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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

 

Project

Abstract

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.

Results

Publications: published and forthcoming

P. Bystranowski, B. Janik, M. Próchnicki, I. Hannikainen, G. Almeida, & N. Struchiner (2021). Do Formalist Judges Abide by Their Abstract Principles? A Two-Country Study in Adjudication, International Journal for the Semiotics of Law

 

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

 

P. Bystranowski, M. Mungan (forthcoming) Proxy Crimes, American Criminal Law Review

 

L. Elkin (forthcoming), Regret averse opinion aggregation, Ergo

 

P. Nowak (forthcoming), Moral and Biological Concept of Death: Which One is Too Nebulous? Journal of Medicine and Philosophy

 

M. Maziarz & M. Zach (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.

 

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. Hypotheses: We predicted that the presence of numeric anchors would bias legal decision-makers’ judgment in the direction of the anchor value. We hypothesized that the effect size of anchoring would be moderated by several variables, which we grouped into three categories: methodological (type of stimuli; type of sample), psychological (standard vs. basic paradigm; anchor value; type of scale on which the participants assessed the target value), and legal (relevance of the anchor; type of the anchor; area of law to which the presented case belonged; presence of any salient numeric values other than the main anchor). Method: Twenty-nine studies (93 effect sizes; N = 8,549) met the inclusion criteria. We divided them into two groups, depending on whether they included a control group, and calculated the overall effect size using a random-effects Model with robust variance estimation. We assessed the influence of moderators using random effects metaregression. Results: The overall effect sizes of anchoring for studies with a control group (z = .27, 95% CI [.21, .33], d = .58, 95% CI [.44, .73]) and without a control group (z = .39, 95% CI [.31, .47], d = .91, 95% CI [.69, 1.12]) were both significant, although we provide some evidence of possible publication bias. We found preliminary evidence of a potential moderating effect of some legally relevant factors, such as legal expertise or the anchor relevance. Conclusions: Existing research indicates anchoring effects exist in legal contexts. The influence of anchors seems to depend on some situational factors, which paves the way for future research on countering the problematic effect in legal settings.


T. Żuradzki (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.

 

Vilius Dranseika (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".

 

T. Żuradzki, K. Wiśniowska (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 contexts, 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, which is commonly used in literature studies (Moretti 2013), linguistics (Baker 2006), and has been recently discussed in the context of the history of ideas (Betti and van den Berg 2016) and philosophy of science (Pence and Ramsey 2018).1 In contrast to other areas of experimental philosophy, which typically involve surveying folk participants with questionnaires aimed at eliciting their intuitions, our method here connects distant reading (a quantitative approach to the large corpus within Christian bioethics) with close reading (qualitative analysis of selected documents or their fragments with the word “dignity”) of scholarly papers. 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.

 

K. Wiśniowska (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. There are some similarities between female genital mutilation and male circumcision: young age of people who are being subjected to those procedures, and - to some extend - symbolic meaning and risk of harm. Female genital mutilation is strictly banned in Western countries, while male circumcision is accepted. 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.
 
 

L. Wroński (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.

 

M. Maziarz, M. Zach (2020), Agent-based modeling for SARS-CoV-2 epidemic prediction and intervention assessment. A methodological appraisalJournal of Evaluation in Clinical Practice

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. However, the evidence for the efficacy of non‐pharmaceutical interventions such as imposed social distancing and school or workplace closures is scarce: few observational studies use quasi‐experimental research designs, and conducting randomized controlled trials seems infeasible. Additionally, evidence from the previous coronavirus outbreaks of SARS and MERS lacks external validity, given the significant differences in contagiousness of those pathogens relative to SARS‐CoV‐2. To address the pressing policy questions that have emerged as a result of COVID‐19, epidemiologists have produced numerous models that range from simple compartmental models to highly advanced agent‐based models. These models have been criticized for involving simplifications and lacking empirical support for their assumptions.

 

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

The goals and tasks of neuroethics formulated by Farahany and Ramos (2020) link epistemological and methodological issues with ethical and social values. The authors refer simultaneously to the social significance and scientific reliability of the BRAIN Initiative. They openly argue that neuroethics should not only examine neuroscientific research in terms of “a rigorous, reproducible, and representative neuroscience research process” as well as “explore the unique nature of the study of the human brain through accurate and representative models of its function and dysfunction”, but also its responsibilities or social consequences. In our commentary, we would like to concentrate on problem selection, which is shortly noticed by Farahany and Ramos, and by BRAIN Initiative’s Neuroethics Report itself. The document raises an important issue related to problem selection, which is strengthening or perpetuating existing prejudices and biases by choosing a research subject: “scientists are prompted to consider how the questions they choose to study in the laboratory might amplify existing biases.” This leads to several further problems: what constitutes bias?; how biases may be embedded in the selection of research programs?; is it possible to conduct completely unbiased research?; who should be a gatekeeper in the case of research that may amplify biases? We try to notice possible answers to these questions in the context of the research on differences (e.g., cognitive, medical, behavioral) between human populations.

 

T. Żuradzki (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.

 

N. Paulo & T. Pölzler (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.

 

S. McFarlane & H. Cipolletti Perez (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. 

 

L. S. Bush & D. Moss (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.

 

T. Żuradzki, P.G. Nowak (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. 

 

M. Maziarz, R. Mróz (2020). Response to Henschen: Causal pluralism in economics "Journal of Economic Methodology" 27 (2): 164-178

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.

Publications: in preparation

T. Żuradzki, 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).

 

T. Żuradzki, 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.

 

T. Żuradzki 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).

Events

Research seminars

Research seminars

Weekly research seminars of the Interdisciplinary Centre for Ethics of the Jagiellonian University (INCET) organized as part of the BIOUNCERTAINTY project take place (usually) on Thursdays between 5.00pm-7.00pm at the Institute of Philosophy of the Jagiellonian University,  52 Grodzka Street, in the hall of Roman Ingarden (25). Information about seminars are available in the section News.

See photos at INCET gallery.
Conferences

Conferences

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

Keynote speakers:

Christian Dahlman (Lund)

Martin Smith (Edinburgh)

Topics:

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.

Team

Principal Investigator

Tomasz Żuradzki

Post-doctoral researchers

Lee Elkin

Assistant researchers

Piotr Bystranowski

Vilius Dranseika

Mariusz Maziarz

Karolina Wiśniowska

Student assistants

Katarzyna Żebrowska

Maciej Piwowarski

Former members

Marcin Waligora Ph.D., Professor at Jagiellonian University

Piotr Nowak

Bartosz Biskup

Adrianna Beczek