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BIOUNCERTAINTY - ERC Starting Grant no. 805498

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Deep uncertainties in bioethics: genetic research, preventive medicine, reproductive decisions (BIOUNCERTAINTY)

Deep uncertainties in bioethics: genetic research, preventive medicine, reproductive decisions (BIOUNCERTAINTY)

Research project financed by the European Research Council (ERC) as part of the Starting Grant competition in 2019-24.

Project number: 805498

Principal Investigator: Tomasz Żuradzki


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Uncertainty is everywhere, as the saying goes, but rarely considered in ethical reflections. This project aims to reinterpret ethical discussions on current advances in biomedicine: instead of understanding bioethical positions as extensions of classical normative views in ethics (consequentialism, deontologism, contractualism etc.), my project interprets them more accurately as involving various normative approaches to decision making under uncertainty. The following hard cases in bioethics provide the motivation for research:

  1. Regulating scientific research under uncertainty about the ontological/moral status (e.g. parthenogenetic stem cells derived from human parthenotes) in the context of meta-reasoning under normative uncertainty.
  2. The value of preventive medicine in healthcare (e.g. vaccinations) in the context of decision-making under metaphysical indeterminacy.
  3. Population or reproductive decisions (e.g. preimplantation genetic diagnosis) in the context of valuing mere existence.

The main drive behind this project is the rapid progress in biomedical research combined with new kinds of uncertainties. These new and “deep” uncertainties trigger specific forms of emotions and cognitions that influence normative judgments and decisions. The main research questions that will be addressed by conceptual analysis, new psychological experiments, and case studies are the following: how do the heuristics and biases (H&B) documented by behavioral scientists influence the formation of normative judgments in bioethical contexts; how to demarcate between distorted and undistorted value judgments; to what extent is it permissible for individuals or policy makers to yield to H&B. The hypothesis is that many existing bioethical rules, regulations, practices seem to have emerged from unreliable reactions, rather than by means of deliberation on the possible justifications for alternative ways to decide about them under several layers and types of uncertainty.

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Research seminars

Research seminars

International conference 'Evidence in Law and Ethics' (ELE2019), 4-5 April 2019

Keynote speakers:

Christian Dahlman (Lund)

Martin Smith (Edinburgh)


Epistemic risk and the role of non-epistemic values in ethical and legal evidential reasoning.
Reasonable doubt, higher-order evidence, statistical evidence, evidentiary thresholds in law and ethics.
Models of evidential reasoning, standards of proof, and evidence-based heuristics in law and ethics.
The concept of testimony in ethical vs legal contexts.
Epistemology of legal (esp. court) disagreement.
The ethics of belief of laymen, experts, lawyers and the judicial system.

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  • Dranseika, V., McCarroll, C.J., Michaelian, K. (2021). Are observer memories (accurate) memories? Insights from experimental philosophy. Consciousness and Cognition.

    A striking feature of our memories of the personal past is that they involve different visual perspectives: one sometimes recalls past events from one’s original point of view (a field perspective), but one sometimes recalls them from an external point of view (an observer perspective). In philosophy, observer memories are often seen as being less than fully genuine and as being necessarily false or distorted. This paper looks at whether laypeople share the standard philosophical view by applying the methods of experimental philosophy. We report the results of five studies suggesting that, while participants clearly categorize both field and observer memories as memories, they tend to judge that observer memories are slightly less accurate than field memories. Our results suggest, however, that in lay thought, the difference between field and observer memories is not nearly as clear-cut as philosophers have generally taken it to be.

  • Earp, B.D., Lewis, J., Dranseika, V. & Hannikainen, I. (2021). Experimental Philosophical Bioethics and  Normative Inference. Theoretical Medicine & Bioethics.

