Not just about "the science": science education and attitudes to genetically modified foods among women in Australia

Final version received 21 December 2016Previous studies investigating attitudes to genetically modified (GM) foods suggest a correlation between negative attitudes and low levels of science education, both of which are associated with women. In a qualitative focus group study of Australian women with diverse levels of education, we found attitudes to GM foods were part of a complex process of making “good” food decisions, which included other factors such as locally produced, fresh/natural, healthy and nutritious, and convenient. Women involved in GM crop development and those with health science training differed in how they used evidence to categorize GM foods. Our findings contribute to a deeper understanding of how GM food, and the role of science and technology in food production and consumption more broadly, is understood and discussed amongst diverse “publics” and across different “sciences,” and to research related to deepening public engagement at the intersection of science and values.Heather J. Bray and Rachel A. Anken

Dealing drugs with the Bush

The past year in bioethics in Australia has been relatively predictable. We continue to struggle with rising healthcare costs, though thankfully not on par with numerous other countries due to a relatively positive economic outlook. We are still fighting difficulties associated with higher medical indemnity costs, which have again caused many physicians to leave private practice, particularly in high-risk and specialty practice areas. In response, the federal government (following a shuffle of ministerial positions including that of the federal health minister) delayed the imposition of the medical indemnity levy for physicians until mid 2005. In May, the Australian Law Reform Commission and the Australian Health Ethics Commission issued their final joint report on genetic testing entitled “Essentially Yours” and endorsed use of genetic tests by insurance companies, despite the concerns of some geneticists and many members of the public about their scientific reliability. However, they also advocated the establishment of the Human Genetics Commission of Australia (HGCA) to oversee such uses of genetic tests in terms of both scientific and actuarial reliability, and debates continue over the implementation of this and a number of their other recommendations. And state governments continue to phase in smoking bans in public places, with most implementing full bans in enclosed restaurants and cafes and planning to require provision of nonsmoking areas in all pubs within the next year.Rachel A. Anken

The moral status of preferences for directed donation: who should decide who gets transplantable organs?

Bioethics has entered a new era: as many commentators have noted, the familiar mantra of autonomy, beneficence, nonmaleficence, and justice has proven to be an overly simplistic framework for understanding problems that arise in modern medicine, particularly at the intersection of public policy and individual preferences. A tradition of liberal pluralism grounds respect for individual preferences and affirmation of competing conceptions of the good. But we struggle to maintain (or at times explicitly reject) this tradition in the face of individual preferences that we find distasteful, suspect, or even repugnant, especially where the broader social good or respect for equality is at stake. Directed donation presents us with such a dilemma: can we uphold the right of self-determination through respect of individual preferences regarding disposition of transplantable organs while at the same time maintaining an allocation system that reflects values of equity and justice claimed to underlie the socially negotiated practice of transplantation? Or are some preferences simply to be deemed unethical and not respected, even if that leads to a reduction in the number of transplantable organs available and to an apparent disregard for the autonomous decisions of the recently deceased?Rachel A. Anken

Inviting everyone to the table: strategies for more effective and legitimate food policy via deliberative approaches

Article first published online: 25 MAR 2016Authors Abstract: It is well-recognized that the general public is not typically involved in food policy debates, with participation often limited to elite participants with special interests. This paper investigates potential strategies for more effective and legitimate food policy utilizing systemic approaches to deliberative democracy. Two main strands are explored: first, it is argued that food is a key domain that could benefit from the move to systematic approaches to deliberative democracy. Examination of various types of public engagement about food, including consultation by submission, consensus and citizen conferences, citizens’ juries, and local food planning, reveals a dominance of micro-public perspectives that warrant greater integration and analysis at a systemic, macro level. Second, the paper contributes to the dialogue on systemic deliberative processes by analyzing tensions that are endemic in the domain of food policy, illustrating some of the points of weakness (and potential strengths) for effective deliberation in similar complex systems as well as presenting suggestions of directions for future research to contribute to the development of a more robust analytic framework for systematic approaches to deliberative democracy.Rachel A. Anken

