Several factors related to fetal risk render it more or less acceptable in justifying constraints on the behavior of pregnant women. Risk is an unavoidable part of pregnancy and childbirth, one that women must balance against other vital personal and family interests. Two particular issues relate to the fairness of claims that pregnant women are never entitled to put their fetuses at risk: relative risks and relatives' risks. The former have been used—often spuriously—to advance arguments against (...) activities, such as home birth, that may incur risk; the latter implicate the nature of relationships in determining the acceptability of coercing or precluding activities. Motivated reasoning by clinicians and judges leads to inaccurate risk assessments, and judgments based on false claims to objectivity. Such judgments undermine the moral and legal standing of pregnant women and do not advance the interests of fetuses, pregnant women, families, or states. (shrink)

Background Changes in policies and practices related to repeat cesareans and home birth in the U.S. have been influenced by different interpretations of the risk of poor outcomes. Methods This article examines two cases—vaginal birth after cesarean (VBAC) and home birth to illustrate how an emphasis on relative over absolute risk has been used to characterize outcomes associated with these practices. The case studies will rely on reviews of the research literature and examination of data on birth (...) trends and outcomes. Results Childbirth involves some unique challenges in assessing health risks, specifically the issues of: (1) timing of risks (lowering health risk in a current birth can increase it in subsequent births); (2) the potential weighing of risks to the mother’s versus the infant’s health; (3) the fact that birth is a condition of health and many of the feared outcomes (for example, symptomatic uterine rupture) involve very low absolute risk of occurrence; and (4) a malpractice environment that seizes upon those rare poor outcomes in highly publicized lawsuits that receive widespread attention in the clinical community. In the cases of VBAC and home birth, the result has been considerable emphasis on relative risks, typically an adjusted odds ratio, with little consideration of absolute risks. Conclusion Assessments of the safety of interventions in childbirth should involve careful consideration and communication of the multiple dimensions of risk, particularly a balancing of relative and absolute risks of poor health outcomes. (shrink)

The existing literature on savings, insurance, and portfolio choices under risk has revealed that quite often comparative statics results depend, among other things, upon the values of the coefficients of relative risk aversion and relative prudence. More specifically the benchmark values for these coefficients are, respectively, one and two. Recently, several papers investigated constraints on the higher degree extensions of the coefficients of relative risk aversion and of relative prudence. The present work provides (...) a unified approach to this question based on the concept of elementary correlation increasing transformations, allowing for a better understanding of changes in risk in the multiplicative case. (shrink)

Sport categorization is often justified by benefits such as increased fairness or inclusion. Taking inspiration from John Rawls, Sigmund Loland’s fair equality of opportunity principle in sport (FEOPs) is a tool for determining whether the existence of an inequality ethically justifies the institution of a new category in any given sport. It is an elegant ethical normative framework, but since FEOPs does not account explicitly for athlete safety (i.e. athlete physical and mental wellbeing), we are left in an ethically dubious (...) situation where the risk of harm associated with a categorization regime might in fact prove to be greater than the risk of harm present within the sport before its introduction. To address this critical gap, I propose the ‘scales of ignorance’ ethical normative framework to weigh the relative risk of harm within a sport, crucially inserting athlete safety into the discourse surrounding ethical justification for categorization in sport. The current paper is the first explicit formulation of assessment and ethical justification of risk of harm in the familiar logic of FEOPs. The scales of ignorance framework can also be used independently of Loland’s approach. Two new concepts are also proposed: ‘insidious risk of harm’ and ‘pernicious risk of harm’. (shrink)

Several factors related to fetal risk render it more or less acceptable in justifying constraints on the behavior of pregnant women. Risk is an unavoidable part of pregnancy and childbirth, one that women must balance against other vital personal and family interests. Two particular issues relate to the fairness of claims that pregnant women are never entitled to put their fetuses at risk: relative risks and relatives' risks. The former have been used—often spuriously—to advance arguments against (...) activities, such as home birth, that may incur risk; the latter implicate the nature of relationships in determining the acceptability of coercing or precluding activities. Motivated reasoning by clinicians and judges leads to inaccurate risk assessments, and judgments based on false claims to objectivity. Such judgments undermine the moral and legal standing of pregnant women and do not advance the interests of fetuses, pregnant women, families, or states. (shrink)

The American Journal of Bioethics, Volume 11, Issue 6, Page 23-25, June 2011.