    This paper explores an emerging sub-field of both empirical bioethics and experimental philosophy, which has been called “experimental philosophical bioethics” (bioxphi). As an empirical discipline, bioxphi adopts the methods of experimental moral psychology and cognitive science; it does so to make sense of the eliciting factors and underlying cognitive processes that shape people’s moral judgments, particularly about real-world matters of bioethical concern. Yet, as a normative discipline situated within the broader field of bioethics, it also aims to contribute to substantive ethical questions about what should be done in a given context. What are some of the ways in which this aim has been pursued? In this paper, we employ a case study approach to examine and critically evaluate four strategies from the recent literature by which scholars in bioxphi have leveraged empirical data in the service of normative arguments.

  • Elkin, L. (2021). The Precautionary Principle and Expert Disagreement. Erkenn.

    The Precautionary Principle is typically construed as a conservative decision rule aimed at preventing harm. But Martin Peterson (JME 33: 5–10, 2007; The ethics of technology: A geometric analysis of five moral principles, Oxford University Press, Oxford, 2017) has argued that the principle is better understood as an epistemic rule, guiding decision-makers in forming beliefs rather than choosing among possible acts. On the epistemic view, he claims there is a principle concerning expert disagreement underlying precautionary-based reasoning called the ecumenical principle: all expert views should be considered in a precautionary appraisal, not just those that are the most prominent or influential. In articulating the doxastic commitments of decision-makers under this constraint, Peterson precludes any probabilistic rule that might result in combining expert opinions. For combined or consensus probabilities are likely to provide decision-makers with information that is more precise than warranted. Contra Peterson, I argue that upon adopting a broader conception of probability, there is a probabilistic rule, under which expert opinions are combined, that is immune to his criticism and better represents the ecumenical principle.

  • Hannikainen, I.R., Tobia, K.P., de Almeida, G.d.F.C.F., Donelson, R., Dranseika, V., Kneer, M., Strohmaier, N., Bystranowski, P., Dolinina, K., Janik, B., Keo, S., Lauraitytė, E., Liefgreen, A., Próchnicki, M., Rosas, A. and Struchiner, N. (2021). Are There Cross-Cultural Legal Principles? Modal Reasoning Uncovers Procedural Constraints on LawCognitive Science, 45: e13024.

    Despite pervasive variation in the content of laws, legal theorists and anthropologists have argued that laws share certain abstract features and even speculated that law may be a human universal. In the present report, we evaluate this thesis through an experiment administered in 11 different countries. Are there cross-cultural principles of law? In a between-subjects design, participants (N = 3,054) were asked whether there could be laws that violate certain procedural principles (e.g., laws applied retrospectively or unintelligible laws), and also whether there are any such laws. Confirming our preregistered prediction, people reported that such laws cannot exist, but also (paradoxically) that there are such laws. These results document cross-culturally and –linguistically robust beliefs about the concept of law which defy people's grasp of how legal systems function in practice.

  • Bystranowski, P., Janik, B., Próchnicki, M. et al. (2021). Do Formalist Judges Abide By Their Abstract Principles? A Two-Country Study in Adjudication. Int J Semiot Law.

    Recent literature in experimental philosophy has postulated the existence of the abstract/concrete paradox (ACP). One recent study supports the thesis that this effect influences judicial decision-making, including decision-making by professional judges, in areas such as interpretation of constitutional principles and application of clear-cut rules. Here, following the existing literature in legal theory, we argue that the susceptibility to such an effect might depend on whether decision-makers operate in a legal system characterized by the formalist or particularist approach to legal interpretation, with formalist systems being less susceptible to the effect.

  • Maziarz, M. (2021). Resolving empirical controversies with mechanistic evidence. Synthese.

    The results of econometric modeling are fragile in the sense that minor changes in estimation techniques or sample can lead to statistical models that support inconsistent causal hypotheses. The fragility of econometric results undermines making conclusive inferences from the empirical literature. I argue that the program of evidential pluralism, which originated in the context of medicine and encapsulates to the normative reading of the Russo-Williamson Thesis that causal claims need the support of both difference-making and mechanistic evidence, offers a ground for resolving empirical disagreements.

  • Bystranowski, P., Janik, B., Próchnicki, M., & Skórska, P. (2021). Anchoring effect in legal decision-making: A meta-analysis. Law and Human Behavior, 45 (1): 1-23.

