The present paper draws on climate science and the philosophy of science in order to evaluate climate-model-based approaches to assessing climate projections. We analyze the difficulties that arise in such assessment and outline criteria of adequacy for approaches to it. In addition, we offer a critical overview of the approaches used in the IPCC working group one fourth report, including the confidence building, Bayesian and likelihood approaches. Finally, we consider approaches that do not feature in the IPCC reports, including three (...) approaches drawn from the philosophy of science. We find that all available approaches face substantial challenges, with IPCC approaches having as a primary source of difficulty their goal of providing probabilistic assessments. (shrink)
Background: Discussing treatment risks has become increasingly important in medical communication. Still, despite regulations, physicians must decide how much and what kind of information to present. Objective: To investigate patients’ preference for information about a small risk of a complication of colonoscopy, and whether medical and personal factors contribute to such preference. To propose a disclosure policy related to our results. Design: Vignettes study. Setting: Department of Gastroenterology, Academic Medical Centre, the Netherlands. Patients: 810 consecutive colonoscopy patients. Intervention: A home-sent (...) questionnaire containing three vignettes. Vignettes varied in the indication for colonoscopy, complication severity and level of risk. Patients were invited to indicate their wish to be informed and the importance of such information. In addition, sociodemograhic, illness-related and psychological characteristics were assessed. Main outcome measurements: Wish to be informed and importance of information. Results: Of 810 questionnaires, 68% were returned. Patients generally wished to be informed about low-risk complications, regardless of the indication for colonoscopy or the severity of the complication. The level of risk did matter, though (OR = 2.48, SE = 0.28, p = 0.001). The information was considered less important if done for population screening purposes or diagnosis of colon cancer, if the complication was less severe (bleeding) and if the risk was smaller (0.01% and 0.1%). Patients’ information preference was also related to age, mood and coping style. Limitations: Difficulty of vignettes. Conclusions: Patients generally wish to be informed about all possible risks. However, this might become uninformative. A stepwise approach is suggested. (shrink)
Recent advances in synthetic biology have made it possible to revive extinct species of animals, a process known as ‘de-extinction’. This paper examines two reasons for supporting de-extinction: the potential for de-extinct species to play useful roles in ecosystems; and human valuing of certain de-extinct species. I focus on the particular case of passenger pigeons to argue that the most critical challenge for de-extinction is that it entails significant suffering for sentient individual animals. I also provide reasons to take existence (...) value, or valuing the mere the fact that a species exists, into consideration in debates over de-extinction. (shrink)
Résumé — Toute vérité est-elle connaissable en principe ? Une réponse négative à cette question suit d’un argument logique dû à F. Fitch, voisin du paradoxe de Moore, et connu sous le nom de paradoxe de la connaissabilité. Le paradoxe de Fitch constitue un obstacle à la conception antiréaliste de la vérité et, plus généralement, semble-t-il, à l’idéal positiviste d’après lequel toute vérité devrait nous être accessible en principe. Dans cet article, j’examine différentes tentatives pour préserver le principe selon lequel (...) toute vérité est connaissable, chacune inspirée d’une forme propre d’antiréalisme . Ces différentes approches sont comparées à une conception réaliste du positivisme, évoquée récemment par Burgess, qui postulerait seulement que toute vérité nécessaire est connaissable. Selon cette conception, certaines vérités contingentes sont effectivement inconnaissables, mais l’accessibilité de principe des vérités nécessaires demeure suffisante pour garantir la confiance positiviste dans la science.— Are all truths knowable ? A negative answer to this question follows from a logical argument related to the Moore Paradox and due to F. Fitch, also known as Fitch’s Knowability Paradox. Fitch’s paradox is widely considered to be an obstacle to the antirealist conception of truth, but even for a realist, it appears to threaten the positivist faith in the accessibility of all truths to our minds. In this paper, I first review different strategies to circumvent the paradox, each of them inspired by a different form of antirealism . I then compare these approaches to a realist version of positivism, discussed recently by Burgess, which would only postulate that all necessary truths are knowable. On that view, some contingent truths are indeed unknowable, but the idea that all necessary truths are within our reach remains sufficient to maintain the positivist faith in scientific knowledge. (shrink)
Background: More and more quantitative information is becoming available about the risks of complications arising from medical treatment. In everyday practice, this raises the question whether each and every risk, however low, should be disclosed to patients. What could be good reasons for doing or not doing so? This will increasingly become a dilemma for practitioners.Objective: To report doctors’ views on whether to disclose or withhold information on low risks of complications.Methods: In a qualitative study design, 37 respondents were included. (...) Focus group interviews were held with 22 respondents and individual in-depth interviews with 15.Results: Doctors have doubts about disclosing or withholding information on complication risk, especially in a risk range of 1 in 200 to 1 in 10 000. Their considerations on whether to disclose or to withhold information depend on a complicated mix of patient and doctor-associated reasons; on medical and personal considerations; and on the kind and purpose of intervention.Discussion: Even though the degree of a risk is important in a doctor’s considerations, the severity of the possible complications and patients’ wishes and competencies have an important role as well. Respondents said that low risks should always be communicated when there are alternatives for the intervention or when the patient may prevent or mitigate the risk. When the appropriateness of disclosing risks is doubtful, doctors should always tell their patients that no intervention is without risk, give them the opportunity to gather all the information they need or want, and enable them to detect a complication at an early stage. (shrink)
Recent highly publicized privacy breaches in health care and genomics research have led many to question whether current standards of data protection are adequate. Improvements in de-identification techniques, combined with pervasive data sharing, have increased the likelihood that external parties can track individuals across multiple databases. This paper focuses on the communication of identifiability risks in the process of obtaining consent for donation and research. Most ethical discussions of identifiability risks have focused on the severity of the risk and how (...) it might be mitigated, and what precisely is at stake in pervasive data sharing. However, there has been little discussion of whether and how to communicate the risk to potential donors. We review the ethical arguments behind favoring different types of risk communication in the consent process, and outline how identifiability concerns can be incorporated into either a detailed or simplified method of communicating risks during the consent process. (shrink)
We present the idea of searching for X-rays as a signature of the mechanism inducing the spontaneous collapse of the wave function. Such a signal is predicted by the continuous spontaneous localization theories, which are solving the “measurement problem” by modifying the Schrödinger equation. We will show some encouraging preliminary results and discuss future plans and strategy.
BackgroundIn the Canadian Alliance for Healthy Hearts and Minds cohort, participants underwent magnetic resonance imaging of the brain, heart, and abdomen, that generated incidental findings. The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants were recruited with (...) a follow-up questionnaire administered to 909 participants at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% of participants, with the highest proportions found in the brain and abdomen. The majority of participants informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)