This article examines the epistemology of risk assessment in the context of financial modelling for the purposes of making loan underwriting decisions. A financing request for a company in the paper and pulp industry is considered in some detail. The paper and pulp industry was chosen because it is subject to some specific risks that have been identified and studied by bankers, investors and managers of paper and pulp companies and certain features of the industry enable analysts to quantify (...) the impact of specific risk events of a given dimension on a company's future financial performance. While companies in other industries may be subject to similar risk factors, the impact of risk events may be more difficult to gauge in those industries. The ability of financial analysts to model the impact of a risk event, and hence quantify a credit risk, increases the predictive accuracy of the model. I argue that bankers and regulators should recognise the uncertainty associated with unquantifiable credit risk in financial models, and they should view this uncertainty as a credit risk factor in and of itself. Evaluating the relative degree to which credit risk is quantifiable in financial models is a potentially significant yet largely unrecognised tool for credit risk management. I consider some possible applications of this assessment tool for managing risk within the banking industry. (shrink)

The American Journal of Bioethics, Volume 11, Issue 6, Page 21-22, June 2011.

The concept of minimal risk has been used to regulate and limit participation by adolescents in clinical trials. It can be understood as setting an absolute standard of what risks are considered minimal or it can be interpreted as relative to the actual risks faced by members of the host community for the trial. While commentators have almost universally opposed a relative interpretation of the environmental risks faced by potential adolescent trial participants, we argue that the ethical (...) concerns against the relative standard may not be as convincing as these commentators believe. Our aim is to present the case for a relative standard of environmental risk in order to open a debate on this subject. We conclude by discussing how a relative standard of environmental risk could be defended in the specific case of an HIV vaccine trial among adolescents in South Africa. (shrink)

The American Journal of Bioethics, Volume 11, Issue 6, Page 22-23, June 2011.

In this paper I discuss the view that the appropriate concept of competence is a decision‐relative one: that a person may be competent to make one decision but not another. The argument that I present is that neither of the two competing theories supporting the decision‐relative approach, internalism and externalism, can provide a coherent explanation of why a person’s competence should be thought to be relative to a particular decision. On the one hand, internalism, which regards competence (...) as exhaustively a matter of the person’s understanding, fails to identify the specific skills or content that would warrant linking a specific decision with competence, and thus cannot provide an account of decision‐relative that parallels task‐relative. On the other hand, externalism, which regards competence as a matter of the person’s understanding in relation to external elements such as risk, cannot adequately defend why a person’s competence to make a decision should ‘track’ the level of probable harm that results from the decision. (shrink)

The American Journal of Bioethics, Volume 12, Issue 10, Page 12-14, October 2012.

The relative input of payoffs and probabilities into risk judgment The study was designed to investigate the relative input of payoffs and probabilities into risk judgment on the basis of the analysis of information search pattern. The modified version of MouselabWeb software was used as an investigative tool. The amount, the kind and the order of information accessed by subjects to evaluate risk was collected from ordinary respondents and respondents trained in mathematics and statistics. In (...) the latter group were 75 students and young researchers working at National Aeronautics and Space Administration. The ordinary subjects were 67 Polish students of social sciences. As expected, the NASA group considered more information than ordinary students and searched for more information about probabilities. However, the ratio of information about payoffs to probabilities was close to 1 in both groups. Moreover, average risk rates were similar in both groups. It was also observed that risk rates were positively related with the amount of information about probabilities considered by subjects. (shrink)

This article investigates a high-profile and ongoing dilemma for healthcare professionals (HCPs), namely whether the existence of a (legal) duty of care to genetic relatives of a patient is a help or a hindrance in deciding what to do in cases where a patient’s genetic information may have relevance to the health of the patient’s family members. The English caseABC v St George’s Healthcare NHS Trust and othersconsidered if a duty of confidentiality owed to the patient and a putative duty (...) of care to the patient’s close relatives could coexist in this context. This article examines whether embracing the concept of coexisting duties could enable HCPs to respect duties in line with their clinical judgement, thereby providing legal support and clarity to professionals to allow them to provide the best possible genetics service to both the patient and their family. We argue that these dual duties, framed as a novel, composite duty to consider the interests of genetic relatives, could allow HCPs to exercise and act on their professional judgements about the relative value of information to family members, without fears of liability for negligence or breach of confidence. (shrink)

In this short response to Gray’s article Capacity and Decision Making we double down on our argument that risk-relativity is a nonsense. Risk relativity is the claim that we should set a higher standard of competence for a person to make a risky choice than to make a safe choice. Gray’s response largely involves calling attention to the complexities, ramifications and multiple value implications of decision-making, but we do not deny any of this. Using the notion of quality (...) of care mentioned by Gray, we construct an argument that might be used to support risk relativity. But it is no more persuasive than the arguments put forward by risk-relativists. (shrink)

