Does Low Dose Ionizing Radiation Cause Cancer? The Interplay of Epistemology and Ethics in Radiation Protection

In order to investigate the relationship between scientific evidence and social commitments this article addresses three questions: (1) does low dose ionizing radiation cause cancer? (2) Is the answer to this question different in a social setting than in a scientific context? (3) What are the consequences of the answers of 1 and 2 for the relationship between epistemology and ethics as played out in radiation protection? Conceptual analysis with basis in the philosophy of science, in particular traditional theories of causality. Whether low dose ionizing radiation causes cancer deeply depends on what we mean by causality. According to traditional scientific conceptions of causality it is not warranted to say that low dose ionizing radiation causes cancer. Standard approaches in radiation protection, however, imply that there is a causal connection, which is due to the strong social commitment in the field. There is a close relationship between social and scientific conceptions of causality, posing a series of challenges: one being that scientists covertly become moral experts, another one that the general public can be misinformed. There is a difference between causality in science and in policy making. Mixing these conceptions, as sometimes is done in radiation protection, can be misleading. Whether low dose ionizing radiation causes cancer is a social and not only a scientific issue. As such those who are warranted to have a say.     

Science and Political Imperatives: Orders of Precedence

An ideal view is sketched of the relationship between the facts established in science and the values of ethics and politics, and of the distinction between them. Some necessary qualifications are drawn, which do not essentially undermine the ideal. Then two cases of scientific work are considered in which considerations of value may in different ways be playing a more intimate role in the science than the ideal would suggest. These are Darwin’s theory of evolution and the current consensus on climate change. Are any general lessons to be drawn from these cases?     

Higher-Level Perspectives and Ethics of Technoscience

New accents in the philosophy of technology and philosophy of science amounting, e.g., to the so-called schools of the “New Experimentalism”, “New Instrumentalism” and, recently, “New Mechanism” emphasize the impact of instruments, experiments, and “mechanisms” of the respective technologies opened up by the progress of ever-improving measuring instruments, procedures etc. In addition, it would be necessary to accentuate the process- and action-orientation including practical responsibility problems and dynamic systems models from an epistemological perspective of the methodological scheme-interpretationist approach developed by the author since the seventies of last century. The necessity of multi-disciplinary mutual influences was already time and again stressed regarding philosophy of science. But relatively new is not only the methodological turn involved but also the necessity to go to higher levels of abstraction, metatheories, action- and value-orientation. Therefore, we have to go more interdisciplinary, systems-oriented, and higher-level. That implies notable consequences for an ethics, or rather, meta-ethics for philosophy of science. Practice-oriented philosophers of (techno-)science will have to go more methodological, multidisciplinary and even (meta-)responsible.     

Freedom as Non-domination and Democratic Inclusion

According to neo-republicans, democracy is morally justified because it is among the prerequisites for freedom as non-domination. The claim that democracy secures freedom as non-domination needs to explain why democratic procedures contribute to non-domination and for whom democracy secures non-domination. This requires an account of why domination is countered by democratic procedures and an account of to whom domination is countered by access to democratic procedures. Neo-republican theory of democracy is based on a detailed discussion of the former but a scant discussion of the latter. We address this lacuna by interpreting the two most influential principles of inclusion, the all-subjected principle and the all-affected principle, in light of neo-republican commitments. The preliminary conclusion is that both principles are able to capture relations of domination between the democratic state and the people controlled by it in the relevant sense. Yet, the state has virtually unlimited powers to control residents, but only limited powers to interfere in the lives of non-residents. Republican aspirations are therefore more in tune with the all-subjected principle according to which only residents in the territory of the state should be granted rights to political participation.     

