Nanotechnology and Risk Governance in the European Union: the Constitution of Safety in Highly Promoted and Contested Innovation Areas

The European Union (EU) is strategically committed to the development of nanotechnology and its industrial exploitation. However, nanotechnology also has the potential to disrupt human health and the environment. The EU claims to be committed to the safe and responsible development of nanotechnology. In this sense, the EU has become the first governing body in the world to develop nanospecific regulations, largely due to legislative action taken by the European Parliament, which has compensated for the European Commission’s reluctance to develop special regulations for nanomaterials. Nevertheless, divergences aside, political bodies in the EU assume that nanotechnology development is controllable and take for granted that both the massive industrial use of nanomaterials and a high level of environmental and health protection are compatible. However, experiences such as the European controversy over agri-food biotechnology, which somewhat delegitimized the regulatory authority of the EU over technological safety and acceptability, arguably show that controllability assumptions are contestable on the grounds of alternative socio-economic and cultural preferences and values. Recently developed inclusive governance models on safety and innovation, such as “Responsible Research and Innovation” (RRI), widely claim that a diversity of considerations and issues are integrated into R&D processes. Even so, the possibility of more radically alternative constitutions of socio-technical safety seems to be seriously limited by the current ideology of innovation and economic imperatives of the global, knowledge-based, capitalist economy.     

Work-Life Balance: an Integrative Review

Based on a thorough review of the literature we introduce an integrated conceptualization of work-life balance involving two key dimensions: engagement in work life and nonwork life and minimal conflict between social roles in work and nonwork life. Based on this conceptualization we review much of the evidence concerning the consequences of work-life balance in terms work-related, nonwork-related, and stress-related outcomes. We then identify a set of personal and organizational antecedents to work-life balance and explain their effects on work-life balance. Then we describe a set of theoretical mechanisms linking work-life balance and overall life satisfaction. Finally, we discuss future research directions and policy implications.     

Health-Related Quality of Life in a Low-Socioeconomic Status Public Rental-Flat Population in Singapore

Health-related quality of life (HRQoL) is a well-established measure of health and general well-being. Socioeconomic status (SES) can affect HRQoL. We sought to determine whether there were differences in HRQoL between low versus higher area-SES flat communities in Singapore. Residents in two integrated public housing precincts comprising of rental-flat blocks (low area-SES neighborhood) and neighboring owner-occupied blocks (higher area-SES neighborhood) were asked to rate their self-perceived HRQoL using the EuroQol Group five dimensions (EQ-5D) instrument. The EQ-5D assesses HRQoL in five domains (mobility, self-care, usual activities, anxiety/mood and pain) and with a global visual analogue scale (EQ-VAS). We evaluated differences in HRQoL between the rental and owner-occupied neighborhoods, and factors associated with anxiety/depression in the rental-flat neighborhood using multivariate logistic regression. The participation rate was 89.1% (634/711). In the owner-occupied neighborhood, 56.7% (216/381) were in full health, compared with 54.2% (137/253) in the rental-flat population (OR = 0.90, 95%CI = 0.66–1.24, p = 0.568). Across the five domains, staying in a rental-flat neighborhood was independently associated with anxiety/depression (adjusted odds ratio [aOR] = 1.79, 95%CI = 1.10–2.92, p = 0.019). In the rental-flat population, having anxiety/depression was independently associated with minority ethnicity, problems with self –care, pain/discomfort, difficulty with healthcare costs, and not being on subsidized primary care (p < 0.05). There was no significant difference on the EQ-VAS between the two neighborhoods (p = 0.627). Staying in a low area-SES neighborhood was associated with more mental health problems. In the rental-flat population, self-reported anxiety/depression was associated with minority ethnicity, physical health problems, and financial disadvantage in healthcare.     

A proposal for teaching bioethics in high schools using appropriate visual education tools

Teaching bioethics with visual education tools, such as movies and comics, is a unique way of explaining the history and progress of human research and the art and science of medicine to high school students. For more than a decade, bioethical concepts have appeared in movies, and these films are useful for teaching medical and research ethics in high schools. Using visual tools to teach bioethics can have both interpretational and transformational effects on learners that will enhance their overall understanding of complex moral and legal issues in medicine and research.High school students are uniquely suited to learn bioethics because they will soon become legal adults. As adults, they will make moral decisions that may affect their health and wellbeing as well as that of their communities and societies.However, not all visual education tools are appropriate for bioethics pedagogy in high school. Bioethics film and comic producers must consider the specifics of student age, race, gender, belief, level of education, and sexual orientation. Such tools must not be dominated by either dystopic or utopic genres, must aim for objectivity, and must consider the complexity of ethical decision making. It is critical that the teacher, who is the final arbiter regarding the use of visual tools in the classroom, determines that the visual learning tool is acceptable for students in any particular education context. In addition, during the conceptualization and creation of these tools, bioethics film and comic producers must work harder to ensure that these visual tools are devoid of any form of stereotyping.     

Patients and agents – or why we need a different narrative: a philosophical analysis

Background

The success of medicine in the treatment of patients brings with it new challenges. More people live on to suffer from functional, chronic or multifactorial diseases, and this has led to calls for more complex analyses of the causal determinants of health and illness.

Methods

Philosophical analysis of background assumptions of the current paradigmatic model.

Results

While these factors do not require a radical paradigm shift, they do give us cause to develop a new narrative, to add to existing narratives that frame our thinking about medical care. In this paper we argue that the increased focus on lifestyle and shared decision making requires a new narrative of agency, to supplement the narrative of “the patient”. This narrative is conceptually linked to the developing philosophy of person-centred care.