    We conducted a meta-analysis to examine whether numeric decision-making in law is susceptible to the effect of (possibly arbitrary) values present in the decision contexts (anchoring effect) and to investigate which factors might moderate this effect.

  • Dranseika, V. (2021). Authenticity, Self-Defining Memories, and the Direction of Change. AJOB Neuroscience, 12 (1): 48-49.

    An open peer commentary to Zawadzki and Adamczyk's target article: "Personality and Authenticity in Light of the Memory-Modifying Potential of Optogenetics".

  • Maziarz, M. & Zach, M. (2021). Assessing the quality of evidence from epidemiological agent-based models for the COVID-19 pandemic. History and Philosophy of the Life Sciences, 43 (10).

    Agent-based models (ABMs) are one of the main sources of evidence for decisions regarding mitigation and suppression measures against the spread of SARS-CoV-2. These models have not been previously included in the hierarchy of evidence put forth by the evidence-based medicine movement, which prioritizes those research methods that deliver results less susceptible to the risk of confounding. We point out the need to assess the quality of evidence delivered by ABMs and ask the question of what is the risk that assumptions entertained in ABMs do not include all the key factors and make model predictions susceptible to the problem of confounding.

  • Żuradzki, T. (2021). Against the Precautionary Approach to Moral Status: The Case of Surrogates for Living Human Brains. American Journal of Bioethics, 20 (1): 53-56.

    My paper builds on the conceptual tools from three interrelated philosophical debates that—as I believe—may help structure important if chaotic discussions about surrogates for living human brains and resolve some practical issues related to regulatory matters. In particular, I refer to the discussions about the “moral precautionary principle” in research ethics (Koplin and Wilkinson 2019); about normative uncertainty in ethics (MacAskill, Bykvist, and Ord 2020), and about the inductive risk problem for animal welfare scientists (Birch 2018). I elucidate upon the possible meanings of the phrase “a too good human brain surrogate” used by Henry T. Greely (2021), and I demonstrate that the evaluation of the practical and regulatory implications of the “goodness” of such surrogates created for research purposes should be sensitive to the possible consequences of two types of errors: the under-attribution and over-attribution of moral status to such beings. Many authors writing about this topic (including Greely 2021, but see also, e.g., Koplin and Savulescu 2019) concentrate only on the first type of error, neglecting the negative consequences of the second type, i.e., over-attribution.

  • Żuradzki, T. & Wiśniowska, K. (2020). A data-driven argument in bioethics: why theologically grounded concepts may not provide the necessary intellectual resources to discuss inequality and injustice in healthcare. American Journal of Bioethics, 12 (20): 25-28.

    In this paper, we use an innovative, empirical, and–as yet–rarely applied method in bioethics, namely corpus analysis. By demonstrating the ambiguity of the concept of dignity discernible when analyzing its use in normative contexts, our work is a novel contribution to the debates among the historians of ideas about conceptual identity and conceptual drift.

  • Wiśniowska, K. (2020). Etyczne aspekty „obrzezania” [Ethical aspects of medically unnecessary child genital cutting]. Analiza i Egzystencja, 51: 45-64.

    Female genital mutilation includes procedures which remove or cause injury to some or all women’s external genital organs. There are a lot of medical risks involved - nevertheless, in some societies it is mainstream practice, carried out mostly on girls younger then fifteen years of age. In this paper, it is considered if it would be acceptable to make compromise in the case of female genital mutilation in the form of so-called Seattle compromise.

  • Wroński, L. (2020). Objective consequentialism and the plurality of chances. Synthese.

    I claim that objective consequentialism (OC) faces a problem stemming from the existence in some situations of a plurality of chances relevant to the outcomes of an agent’s acts. I suggest that this phenomenon bears structural resemblance to the well-known Reference Class problem. I outline a few ways in which one could attempt to deal with the issue, suggesting that it is the higher-level chance that should be employed by OC.

  • Maziarz, M. & Zach, M. (2020). Agent-based modeling for SARS-CoV-2 epidemic prediction and intervention assessment. A methodological appraisal. J Eval Clin Pract, 26: 1352–1360.

