HC’s – Ethics in health and life sciences
HC’s – Ethics in health and life sciences
HC 1 – Introduction to ethics
Ethics is the practical study of deciding how we ought to act. We have to engage in ethical reflection
when the values, rights, interests, desires of ‘another’ are at stake or harmed. Almost anything can
be morally pertinent ‘other’. Ethical reasoning requires an open mind and critical reasoning skills. It
provides you with reasons to justify our decisions. Ethics are everywhere!
Ethics as design discipline
Safe-by-design is an approach to design that revolves around thinking before doing, taking safety
into account in research and innovation, and ultimately its very about doing the right thing (and
making this the standard practice).
Certain risks (such as working with GMO’s) have standardized ways of dealing with these risks (Buro
GGO). This is nice because this prevents a lot of harm / danger in the world. When you comply with
this ‘dealing’, you would think you do things right. But it does not also mean that you do the right
thing (e.g. ask yourself; is it good for the world?).
How does safety connect with ethics? With ethics you decide how we ought to act. It gives a
systematic reflection on morality (values, norms, beliefs), and it provides you with reasons to justify
our decisions. Moral problems arise when the values, rights, interests, desires of another are at stake
or harmed. Safety is a very important value. Being safe means being protected against harmful
events, products, processes, etc. Safety can concern the environment, animals, humans, species,
ecosystems, etc.
When we talk about safe-by-design, we talk about preventing a safety issue, by designing your
research/technology/organization in such way that you’ve already taken into account these safety
issues. Designing consists of 5 phases: 1) vision, 2) concept, 3) develop, 4) validate, and 5) produce.
These steps will not always follow this order, the order can vary; life is a mess. You need to take
safety into account at the first phase. But this is not very commonly done.
Technoscience: new way thinking about science, technology and innovation. Because you can,
nowadays, not think about science without the use of technology and social context. Innovation is
not necessarily new knowledge, it is the implementation of invention/knowledge in practice.
Safety is often regarded as a regulatory requirement; safe because it is in compliance with the rules,
and/or because end-of-pipe interventions are made to ensure safety. But we currently see a shift
towards safety as a core value in research and innovation and a precondition for product
development. This is what safe-by-design is all about: taking into account safety pro-actively, early
on, continuously and integrally in research and innovation trajectories.
The pacing problem: technological innovation always (you won’t regulate something that is not there
yet) outpaces the ability of laws and regulations to keep up. This means that often when working on
emerging technologies, there are no relevant laws or regulations (yet) to warrant for safety and
other public values.
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,HC’s – Ethics in health and life sciences
We also have a problem about decision making; the Collingridge dilemma: ‘When change is easy, the
need for it cannot be foreseen; when the need for change is apparent, change has become
expensive, difficult, and time-consuming.’ In the beginning of a new invention (e.g. lead in gasoline),
it is not known yet that there are safety hazards. Just after a couple years this becomes clear, but the
product has already become more known and widely used → more difficult to change.
To fight this there is the precautionary principle; as long as you don’t know for sure that something
is absolutely safe, we treat it as being too risky to go forward with it. Better safe than sorry.
Safe-by-design suggest that using the precautionary principle for
better (more safe) designing the innovation. There are 4 different
types of innovation:
- Niche innovation
o Builds on existing knowledge but reaches out to new customers
or markets
o E.g. GPS device for cyclists
- Architectural innovation
o Is based on new knowledge that opens up new markets for the
innovator
o E.g. the internet: new market emerges from new
technology/knowledge
- Regular innovation
o Builds on existing knowledge and aims at existing customers
o E.g. new iPhone model
- Revolutionary innovation
o Is aimed at existing customers but based on new knowledge
o E.g. electronic cars
The more radical/revolutionary the innovation is, to harder it is to predict how it will be used (and
thus what the risks are). There are different levels of risk and uncertainty:
- Risk: you know what might go wrong (and what the consequences are) and you know the
probability of those consequences occurring. E.g. you put a hungry lion in a cage, and walk into it
→ you know the risks and what probably will happen
- Scenario uncertainty: you know what might go wrong, but can not meaningfully attach a
probability to the occurrence of these consequences. E.g.: certain Samsung phones were not
allowed in airplanes because they could explode. It was not known what the probability was, but
only known what possibly could go wrong. → so they banned the phones
- Ignorance: you don’t know what might go wrong, and also don’t know the probability
- Indeterminacy: because the future is still open and undetermined, all sorts of actors might use
the technology differently than foreseen or expected by designers. E.g. the internet; when first
build, nobody had any clue about how dangerous some parts can be (e.g. scamming)
- Normative ambiguity: uncertainty/disagreement about the norms and values. Safe-by-design is
at most value on this.
Keep in mind that safety is just one value, and there are many other values; transparency, openness,
democracy, equality, justice, privacy, sustainability, welfare, etc. These should also be taken into
account when researching, designing and innovating.
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, HC’s – Ethics in health and life sciences
HC 2 – WAIR learning tool
How do we approach safety?; How to we decrease the amount of uncertainty? How do people feel
safe? So safety is really broad. What can we design? What can we design to accommodate safety? It
is not about designing a practical thing, but it has also to do with laws and regulation.
Designing consists of multiple perspectives/dimensions of interaction; futures, needs and problems,
safety, alternatives, and stakeholders. The WAIR tool looks/uses all these perspectives.
The rest of this explanation is very visual; need to watch the video.
HC 3 – Video: deontology, utilitarianism and theory of
justice
According to Kant human morality all comes down to one foundation: categorical imperative; the
duty to act a certain way in every moment/event. Hypothetical impetrative; duty to act a certain
way that is dependent on the context (in some cases you have the duty to act a certain way, not in all
cases). This is deontology = the duty to act right (justified or not is judged on the action itself).
Consequentialism (the same as utilitarianism) = judging based on the consequences (calculation of
all bad an good consequences that might happen).
Ethics is about critical reasoning to find out what is the right way to act; justify your actions. So the
ethical theory rests on reasoning. The time of the theories from Kant and others was in the time of
the enlightenment; people began to think for themselves. ‘reason gives us the power to become
free’; Descartes, Hume, Kant. They all have different ideas.
Decartes: reason provides us with certainty about the world; our senses are always troubled, we can
never trust what everybody is telling us, you can only rely on is that you are thinking about this issue.
So he believes that rational thinking is the start of every thought/theory → rationalism (we already
have an concept of each thing in our mind, and we recognize it in the world/reality).
Hume: nothing is on our mind what was not before in our senses; we need to start with observing
the world, understanding it → empiricism (first we observe something, next we compute this in our
mind). Hume believed that our judgement/decisions are empowered by passions and they follow
hard wired roads (biology) to promote our interests and those of our fellows, with whom we
sympathize. We base our actions on the law of regularity; good and evil are positive and negative
feelings when evaluating acts of ourselves/others.
Jeremy Benthan: good an devil are pleasure and pain of sensory data. We need to find the rule that
provides happiness for everyone. The greater good of the whole. If there is more happiness than
pain, the action is justified.
Utilitarianism: aim is to produce the greatest good for the greatest number. This started with the
ideas of Hume, further developed by Bentham and Mill. It is the judgement of an action based on its
consequences.
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