to Google translate: Proceed carefully with vaccine against covid-19

Pär Segerdahl

Written by…

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

We have a clinical perspective

Why should we care about the environment and climate change?

Jessica Nihlén FahlquistTo most of us, it is self-evident that we, as human beings and societies, should care about the environment and climate change. Greta Thunberg has, in a remarkable way, spurred political interest and engagement in climate change. This effort has affected our thoughts and emotions concerning environmental policy. However, when we dig deeper into the philosophical debate, there are different ideas on why we should care about the environment. That is, even though we agree on the need to care, there are various arguments as to why and how we should do that.

First, some scholars argue that we should care about nature because we need it and what we get from it. Nature is crucial to us, for example, because it provides us with water and food as well as air to breathe. Without nature and a good climate, we simply cannot live on planet Earth. Unless we make a substantial effort, our lifestyle will lead to flooding, unmanageable migration and many other enormous challenges. Furthermore, it will affect poorer people and poorer regions the most, making it a crucial issue of justice.

Second, some philosophers argue that it is wrong to base our concern for nature and the environment on the needs of, and effects on, human beings. The anthropocentric assumptions are wrong, they argue. Even without human beings, nature has a value. Its value is intrinsic and not merely instrumental. Proponents of this view often claim that animals have values, and possibly even rights, that should be protected. They disagree on whether it is individual animals, species or even ecosystems that should be protected.

Environmental philosophy consists of many different theoretical schools, and the notions they defend underlie societal debate, explicitly or merely implicitly. Some notions are based on consequentialist ethics and others on deontological ethics. In addition to these two schools of thought, virtue ethics has become influential in the philosophical debate.

Environmental Virtue Ethics holds that it is inadequate to focus on consequences, duties and rights. Furthermore, it is inadequate to focus on rules and legislation. Our respect for and reverence for nature is based on the virtues we ought to develop as human beings. In addition, society should encourage such virtues. Virtue ethics focuses on the character traits, on the dispositions to act, and on the attitudes and emotions that are relevant to a certain area, in this case the environment. It is a richer, more complex theory than the other two mentioned. Even though virtues were first discussed during Antiquity, and the concept might seem obsolete, they are highly relevant in our time. Through reflection, experience and role models, we can all develop virtues crucial to environmental protection and sustainability. The idea is not only that society needs these virtuous people, but that virtuous human beings blossom as individuals when they develop these virtues. They argue that it is wrong to see nature as a commodity belonging to us. Instead, it is argued, we are part of nature and have a special relationship with it. This relationship should be the focus of the debate.

Whereas Environmental Virtue Ethics focuses on ethical virtues, that is, how we should relate to nature through our development into virtuous individuals, a related school of thought focuses on the aesthetical value of nature. It is pointed out that not only does nature have ethical value, but an aesthetical value in virtue of its beauty. We should spend time in nature in order to fully appreciate its aesthetical value.

All of the mentioned schools of thought agree that we should care about the environment and climate. They also hold that sustainability is an important national and global goal. Interestingly, what is beneficial from a sustainability perspective is not necessarily beneficial to climate changes. For instance, nuclear energy could be considered good for climate change due to its marginal emissions, but it is doubtful that it is good for sustainability considering the problems of nuclear waste.

Finally, it is important to include the discussion of moral responsibility. If we agree that it is crucial to save the environment, then the question arises who should take responsibility for materializing this goal. One could argue that individuals bear a personal responsibility to, for example, reduce consumption and use sustainable transportation. However, one could also argue that the greatest share of responsibility should be taken by political institutions, primarily states. In addition, a great share of responsibility might be ascribed to private actors and industries.

We could also ask whether, and to what extent, responsibility is about blame for past events, for example, the western world causing too much carbon emissions in the past. Alternatively, we could focus on what needs to be done now, regardless of causation and blame. According to this line of thinking, the most important question to ask is who has the resources and capacity to make the necessary changes. The questions of responsibility could be conceptualized as questions of individual versus collective responsibility and backward-looking versus forward-looking responsibility.

As we can see, there are many philosophically interesting aspects and discussions concerning the question why we should care about the environment. Hopefully, these discussions can contribute to making the challenges more comprehensible and manageable. Ideally, they can assist in the tremendous work done by Greta Thunberg and others like her so that it can lead to agreement on what needs to be done by individuals, nations and the world.

Jessica Nihlén Fahlquist

Nihlén Fahlquist, J. 2018. Moral Responsibility and Risk in Modern Society – Examples from emerging technologies, public health and environment. Routledge Earth Scan Risk in Society series: London.

Van de Poel, I. Nihlén Fahlquist, J, Doorn, N., Zwart, S, Royakkers L, di Lima, T. 2011. The problem of many hands: climate change as an example. Science and Engineering Ethics.

Nihlen Fahlquist J. 2009. Moral responsibility for environmental problems – individual or institutional? Journal of Agricultural and Environmental Ethics, Volume 22(2), pp. 109-124.

This post in Swedish

Approaching future issues - the Ethics Blog



Risks are not just about numbers

Jessica Nihlén FahlquistOn a daily basis, we are informed about risks. The media tell us that obesity increases the risk of cardiovascular diseases and that we can reduce the risk of Alzheimers by eating the right kind of food. We are confronted with the potential danger of nanoparticles and mobile phone radiation. Not to mention the never ending discussion about nuclear power. Some news are more serious than others, but we cannot avoid risk information as such.