Conclusions

If patients are seen also as “agents” this will result in a substantial shift in practical decisions: The development and adoption of this narrative will help practitioners work with patients to their mutual benefit, harnessing the patients’ motivation, shifting the focus from treatment to prevention and preventing unnecessary and harmful treatments that can come out of our preoccupation with the patient narrative. It will also help to shift research efforts, conceptual and empirical, from “treating” and “battling” diseases and their purported “mechanisms” to understanding complex contributing factors and their interplay.

     

Person Skilled in the Art in Synthetic Biology from Iraqi and Malaysian Perspectives

This article presents the problem of a person skilled in the field of synthetic biology. The person skilled in the art is one of the notions which have to be revisited due to the multidisciplinary nature of synthetic biology which involves numerous fields. The article studies this problem from the perspectives of Iraqi and Malaysian patent laws. First, it conceptualizes synthetic biology and person skilled in the art. The Iraqi and Malaysian attitudes regarding person skilled in the art are then addressed. Afterwards, the paper points out the multidisciplinary nature of synthetic biology. In its last part, it discusses the person skilled in synthetic biology and how patent offices and courts deal with this point. Finally, the authors submit that the use of a team of skilled persons to substitute for a single technician would render the obviousness test a subjective assessment dependent on the inventor. The level of non-obviousness would differ in similar cases simply because of the number of inventors. Consequently, the suggestion of having a hypothetical team instead of one person is irrelevant because skills that are attributed to the skilled notional person are not real skills. Thus, replacing him is easy, but the replacement would be fruitless because the skills attributed to a person or a team will be similar.     

The Power of Analogies for Imagining and Governing Emerging Technologies

The emergence of new technologies regularly involves comparisons with previous innovations. For instance, analogies with asbestos and genetically modified organisms have played a crucial role in the early societal debate about nanotechnology. This article explores the power of analogies in such debates and how they could be effectively and responsibly employed for imagining and governing emerging technologies in general and nanotechnology in particular. First, the concept of analogical imagination is developed to capture the explorative and anticipatory potential of analogies. Yet analogies do not simply stimulate imagination, they also restrict it by framing emerging technologies in specific ways. Thus, second, the article argues that tracing the rhetorical and persuasive power of analogical arguments is essential for understanding how analogies are constructed to legitimise assessments, funding policies, and governance approaches. Third, the article addresses factors that account for the persuasiveness of analogies in debates about emerging technologies. The article concludes with reflections on how analogical imagination and an enhanced analogical sensibility for framing and persuasive effects can foster responsible research and innovation (RRI).     

Models of Public Engagement: Nanoscientists’ Understandings of Science–Society Interactions

This paper explores how scientists perceive public engagement initiatives. By drawing on interviews with nanoscientists, it analyzes how researchers imagine science–society interactions in an early phase of technological development. More specifically, the paper inquires into the implicit framings of citizens, of scientists, and of the public in scientists’ discourses. It identifies four different models of how nanoscientists understand public engagement which are described as educational, paternalistic, elitist, and economistic. These models are contrasted with the dialog model of public engagement promoted by social scientists and policymakers. The paper asks if and in what ways participatory discourses and practices feed back into scientists’ understandings, thus co-producing public discourses and science.     

Frame Reflection Lab: a Playful Method for Frame Reflection on Synthetic Biology

Synthetic biology is an emerging technology that asks for inclusive reflection on how people frame the field. To unravel how we can facilitate such reflection, this study evaluates the Frame Reflection Lab (FRL). Building upon playfulness design principles, the FRL comprises a workshop with video-narratives and co-creative group exercises. We studied how the FRL facilitated frame reflection by organizing workshops with various student groups. Analysis of 12 group conversations and 158 mini-exit surveys yielded patterns in first-order reflection (problem analysis and solution finding in reflection on the development of synthetic biology as a field) as well as patterns in second-order reflection (reflection on values and assumptions underlying the first-order reflection). Also patterns in participants’ (re)framing of synthetic biology could be induced; participants’ viewpoints converged to some extent, yet with openness to individual viewpoint differences. Although the FRL method fortified the reflection processes of participants, the narratives and the workshop’s flexible format could inhibit the reflection too. Therefore, we advise designers of future frame reflection methods to apply stronger conversational facilitation and narratives of slightly mysterious yet identifiable narrators, in case e.g. video-narratives are created and used to scaffold the reflection process. Nevertheless, we argue that the use of a playful frame reflection method like the FRL could function well as (1) a step to precede more application-specific deliberation or decision-making on synthetic biology and as (2) a method for the collection of contemporary citizen viewpoints plus rationales underlying these, for the further (societally) responsible development of the emerging field.     

Giving Voice to Patients: Developing a Discussion Method to Involve Patients in Translational Research

Biomedical research policy in recent years has often tried to make such research more ‘translational’, aiming to facilitate the transfer of insights from research and development (R&D) to health care for the benefit of future users. Involving patients in deliberations about and design of biomedical research may increase the quality of R&D and of resulting innovations and thus contribute to translation. However, patient involvement in biomedical research is not an easy feat. This paper discusses the development of a method for involving patients in (translational) biomedical research aiming to address its main challenges.After reviewing the potential challenges of patient involvement, we formulate three requirements for any method to meaningfully involve patients in (translational) biomedical research. It should enable patients (1) to put forward their experiential knowledge, (2) to develop a rich view of what an envisioned innovation might look like and do, and (3) to connect their experiential knowledge with the envisioned innovation. We then describe how we developed the card-based discussion method ‘Voice of patients’, and discuss to what extent the method, when used in four focus groups, satisfied these requirements. We conclude that the method is quite successful in mobilising patients’ experiential knowledge, in stimulating their imaginaries of the innovation under discussion and to some extent also in connecting these two. More work is needed to translate patients’ considerations into recommendations relevant to researchers’ activities. It also seems wise to broaden the audience for patients’ considerations to other actors working on a specific innovation.