    Our purpose is to assess epidemiological agent‐based models—or ABMs—of the SARS‐CoV‐2 pandemic methodologically. The rapid spread of the outbreak requires fast‐paced decision‐making regarding mitigation measures.

  • Malinowska, J.K. & Żuradzki, T. (2020). Non-Epistemological Values in Collaborative Research in Neuroscience: The Case of Alleged Differences between Human Populations. AJOB Neuroscience, 11 (3): 203-206.

    What constitutes bias?; how biases may be embedded in the selection of research programs?; is it possible to conduct completely unbiased research? Joanna K. Malinowska and Tomasz Żuradzki try to notice possible answers to these questions in their commentary "Non-Epistemological Values in Collaborative Research in Neuroscience: The Case of Alleged Differences Between Human Populations".

  • Żuradzki, T. (2020). The Fifth Face of Fair Subject Selection: Population Grouping. American Journal of Bioethics, 20 (2): 41-43.

    The article by MacKay and Saylor (2020) claims that the principle of fair subject selection yields conflicting imperatives (e.g. in the case of pregnant women) and should be understood as “a bundle of four distinct sub-principles” (i.e. fair inclusion, burden sharing, opportunity, distribution of third-party risks), each having conflicting normative recommendations. In my commentary article, written from the philosophical perspective, I notice a number of interrelated problems which I believe have not been discussed thoroughly in the target article: (1) the precise way in which health care priority setting should influence the content of health research priority setting and fair inclusion principles; (2) the distinction between group and individual benefits and burdens from clinical research; (3) the reference class problem in medical research.

  • Paulo, N. & Pölzler, T. (2020). X-Phi and Impartiality Thought Experiments: Investigating the Veil of Ignorance. Diametros, 17 (64): 72-89.

    This paper discusses “impartiality thought experiments”, i.e., thought experiments that attempt to generate intuitions which are unaffected by personal characteristics such as age, gender or race. We focus on the most prominent impartiality thought experiment, the Veil of Ignorance (VOI), and show that both in its original Rawlsian version and in a more generic version, empirical investigations can be normatively relevant in two ways: First, on the assumption that the VOI is effective and robust, if subjects dominantly favor a certain normative judgment behind the VOI this provides evidence in favor of that judgment; if, on the other hand, they do not dominantly favor a judgment this reduces our justification for it. Second, empirical investigations can also contribute to assessing the effectiveness and robustness of the VOI in the first place, thereby supporting or undermining its applications across the board.

  • McFarlane, S. & Cipolletti Perez, H. (2020). Some Challenges for Research on Emotion and Moral Judgment: The Moral Foreign-Language Effect as a Case Study. Diametros, 17 (64): 56-71.

    In this article, we discuss a number of challenges with the empirical study of emotion and its relation to moral judgment. We examine a case study involving the moral foreign-language effect, according to which people show an increased utilitarian response tendency in moral dilemmas when using their non-native language. One important proposed explanation for this effect is that using one’s non-native language reduces emotional arousal, and that reduced emotion is responsible for this tendency. We offer reasons to think that there is insufficient evidence for accepting this explanation at present. We argue that there are three themes that constrain our current ability to draw firm empirical conclusions: 1) the frequent use of proxies or partial measures for emotions, 2) the lack of a predictive and generalizable theory of emotion and specific emotion-types, and 3) the obscurity of a baseline level of neutrality with respect to participant emotion. These lessons apply not only to research on the moral foreign-language effect, but to empirical research in moral psychology more generally.

  • Bush, L. S. & Moss, D. (2020). Misunderstanding Metaethics: Difficulties Measuring Folk Objectivism and Relativism. Diametros, 17 (64): 6-21.