In addition to the media, government agencies inform the public about risks. The Swedish National Food Agency encourages people to eat fish because of its potential to reduce the risk of cardiovascular disease. But we should also reduce the intake of wild-caught salmon and herring due to the health risks associated with mercury.

Contemporary society has been described as a risk society, simply put a society preoccupied with risks. We invest a great amount of our common resources in risk management and communication. Sometimes, it appears as though risks are communicated in a hasty way. As soon as a risk is “found,” it is assumed that the responsibility of the government and possibly of the media is to inform the public. It is not acknowledged that what is considered to be a risk is not always straightforward and value neutral.

Whereas experts define risk as probability multiplied by negative outcome and weigh risks against benefits, several studies have shown that lay people conceive of risk in a much more complex and nuanced way. According to the expert notion, a risk is acceptable if the benefits outweigh the risks. However, individual lay people include other factors, for example, whether risks and benefits are distributed fairly and whether the risk has been taken voluntarily or it is one person exposing another to the risk. Studies in risk perception have also been acknowledged by ethicists and philosophers, who point out that not only do factors like voluntariness and fairness de facto influence people’s notion of the acceptability of risk, but we should care about these values. They are normatively important.

These insights about risk as ethically relevant and value-laden should influence how risks are managed and communicated in society. One example is how government agencies view risks and benefits in the case of infant feeding. Breastfeeding is seen as the best option in terms of risks and benefits. Mothers are expected to breastfeed their babies if they want to do what is best for their baby. Scientific and value-laden statements are mixed in the information provided to new parents. Women, adoptive parents and male gay couples who cannot breastfeed are negatively affected by this message. Women who cannot breastfeed oftentimes feel guilty and think that they are harming their babies for life by not breastfeeding. This should be taken into account when communicating with parents-to-be and new parents. The relationship between government agencies and ordinary people is inevitably unequal and the former should take responsibility for the effects of risk communication.

Another example is the H1N1 virus and the Pandemrix vaccination program in Sweden in 2009. The government informed the public that the vaccine was completely safe and that everybody should get vaccinated for solidarity reasons. After some time, it turned out that a group of teenagers had their lives more or less destroyed because they got narcolepsy probably due to the vaccination. This deserves a thorough ethical discussion.

There are currently signs that some people now hesitate to have their children take part in the regular vaccination program, including protection against, for example, measles. The regular vaccines are much more tested and substantially safer than Pandemrix. The opposition against vaccines are generally based on misconceptions and deficient studies. However, instead of mocking “ignorant” people and thinking that it is possible to change the perception and attitude of anxious parents by informing more about numbers, the anxiety and the lacking trust should be taken seriously. A respectful dialogue is needed.

This does not mean that the opponents of vaccination have the same and as accurate information as proponents of vaccination, who have science on their side. However, risks are not just about numbers!

Read more:

Jessica Nihlén Fahlquist

We care about communication - the Ethics Blog


How do people live with genetic risk?

PÄR SEGERDAHL Associate Professor of Philosophy and editor of The Ethics BlogFor the doctor, the patient’s disease is a virus infection, a non-functioning kidney, a mutation. The disease is a disorder within the patient’s body.

But for the patient, the disease is not least a disorder of his or her life and of how the body functions in daily life. The disease disrupts the patient’s plans and direction of life. This can be experienced with grief as a loss of what was “one’s life.”

The concept of disease is ambiguous. It has one meaning in medicine; another in the patient’s own life and experience. Also the diseased body is ambiguous. The doctor’s conception of the patient’s bodily disorder is something else than the patient’s experience of the disorder of the body.

At one of our seminars, Serena Oliveri (see below) discussed how people experience genetic risk of disease.

Also genetic risk is ambiguous I believe Oliveri wants to say. Genetic risk has one meaning in genetics (hard to grasp even for geneticists and physicians). But what happens in people’s own lives when they get to know the risk? How does one live with the risk of developing breast cancer or Alzheimer’s disease in the future? How does one live as “someone who is at risk?”

Oliveri indicates that the challenge here isn’t only that of informing people in more comprehensible ways. No matter how well the doctor explains the disease or the genetic risk to the patient, disease and genetic risk continue to be ambiguous. Disease and genetic risk continue to have different meanings in the medical setting and in people’s own lives.

The ambiguity is inevitable. For we do not cease to live and to experience life just because some medical or genetic issue was explained to us in very comprehensible ways. So how does life change when it becomes a life with genetic risk? That question needs to be investigated.

The ambiguity is a responsibility. Today, it is becoming increasingly easy and cheap to provide people with genetic risk information. You can even buy your own genetic test online! That aspect of genetics develops more rapidly today than the methods of treating or giving advice to people at risk.

Through genetic tests, then, it has become very easy to create people who “live at risk” without us really knowing yet what it means in those people’s lives. And without us really knowing yet what they should do with the risk in the form of treatments or changes in lifestyle.

We are dealing with ambiguous concepts, Oliveri points out, and therefore we face double challenges.

Pär Segerdahl

  • Serena Oliveri, PhD, is a Post-Doc researcher in Cognitive Psychology and Decision-Making processes at the University of Milan and a member of the Applied Research Unit for Cognitive and Psychological Science at the European Institute of Oncology (IEO). Her research interests focus on medical decision making, risk analysis related to genetic information, effects on cognitive functions of cancer treatments and cognitive enhancement. She is author of several scientific papers published on indexed peer-reviewed international journals. She participates in the project “Mind the risk” at CRB, which among other issues investigated the questions in this post.

In dialogue with patients