How do value-judgements enter model-based assessments of climate sensitivity?

Philosophers argue that many choices in science are influenced by values or have value-implications, ranging from the preference for some research method’s qualities to ethical estimation of the consequences of error. Based on the argument that awareness of values in the scientific process is a necessary first step to both avoid bias and attune science best to the needs of society, an analysis of the role of values in the physical climate science production process is provided. Model-based assessment of climate sensitivity is taken as an illustrative example; climate sensitivity is useful here because of its key role in climate science and relevance for policy, by having been the subject of several assessments over the past decades including a recent shift in assessment method, and because it enables insights that apply to numerous other aspects of climate science. It is found that value-judgements are relevant at every step of the model-based assessment process, with a differentiated role of non-epistemic values across the steps, impacting the assessment in various ways. Scrutiny of current philosophical norms for value-management highlights the need for those norms to be re-worked for broader applicability to climate science. Recent development in climate science turning away from direct use of models for climate sensitivity assessment also gives the opportunity to start investigating the role of values in alternative assessment methods, highlighting similarities and differences in terms of the role of values that encourage further study

Cryopreserved platelets in bleeding management in remote hospitals: A clinical feasibility study in Sweden

BackgroundBalanced transfusions, including platelets, are critical for bleeding patients to maintain hemostasis. Many rural hospitals have no or limited platelet inventory, with several hours of transport time from larger hospitals. This study aimed to evaluate the feasibility of using cryopreserved platelets that can be stored for years, in remote hospitals with no or limited platelet inventory.Material and methodsThree remote hospitals participated in a prospective study including adult bleeding patients where platelet transfusions were indicated. Cryopreserved platelets were prepared in a university hospital, concentrated in 10 ml, transported on dry ice, and stored at −80°C at the receiving hospital. At request, the concentrated platelet units were thawed and diluted in fresh frozen plasma. The indications, blood transfusion needs, and laboratory parameters pre- and post-transfusion, as well as logistics, such as time from request to transfusion and work efforts in preparing cryopreserved platelets, were evaluated.ResultsTwenty-three bleeding patients were included. Nine patients (39%) were treated for gastrointestinal bleeding, five (22%) for perioperative bleeding, and four (17%) for trauma bleeding. The transfusion needs were 4.9 ± 3.3 red blood cell units, 3.2 ± 2.3 plasma units, and 1.9 ± 2.2 platelet units, whereof cryopreserved were 1.5 ± 1.1 (mean ± SD). One patient had a mild allergic reaction. We could not show the difference in laboratory results between pre- and post-transfusion of the cryopreserved units in the bleeding patients. The mean time from the order of cryopreserved platelets to transfusion was 64 min, with a range from 25 to 180 min.ConclusionCryopreserved platelets in remote hospitals are logistically feasible in the treatment of bleeding. The ability to have platelets in stock reduces the time to platelet transfusion in bleeding patients where the alternative often is many hours delay. Clinical effectiveness and safety previously shown in other studies are supported in this small feasibility study

Utveckling av plattformsoberoende fristående applikationer med webbteknologi

Målet med det här projektet är att undersöka möjligheten att utveckla plattformsoberoende fristående applikationer med webbutvecklingsverktyg i ramverket Electron samt hitta skillnader i andra utvecklingsmetoder som Java och Swing eller C++ och Qt genom att vidareutveckla en existerande applikation kallad Electra. Electra är ett verktyg utvecklat för företaget Bitsmith AB som underlättar hanteringen, läsningen och uppladdningen av färdskrivardata till deras webbtjänst. Bitsmith ville undersöka möjligheten att utveckla plattformsoberoende applikationer med Electron. En lösning på det problemet leder till att företaget kan ge ut en applikation som når kunder som inte nödvändigtvis använder Windows i deras IT-miljö som endast har en kodbas. Electron drivs av Node.js för programlogik och Chromium för rendering av webbsidor som gränssnitt. Applikationen utvecklas därför med språken JavaScript, HTML och CSS. Andra moderna hjälpbibliotek skrivna i JavaScript som React för komponentbaserade gränssnitt och Redux för tillståndshantering används för att snabba upp utvecklingen och göra applikationen mer robust. Testdriven utveckling används för att visa att applikationen fungerar likvärdigt på moderna versioner av Windows, Mac och Linux. Enhetstesterna testar applikationens förmåga att hantera tillstånd, kontrollera att komponenter ritas ut och fungerar korrekt och att kontrollera så att övriga system fungerar enligt förväntan så långt det är möjligt. Resultatet av enhetstesterna visar att det är möjligt att utveckla en applikation som fungerar likvärdigt på moderna versioner av Windows, Mac och Linux. Jämfört med andra utvecklingsmetoder är det enkelt att komma igång med att utveckla i Electron då det använder sig av språk och metoder som är enklare än exempelvis utveckling i C++ då utvecklingen sker på en högre nivå med JavaScript, HTML och CSS. Dessa språk används redan av många och det är möjligt att föra över kunskapen man redan har till applikationsutveckling. De som redan har erfarenhet av webbutveckling kan enkelt skapa plattformsoberoende fristående applikationer. Metoden och verktygen som har använts i det här projektet kan även appliceras i andra applikationsprojekt