Double meanings will not save the principle of double effect

In an article somewhat ironically entitled “Disambiguating Clinical Intentions,” Lynn Jansen promotes an idea that should be bewildering to anyone familiar with the literature on the intention/foresight distinction. According to Jansen, “intention” has two commonsense meanings, one of which is equivalent to “foresight.” Consequently, questions about intention are “infected” with ambiguity—people cannot tell what they mean and do not know how to answer them. This hypothesis is unsupported by evidence, but Jansen states it as if it were accepted fact. In this reply, we make explicit the multiple misrepresentations she has employed to make her hypothesis seem plausible. We also point out the ways in which it defies common sense. In particular, Jansen applies her thesis only to recent empirical research on the intentions of doctors, totally ignoring the widespread confusion that her assertion would imply in everyday life, in law, and indeed in religious and philosophical writings concerning the intention/foresight distinction and the Principle of Double Effect. Key words: double effect, end-of-life, foresight, intention, sedatio

A view of bioethics from down under

When I immigrated to Australia from the United States a few years ago, at first I found many similarities between the countries. But underneath the apparent similarities, notably a shared language, lay much deeper differences in history, politics, and culture that have considerable impacts on attitudes and approaches to issues in bioethics and medicine. For instance, debates continue regarding cloning and embryonic stem cell research, particularly given the long history of research in reproductive medicine and reproductive technologies in Australia. Although there are individuals and groups opposed to such research on grounds associated with pro-life or anti-abortion stances, the discussions more often hinge on what should be funded by the government and eventually what should be provided to all within the public system of healthcare. This theme is one common thread that unites many current controversies in bioethics, but perhaps not for the reasons that an outsider might at first expect. Indeed, allocation of limited resources is part of what is considered relevant, but money is rarely presented as the decisive issue in these debates. Instead, considerations such as what is medically necessary (based on a broad definition of what is medical), what contributes to a “good life” (as defined by what are increasingly heterogeneous community standards), and how to respect and enable fulfillment of autonomous decisions by individuals and families in this rapidly changing context are key to many of the disputes. This brief report is necessarily selective, but it is designed to give a flavor of the terms of the debates as they are currently developing.Rachel A. Alken

Detecting themes and variations: The use of cases in developmental biology

This article unpacks a particular use of ‘cases’ within developmental biology, namely as a means of describing the typical or canonical patterns of phenomena. The article explores how certain cases have come to be established within the field and argues that although they were initially selected for reasons of convenience or ease of experimental manipulation, these cases come to serve as key reference points within the field because of the epistemological structures imposed on them by the scientists using them and, hence, become usable in a wider variety of circumstances including future theory development.Rachel A. Anken

From food consumers to food citizens: reconceptualising environmentally-conscious food decision-making

Rachel Anken

Beyond rhetoric in debates about the ethics of marketing prescription medicines to consumers: The importance of vulnerability in people, situations and relationships

Background This article examines community responses to the marketing of prescription medicines. Historically, debates about such marketing have focused on alleged unscrupulousness of pharmaceutical companies and on the quality of information provided. 2 Methods Six focus groups were conducted in Sydney, Australia, three with older and three with younger community members. Analysis examined interactions between group members, the positions participants took up, conflicting arguments, and explanations for variation. Results Participants argued specifically rather than generally about consumer marketing of medicines. Neither the moral purpose of corporations nor the quality of information in advertisements was particularly important. Instead, pharmaceutical marketing was assessed in relation to vulnerabilities that existed in individual consumers, in doctors, in the contexts of illness and as a result of medications being potentially dangerous. Conclusions The critical ethical issue in prescription medicine marketing may be the existence of vulnerabilities and the responsibilities they may generate. We outline three possible policy responses suggested by these participants. Key words: DTCA, direct-to-consumer advertising, marketing, vulnerability, doctor-patient relationship, drug industryAustralian National Health and Medical Research Council (NHMRC) Grant 457497