Molecular Tumor Boards: Ethical Issues in the New Era of Data Medicine

The practice and development of modern medicine requires large amounts of data, particularly in the domain of cancer. The future of personalized medicine lies neither with “genomic medicine” nor with “precision medicine”, but with “data medicine” (DM) (big data, data mining). The establishment of this DM has required far-reaching changes, to establish four essential elements connecting patients and doctors: biobanks, databases, bioinformatic platforms and genomic platforms. The “transformation” of scientific research areas, such as genetics, bioinformatics and biostatistics, into clinical specialties has generated a new vision of care. Molecular tumor boards (MTB) are one response to these changes and are now providing better access to next-generation sequencing (NGS) and new cancer treatments to patients with inoperable or metastatic cancers, and those for whom the usual treatment has failed. However, MTB face a crucial ethical challenge: maintaining and improving the trust of patients, clinicians, researchers and industry in academic medical centers supported by private or public funding rather than providing genetic data directly to private companies. We believe that, in this era of DM, appropriate modern digital communication networks will be required to maintain this trust and to improve the organization and effectiveness of the system. There is, therefore, a need to reconsider the form and content of informed consent (IC) documents at all academic medical centers and to introduce dynamic and electronic informed consent (e-IC).     

Using Surplus Embryos and Research Embryos in Stem Cell Research: Ethical Viewpoints of Buddhist,Hindu and Catholic Leaders in Malaysia on the Permissibility of Research

The sources of embryos for Embryonic Stem Cell Research (ESCR) include surplus embryos from infertility treatments, and research embryos which are created solely for an ESCR purpose. The latter raises more ethical concerns. In a multi-religious country like Malaysia, ethical discussions on the permissibility of ESCR with regard to the use surplus and research embryos are diversified. Malaysia has formulated guidelines influenced by the national fatwa ruling which allows the use of surplus embryos in ESCR. Input from other main religions is yet to be documented. In light of this, this study addresses (i) the ethical viewpoints of Buddhist, Hindu and Catholic leaders on the permissibility of using surplus and research embryos; and (ii) the moral standpoints of religious leaders towards attaining a consensus on the practice of ESCR in Malaysia. Responses from the religious leaders were obtained via semi-structured, face-to-face interviews. The findings show that generally the Buddhist and Hindu leaders approve the use of surplus embryos. Their responses on the creation of research embryos for ESCR are varied. Meanwhile, the Catholic leaders distinctively objected to ESCR regardless of the embryo sources, referring to it as the destruction of life. Taking into account the diverse views, this study explores the response of the religious leaders for a general consensus wherever possible. The ethical discourse surrounding ESCR in a multi-religious setting offers new perspective, which needs to be explored in a broader global community.     

Mentoring for Responsible Research: The Creation of a Curriculum for Faculty to Teach RCR in the Research Environment

Despite more than 25 years of a requirement for training in the responsible conduct of research (RCR), there is still little consensus about what such training should include, how it should be delivered, nor what constitutes “effectiveness” of such training. This lack of consensus on content, approaches and outcomes is evident in recent data showing high variability in the development and implementation of RCR instruction across universities and programs. If we accept that one of the primary aims of instruction in RCR/research ethics is “to foster a community of social responsibility” (Antes et al. 2009: 398), then it makes sense to consider the research environment itself—where learning one’s science happens where one also engages in social interaction around that science. In order to take the best advantage of that already existing/naturally occurring research environment, the authors, through a deliberative, collaborative, and integrative process, crafted a workshop curriculum meant to arm research faculty with concrete and specific tools to effectively introduce research ethics in the context of the research environment.     

Respecting Context to Protect Privacy: Why Meaning Matters

In February 2012, the Obama White House endorsed a Privacy Bill of Rights, comprising seven principles. The third, “Respect for Context,” is explained as the expectation that “companies will collect, use, and disclose personal data in ways that are consistent with the context in which consumers provide the data.” One can anticipate the contested interpretations of this principle as parties representing diverse interests vie to make theirs the authoritative one. In the paper I will discuss three possibilities and explain why each does not take us far beyond the status quo, which, regulators in the United States, Europe, and beyond have found problematic. I will argue that contextual integrity offers the best way forward for protecting privacy in a world where information increasingly mediates our significant activities and relationships. Although an important goal is to influence policy, this paper aims less to stipulate explicit rules than to present an underlying justificatory, or normative rationale. Along the way, it will review key ideas in the theory of contextual integrity, its differences from existing approaches, and its harmony with basic intuition about information sharing practices and norms.