Ethical Aspects of Radiation Risk Management

This thesis is based on the assumption that the intersection of moral philosophy and practical risk management is a rewarding area to study. In particular, the thesis assumes that concepts, ideas, and methods that are used in moral philosophy can be of great benefit for risk analysis, but also that practices in risk regulation provide a useful testing ground for moral philosophical theories. The thesis consists of an introduction and five articles. Article I is a review article on social and ethical aspects of radiation protection related to nuclear power generation. The paper concludes that four areas of social and ethical issues stand out as central: The first is uncertainty and the influence of value judgments in scientific risk assessments. The second is the distributions of risks and benefits between different individuals, in both space and time. The third is the problem of setting limits when there is no known level of exposure associated with a zero risk. The fourth is related to stakeholder influence and risk communication. Article II discusses ethical issues related to the proposal that doses (or risks) below a certain level should be excluded from the system of radiation protection, without any regard for the number of people exposed. Different arguments for excluding small radiation doses from regulation are examined and a possible solution to the problem of regulating small risks is proposed in the article: Any exclusion of small doses (or risks) from radiation protection ought to be based on a case-by-case basis, with the condition that the expected value of harm remains small. Article III examines what makes one distribution of individual doses better than another distribution. The article introduces a mathematical framework based on preference logic, in which such assessments can be made precisely in terms of comparisons between alternative distributions of individual doses. Principles of radiation protection and from parallel discussions in moral philosophy and welfare economics are defined using this framework and their formal properties analyzed. Article IV argues that the ethical theory of “responsibility-catering prioritarianism” is well positioned to deal with the reasonable requirements in an ethical theory of risk. The article shows how responsibility-catering prioritarianism can be operationalized using a prioritarian social welfare function based on hypothetical utilities. For this purpose, a hypothetical utility measure called ‘responsibility-adjusted utility’ is proposed, which is based on the utility that would normally be expected given circumstances outside of the control of the individual. Article V was written as a response to the Fukushima disaster. Several authors have called the Fukushima disaster a ‘black swan.’ However, the article argues that the hazards of large earthquakes and tsunamis were known before the accident, and introduces and defines the concept of a ‘black elephant,’ as (i) a high-impact event that (ii) lies beyond the realm of regular expectations, but (iii) is ignored despite existing evidence.QC 2012081

Ethical Aspects of Radiation Risk Management

This thesis is based on the assumption that the intersection of moral philosophy and practical risk management is a rewarding area to study. In particular, the thesis assumes that concepts, ideas, and methods that are used in moral philosophy can be of great benefit for risk analysis, but also that practices in risk regulation provide a useful testing ground for moral philosophical theories. The thesis consists of an introduction and five articles. Article I is a review article on social and ethical aspects of radiation protection related to nuclear power generation. The paper concludes that four areas of social and ethical issues stand out as central: The first is uncertainty and the influence of value judgments in scientific risk assessments. The second is the distributions of risks and benefits between different individuals, in both space and time. The third is the problem of setting limits when there is no known level of exposure associated with a zero risk. The fourth is related to stakeholder influence and risk communication. Article II discusses ethical issues related to the proposal that doses (or risks) below a certain level should be excluded from the system of radiation protection, without any regard for the number of people exposed. Different arguments for excluding small radiation doses from regulation are examined and a possible solution to the problem of regulating small risks is proposed in the article: Any exclusion of small doses (or risks) from radiation protection ought to be based on a case-by-case basis, with the condition that the expected value of harm remains small. Article III examines what makes one distribution of individual doses better than another distribution. The article introduces a mathematical framework based on preference logic, in which such assessments can be made precisely in terms of comparisons between alternative distributions of individual doses. Principles of radiation protection and from parallel discussions in moral philosophy and welfare economics are defined using this framework and their formal properties analyzed. Article IV argues that the ethical theory of “responsibility-catering prioritarianism” is well positioned to deal with the reasonable requirements in an ethical theory of risk. The article shows how responsibility-catering prioritarianism can be operationalized using a prioritarian social welfare function based on hypothetical utilities. For this purpose, a hypothetical utility measure called ‘responsibility-adjusted utility’ is proposed, which is based on the utility that would normally be expected given circumstances outside of the control of the individual. Article V was written as a response to the Fukushima disaster. Several authors have called the Fukushima disaster a ‘black swan.’ However, the article argues that the hazards of large earthquakes and tsunamis were known before the accident, and introduces and defines the concept of a ‘black elephant,’ as (i) a high-impact event that (ii) lies beyond the realm of regular expectations, but (iii) is ignored despite existing evidence.QC 2012081