    In this article, we discuss a number of challenges with the empirical study of emotion and its relation to moral judgment. We examine a case study involving the moral foreign-language effect, according to which people show an increased utilitarian response tendency in moral dilemmas when using their non-native language. One important proposed explanation for this effect is that using one’s non-native language reduces emotional arousal, and that reduced emotion is responsible for this tendency. We offer reasons to think that there is insufficient evidence for accepting this explanation at present. We argue that there are three themes that constrain our current ability to draw firm empirical conclusions: 1) the frequent use of proxies or partial measures for emotions, 2) the lack of a predictive and generalizable theory of emotion and specific emotion-types, and 3) the obscurity of a baseline level of neutrality with respect to participant emotion. These lessons apply not only to research on the moral foreign-language effect, but to empirical research in moral psychology more generally.

  • Maziarz, M. & Mróz, R. (2020). A rejoinder to Henschen: the issue of VAR and DSGE models. Journal of Economic Methodology, 27 (3): 266-268.

    In his recent paper in the Journal of Economic Methodology, Tobias Henschen puts forth a manipulationist definition of macroeconomic causality that strives for adequacy. As the notion of ‘adequacy’ remains underdeveloped in that paper, in this study we offer a discussion of what it means for a definition of causality to be adequate to macroeconomics. One of the meanings of adequacy is that the definition of causality describes the types of relations for which macroeconomic causal models stand for. On this understanding of adequacy, we take issue with Henschen’s claim. We argue that his manipulationist definition is only applicable to a sample of causal models used by macroeconomists. There are other sets of macroeconomic causal models to which probabilistic and mechanistic definitions seem more adequate. We show relevant examples to support this claim and conclude that a moderate causal pluralism is an adequate stance with respect to macroeconomic causal models.

  • Żuradzki, T. & Nowak, P.G. (2019). Deep Uncertainties in the Criteria for Physician Aid-in-Dying for Psychiatric Patients. American Journal of Bioethics, 10 (19): 54-56.

    In their insightful article, Brent Kious and Margaret Battin (2019) correctly identify an inconsistency between an involuntary psychiatric commitment for suicide prevention and physician aid in dying (PAD). They declare that it may be possible to resolve the problem by articulating “objective standards for evaluating the severity of others’ suffering,” but ultimately they admit that this task is beyond the scope of their article since the solution depends on “a deep and difficult” question about comparing the worseness of two possible scenarios: letting someone die (who could have been helped) with not letting someone die (whose suffering could only be alleviated by death). In our commentary, we argue that creating such standards is more difficult than the  authors assume because of the many types of deep uncertainties we have to deal with: (1) diagnostic, (2) motivational, and (3) existential.

In preparation

  • Żuradzki, T. Regulating scientific research under deep uncertainty: the case of ontologically ambiguous entities

    Human embryos in the early stages of development are ontologically ambiguous entities. The same concerns e.g. induced pluripotent stem cells reprogrammed from human somatic cells, embryo-like products of parthenogenesis, human-nonhuman chimeras, human organoids. This ontological ambiguity (an example of deep uncertainty) which has been discussed extensively by philosophers and bioethicists in recent years is an underlying reason for the uncertainty about the moral and legal status of these beings. In my presentation – a part of a larger project aimed at analyzing decision theory as a model for reasoning in ethics – I want to discuss whether this uncertainty about status cast doubt on the arguments claiming strong or even full protection of these beings. Or is it the other way around: does it give a reason for acting in a cautious way and treating these entities as if they had very high status (a higher-order precautionary principle). In recent years there have been a number of attempts to understand and to find the relevant criteria for making decisions under deep uncertainty, but this topic is still unexplored in the case of ontologically ambiguous entities. Some scholars have proposed the decision theoretic approach modeled on the cases of factual risk according to which we ought (although the very nature of this ought may be contested) to represent any higher-order uncertainties in terms of those first-order (e.g. that we ought to evaluate the subjective probabilities of different doctrines about ontologically ambiguous entities and combine them with the disvalues attached by these doctrines to the creation/destruction of these entities and/or social benefits of this kind of research). I will show that this approach faces serious objections (e.g. the problem of inter-theoretical comparisons of values) and the decision theoretic approach should be understood in this case as a metaphor (not a model).

