Uncertainty, Scarcity and Transparency: Public Health Ethics and Risk Communication in a Pandemic

Communicating public health guidance is key to mitigating risk during disasters and outbreaks, and ethical guidance on communication emphasizes being fully transparent. Yet, communication during the pandemic has sometimes been fraught, due in part to practical and conceptual challenges around being transparent. A particular challenge has arisen when there was both evolving scientific knowledge on COVID-19 and reticence to acknowledge that resource scarcity concerns were influencing public health recommendations. This essay uses the example of communicating public health guidance on masking in the United States to illustrate ethical challenges of developing and conveying public health guidance under twin conditions of uncertainty and resource scarcity. Such situations require balancing two key principles in public health ethics: the precautionary principle and harm reduction. Transparency remains a bedrock value to guide risk communication, but optimizing transparency requires consideration of additional ethical values in developing and implementing risk communication strategies

Helping New Jersey State Agencies and Departments Align Their Actions with GHG Reduction Mandates and Environmental Justice Principles

This white paper analyzes New Jersey’s implementation gap in both the climate and justice space. Its findings are potentially applicable to the many other states who have set climate and justice goals, without robustly embedding them into their existing legal and administrative landscapes. New Jersey already has GHG reduction targets, a plan, and mapped pathways. While more aggressive tactics and targets may be required to meet evolving scientific knowledge, and cost-effective technology and markets will evolve over time, New Jersey’s climate-alignment tools and pathways are clear. The EMP, the 2020 GWRA 80x50 Report, and EO-274, among other strong state initiatives, together demonstrate unequivocally that enacting an all agency, systematic approach to GHG reductions is essential. Likewise, New Jersey already has done the work to “Further the Promise” of environmental justice. Enacting an all agency, systematic approach to addressing past inequities and ensuring current operations are consistent with environmental justice principles will ensure that this effort yields legally durable results. This paper suggests legislative amendments that will spur expedited, equitable, climate aligned state action

TOWARD AN EVIDENCE-BASED SPIRITUALITY: SOME GLIMPSES OF AN EVOLVING VISION

In my recent book The End of Materialism: How Evidence of the Paranormal is Bringing Science and Spirit Together, I have argued that great psychological damage is done by a scientistic mindset of Dismissive Materialism, which automatically condemns all spirituality as stupid and neurotic, and that consideration of actual scientific evidence shows that it is reasonable to be both scientific and spiritual in one’s orientation to life. My focus now is on how we can begin to develop an evidence-based (or at least evidence-enriched) spirituality for the twenty-first century. Such a spirituality should be practically effective in enriching people’s lives as well as consistent with current and evolving scientific knowledge. After a brief review of the scientific evidence showing that humans sometimes possess the kinds of qualities we would expect in a spiritual being, I then discuss the nature of knowledge acquisition and refinement, showing its compatibility with essential science. Next, I sketch eight examples of possible research directions for building knowledge for an evidence-based spirituality, and briefly discuss irrational levels of resistance to such an enterprise

Automating Wetland Prioritization Analyses Using GIS

In environmental and conservation fields, managers and other decision makers need to prioritize their efforts to specific areas using multiple-criteria decision analysis, to maximize environmental protection given limitations of budget and time. However, creating these prioritization models requires a combination of both scientific and technical skills, and many of those with the expertise to create scientifically sound prioritization models have limited time to devote to the technical aspects of the analysis. There was a need to automate this analysis process to enable scientists and other decision makers to quickly repeat analyses with different criteria and compare the results. This project automated a wetland prioritization analysis in California for the U.S. Fish and Wildlife Service (USFWS) into a collection of ArcGIS ModelBuilder tools. This project then created a GIS web application to enable USFWS employees to re-do the prioritization analysis with different weights for the various ecological factors that were included in the analysis (such as endangered species habitat, important bird areas, etc.). With the analysis process thus simplified, scientists and decision makers in the USFWS can now apply current and evolving scientific knowledge and compare wetland priorities in a multiple criteria decision analysis framework

Has Global Health Law Risen to Meet the COVID-19 Challenge? Revisiting the International Health Regulations to Prepare for Future Threats

Global health law is essential in responding to the infectious disease threats of a globalizing world, where no single country, or border, can wall off disease. Yet, the Coronavirus Disease (COVID-19) pandemic has tested the essential legal foundations of the global health system. Within weeks, the SARS-CoV-2 coronavirus has circumnavigated the globe, bringing the world to a halt and exposing the fragility of the international legal order. Reflecting on how global health law will emerge in the aftermath of the COVID-19 pandemic, it will be crucial to examine the lessons learned in the COVID-19 response and the reforms required to rebuild global health institutions while maintaining core values of human rights, rule of law, and global solidarity in the face of unprecedented threats

Team-Based Competencies: Building a Shared Foundation for Education and Clinical Practice

Highlights discussions from a February 2011 conference on the need for collaborative health care, factors supporting and restraining change, and strategies for advancing interprofessional collaboration in education and practice

Lockean Freedom and the Proviso’s Appeal to Scientific Knowledge

I argue in this paper that Locke and contemporary Lockeans underestimate the problems involved in their frequent, implicit assumption that when we apply the proviso we use the latest scientific knowledge of natural resources, technology, and the economy’s operations. Problematic for these theories is that much of the pertinent knowledge used is obtained through particular persons’ labor. If the knowledge obtained through individuals’ labor must be made available to everyone and if particular persons’ new knowledge affects the proviso’s proper application, then some end up without freedom to pursue their own ends and some find their freedom subject to others’ arbitrary will

Health professionals and scientists’ views on genome-wide NIPT in the French public health system: critical analysis of the ethical issues raised by prenatal genomics

In France, since January 2020, laboratories have started to make available genome-wide Non-Invasive Prenatal Testing (GW-NIPT) beyond the three common trisomies (T21, T13 and T18) at the same cost as standard NIPT. With the possible margins for interpretation of the legal framework and in the absence of clear and updated guidelines, health professionals are left with questions about which type of screening offer may be clinically responsible, morally appropriate, and, at the same time, respectful of women’s values and ability to make autonomous choices. The aim of this study is to provide an analysis and understanding of the challenging dimensions of clinical practices in the context of evolving scientific knowledge and techniques in prenatal genomics. In this article, we develop a critical analysis of the arguments and concerns that emerge around the offer of expanded NIPT and are discussed by health professionals and scientists. To achieve this, we conducted qualitative semi-structured interviews with 17 health professionals and scientists from September 2021 to February 2022 and a comprehensive literature review (regulatory, scientific, medical, institutional sources). The results of our empirical research highlight the importance of addressing ethical issues related to the differing quality of counselling, the complexity of achieving informed consent, and the avoidance of harm to pregnant women in the feedback of findings beyond T21, T18 and T13. If there is an increase in the provision of GW-NIPT within the French public health system, it will be essential to promote medical practices that respect reproductive choices of women, support their autonomous decision and their understanding of the limitations and uncertainties associated with GW screening. Further research is required to provide an insight into women’s perceptions in order to refine our analysis from the patients’ perspective