Ethical aspects of radiation protection

This aim of this thesis is to examine ethical aspects of radiation protection from ionizing radiation. Radiation protection is the professional field that deals with the protection of humans and the environment from the harmful effects of radiation. The field is based on scientific knowledge of the health effects of radiation, but also on ethical value judgements. This thesis consists of a summary and three essays. Essay 1 gives an overview of ethical issues in radiation protection. Based on this overview four ethical problem areas are identified as central for radiation protection. The first are ethical problems related to uncertainty and the influence of value judgements, especially in scientific risk assessment. The second problem area is ethical issues regarding distributions of risks and benefits between different individuals, both in space and time. The third general problem area is related to limit-setting. A major problem here is how to set limits in an ethically justifiable way when there is no known level of exposure that is associated with a zero risk. The fourth area concerns procedural justice and social decision-making in radiation protection. Essay 2 discusses ethical problems related to the proposal that individual risks below a certain level should be excluded from the system of radiation protection, without any regard to the number of people exposed. It is concluded that there are at least three problems associated with disregarding very small risks: (1) that many small risks to an individual may add up to a large risk for that individual, (2) that many small risks to many individuals may add up to a large expected value of harm, and (3) that a small risk each to many individuals may add up to a large probability that several people are harmed. It is also argued that the proposal is hard to justify in a rights-based ethical setting. Essay 3 examines what makes one distribution of individual doses better than another. This is done by creating a mathematical framework, based on preference logic, in which such assessments of can be made precisely in terms of comparisons between alternative distributions of individual doses. Principles from radiation protection and from parallel discussions in moral philosophy and welfare economics are defined using this framework and then analysed on basis of their formal properties. The analysis shows that there can be efficiency-related problems with a strict application of individual dose constraints. It is concluded that a principle that assigns extra weight to individual doses exceeding a certain limit, in proportion to the size of the excess dose, may be preferable to the standard combination of principles in radiation protection, since it satisfies efficiency related properties better without sacrificing other desirable properties.QC 2010112

Ethical Aspects of Radiation Risk Management

This thesis is based on the assumption that the intersection of moral philosophy and practical risk management is a rewarding area to study. In particular, the thesis assumes that concepts, ideas, and methods that are used in moral philosophy can be of great benefit for risk analysis, but also that practices in risk regulation provide a useful testing ground for moral philosophical theories. The thesis consists of an introduction and five articles. Article I is a review article on social and ethical aspects of radiation protection related to nuclear power generation. The paper concludes that four areas of social and ethical issues stand out as central: The first is uncertainty and the influence of value judgments in scientific risk assessments. The second is the distributions of risks and benefits between different individuals, in both space and time. The third is the problem of setting limits when there is no known level of exposure associated with a zero risk. The fourth is related to stakeholder influence and risk communication. Article II discusses ethical issues related to the proposal that doses (or risks) below a certain level should be excluded from the system of radiation protection, without any regard for the number of people exposed. Different arguments for excluding small radiation doses from regulation are examined and a possible solution to the problem of regulating small risks is proposed in the article: Any exclusion of small doses (or risks) from radiation protection ought to be based on a case-by-case basis, with the condition that the expected value of harm remains small. Article III examines what makes one distribution of individual doses better than another distribution. The article introduces a mathematical framework based on preference logic, in which such assessments can be made precisely in terms of comparisons between alternative distributions of individual doses. Principles of radiation protection and from parallel discussions in moral philosophy and welfare economics are defined using this framework and their formal properties analyzed. Article IV argues that the ethical theory of “responsibility-catering prioritarianism” is well positioned to deal with the reasonable requirements in an ethical theory of risk. The article shows how responsibility-catering prioritarianism can be operationalized using a prioritarian social welfare function based on hypothetical utilities. For this purpose, a hypothetical utility measure called ‘responsibility-adjusted utility’ is proposed, which is based on the utility that would normally be expected given circumstances outside of the control of the individual. Article V was written as a response to the Fukushima disaster. Several authors have called the Fukushima disaster a ‘black swan.’ However, the article argues that the hazards of large earthquakes and tsunamis were known before the accident, and introduces and defines the concept of a ‘black elephant,’ as (i) a high-impact event that (ii) lies beyond the realm of regular expectations, but (iii) is ignored despite existing evidence.QC 2012081