  • Żuradzki, T. Reporting incidental findings under uncertainty

    When conducting biomedical research (e.g. genomic), researchers may obtain information that is beyond the aims of the study but may be relevant to the participants. An emerging consensus says that reporting incidental findings to participants should be based on the potential for medical benefit. Schaefer & Savulescu (2018) have recently criticized this “best-medical-interests” standard as being too narrow. They have argued that research subjects have a right to know about any comprehensible piece of information about them which is generated by the research which they are participating in, even if it is of no direct medical benefit to them. In my paper I will criticize their three main arguments based on the notions of autonomy, interests and privacy. I will show that they use a very narrow concept of autonomy as the ability to make informed decisions; they do not take into account the psychology of genetic risk perception; and they rely on an overly individualistic approach to research ethics.

  • Żuradzki, T. The conceptualization of vaccination refusals: between science denial and violation of rational choice

    Vaccination programmes have been acknowledged as the greatest public health achievement of the last decades. Therefore, it may be surprising that growing number of people are opting not to vaccinate their children (Omer 2012).[1] On the one hand, vaccination refusals seem to be clear examples of science denial that may result, among others reasons, from exposure to scientific fraud (an infamous report linking the measles vaccine to autism, later retracted). On the other hand, some countries (e.g. the US and Australia) offer non-medical exemptions from mandatory vaccination. It is surprising, because these kinds of exceptions are usually limited to value disagreements, but are not accepted in cases of science denial (e.g. objections to teaching evolution in schools). Moreover, reputable journals in medicine, bioethics or social science publish papers defending parental “conscientious objection” to mandatory vaccination programmes (Salmon 2006; Navin, Largent 2017). In my presentation I show there are no good reasons to assume that anyone should be allowed to refuse “to vaccinate their dependants on conscientious grounds” (Clarke et al. 2017).
    First, I want to analyze a suitable ethical framework for mandatory vaccination of children or specific populations (e.g. health care personnel): public health ethics (that implies a consequentialist approach) versus traditional bioethics (that concentrates on autonomous consent and individual risk-benefit ratio).
    Second, I want to discuss vaccination refusals in the context of philosophical (or legal) theories of responsibility of those who opt out for harms to others, including: i) collective action problem (e.g. few persons being unvaccinated, where herd immunity is achieved, are very unlikely to cause harm); ii) responsibility for imposing mere risks of harm to others (Jamrozik et al. 2016).
    Third, I want to analyze explanations of vaccination refusal (see systematic reviews: Mills et al. 2005; Wang et al. 2014). i) Free-riding without rejecting scientific consensus. Some individuals may be pro vaccination in general, but prefer to keep children unvaccinated as long as enough others are vaccinated and risks have largely been eliminated. I will show that even if someone agrees that free-riding is not always objectionable (Dare 1998), it would be hard to establish the content of beliefs about vaccination refusal (cf. Jamrozik 2017). ii) Religious reasons. Despite of the fact that no major organized religion prohibits vaccination (Grabenstein 2013), some Catholics have questioned some vaccines as “morally illicit” (Carson, Flood 2017), because they were developed in cell cultures derived from tissue originally taken from an aborted fetus (WI-38; MRC-5). The Catholic teaching permits parents to use a vaccine despite its “illicit origin” (CDF 2008), although every act of vaccination is “a form of very remote mediate material cooperation” (PAL 2006) with the evil. Both documents underline that parents “should take recourse… to the use of conscientious objection with regard to the use of vaccines produced by means of cell lines of aborted human fetal origin” (PAL 2006). But in this context “conscientious objection” does not mean vaccination refusal, but only a symbolic act (e.g. signing a petition). iii) A mistrust concerning the necessity, safety, and efficacy of vaccines. Some people may disagree about the authority of science, and same individuals reject only the orthodox account of the risks and benefits of immunization. But these views are clearly related to the different biases that make pro-vaccination beliefs more counter-intuitive, and anti-vaccination beliefs – more intuitive, especially once vaccinations have made some diseases rare (Miton, Mercier 2015). For example: omission bias (Wroe at al. 2005); in-group favoritism (Kahan et al. 2010); identified victim effect (Hare 2012).

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