Toward a responsibility-catering prioritarian ethical theory of risk

Standard tools used in societal risk management such as probabilistic risk analysis or cost–benefit analysis typically define risks in terms of only probabilities and consequences and assume a utilitarian approach to ethics that aims to maximize expected utility. The philosopher Carl F. Cranor has argued against this view by devising a list of plausible aspects of the acceptability of risks that points towards a non-consequentialist ethical theory of societal risk management. This paper revisits Cranor’s list to argue that the alternative ethical theory responsibility-catering prioritarianism can accommodate the aspects identified by Cranor and that the elements in the list can be used to inform the details of how to view risks within this theory. An approach towards operationalizing the theory is proposed based on a prioritarian social welfare function that operates on responsibility-adjusted utilities. A responsibility-catering prioritarian ethical approach towards managing risks is a promising alternative to standard tools such as cost–benefit analysis

A Value Sensitive Scenario Planning Method for Adaptation to Uncertain Future Sea Level Rise

Value sensitive design (VSD) aims at creating better technology based on social and ethical values. However, VSD has not been applied to long-term and uncertain future developments, such as societal planning for climate change. This paper describes a new method that combines elements from VSD with scenario planning. The method was developed for and applied to a case study of adaptation to sea level rise (SLR) in southern Sweden in a series of workshops. The participants of the workshops found that the method provided a framework for discussing long-term planning, enabled identification of essential values, challenged established planning practices, helped find creative solutions, and served as a reminder that we do not know what will happen in the future. Finally, we reflect on the limitations of the method and suggest further research on how it can be improved for value sensitive design of adaptation measures to manage uncertain future sea level rise.QC 20211124</p

Translation, Cross-Cultural Adaptation, and Psychometric Evaluation of the Swedish Version of ENDOCARE : An Instrument to Measure Patient Centeredness of Endometriosis Care

Objectives: The need for quality improvement within endometriosis healthcare is widely acknowledged. The ENDOCARE questionnaire (ECQ) measures patient centeredness of endometriosis care. The aims of this study were (1) to translate and culturally adapt ECQ into Swedish, (2) to evaluate validity (construct validity), and (3) to measure reliability (internal consistency and test-retest reliability). Design: This is a cross-sectional randomized study. Participants, Setting, and Methods: ECQ was first translated according to a well-established guideline and was thereafter sent to 500 randomly selected women with endometriosis, who had visited participating clinics during the past 3 years. The first 150 women who returned their questionnaires were immediately sent the same questionnaire again. The ECQ consists of 3 parts. The first part contains demographic and clinical questions, while part II has 38 items that are answered according to 2 aspects: percentage of negative experience of care and mean personal importance. A patient-centeredness score (PCS) is calculated based on these 2 aspects. The items are also divided into 10 dimensions of care. Part III is a grading of overall experience and an open-ended question on any missing aspect in the questionnaire. Results: A total of 187 native Swedish-speaking women participated. Data completeness was high (&gt;90%). The overall PCS median was 3.5. The highest median PCS was found in the dimension regarding endometriosis clinic staff and the lowest in emotional support and alleviation of fear and anxiety and the involvement of significant others. Factor analysis could roughly confirm 2 of the 10 dimensions. The Cronbach's alpha coefficient for PCS ranged from 0.35 to 0.73. The test-rest analysis showed acceptable reliability. Limitations: The most important limitation was the relatively low participation rate and the risk of recall bias. It is likely that women gave their answers based on their most recent experiences. Conclusions: Overall, our results indicate that the Swedish version of the ECQ is a usable instrument to measure patient centeredness in endometriosis care, but due to the unstable factor analysis, conclusions based on the dimensions should be made with caution