This essay explains the notion of luck in terms of risk. It starts by distinguishing two senses of risk, the risk that an event has of occurring and the risk at which an agent is with respect to an event. It cashes out the former in modal terms and the latter in terms of lack of control. It then argues that the presence or absence of event-relative risk marks a distinction between two types of (...) luck or fortune commonly overlooked in ordinary usage of the terms “luck” and “fortune.” After offering a detailed account of the notion of control, the essay advances a new version of the so-called lack of control account of luck: lucky events are events with respect to which one is at risk and hence events over which one lacks control in the specified way. Finally, it argues that its account steers clear of counterexamples to the lack of control account of luck. (shrink)

Is surveillance that is targeted towards specific individuals easier to justify than surveillance that targets broad categories of people? Untargeted surveillance is routinely accused of treating innocent people as suspects in ways that are unfair and of failing to pursue security effectively. I argue that in a wide range of cases untargeted surveillance treats people less like suspects than more targeted alternatives. I also argue that it often deters unwanted behaviour more effectively than targeted alternatives, including profiling. In practice, untargeted (...) surveillance is likely to be least costly morally and most efficient when used as a means of enforcing the rules of a specific activity or institution. Targeted alternatives are likely to be more appropriate means of law enforcement. (shrink)

The American Journal of Bioethics, Volume 11, Issue 6, Page 14-16, June 2011.

Direct-to-consumer genetic testing is a growing phenomenon, fuelled by the notion that knowledge equals control. One ethical question that arises concerns the proband’s duty to share information indicating genetic risks in their relatives. However, such duties are unenforceable and may result in the realisation of anticipated harm to relatives. We argue for a shift in responsibility from proband to provider, placing a duty on test providers in the event of identified actionable risks to relatives. Starting from Parker and Lucassen’s 'joint (...) account model', we adapt Kilbride’s application of the rule of rescue and balance it against the relative’s right not to know, placing responsibility on the providers of direct-to-consumer genetic testing. Where the risk of disease to a relative is actionable, we argue providers ought to share results even in the face of the proband’s objections. Confidentiality issues are navigated by a pre-emptive consent model, whereby consumers agree to the sharing of certain information with their relatives ahead of testing and as a condition of testing. When a relative is informed, the proband’s privacy is protected by maximal deidentification, and the rights of the relative are met by a stepwise approach to informing that allows them to decide how much information they receive. (shrink)

Genetic testing has familial implications. Counsellors find themselves in (moral) conflict between medical confidentiality (towards the patient) and a potential right or even duty to warn at-risk relatives. Legal regulations vary between countries. English literature about German law is scarce. We reviewed the literature of relevant legal cases, focussing on German law, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This article aims to familiarise counsellors with their responsibilities, compare the situation between countries and point (...) out legally unresolved areas.According to the German Genetic Diagnostics Act (Gendiagnostikgesetz) in case of an ‘avoidable or treatable’ genetic disorder, geneticists ought to confine themselves to the obligated advice to the patient. Whether a breach of the duty of confidentiality can be justified in exceptional cases by ‘necessity as justification’ for actively informing relatives at risk remains legally unclear. In case of a ‘neither avoidable nor treatable’ genetic disease, geneticists should also refrain from actively informing relatives as the justifiable state of emergency does not permit to break the duty of confidentiality. (shrink)

Advances in genetic diagnostics lead to more patients being diagnosed with hereditary conditions. These findings are often relevant to patients’ relatives. For example, the success of targeted cancer prevention is dependent on effective disclosure to relatives at risk. Without clear information, individuals cannot take advantage of predictive testing and preventive measures. Against this background, we argue that healthcare professionals have a duty to make actionable genetic information available to their patients’ at-risk relatives. We do not try to settle (...) the difficult question of how this duty should be balanced against other duties, such as the duty of confidentiality and a possible duty not to know one’s genetic predisposition. Instead, we argue for the importance of recognising a general responsibility towards at-risk relatives, to be discharged as well as possible within the limits set by conflicting duties and practical considerations. According to a traditional and still dominant perspective, it is the patient’s duty to inform his or her relatives, while healthcare professionals are only obliged to support their patients in discharging this duty. We argue that this perspective is a mistake and an anomaly. Healthcare professionals do not have a duty to ensure that their patients promote the health of third parties. It is often effective and desirable to engage patients in disseminating information to their relatives. However, healthcare professionals should not thereby deflect their own moral responsibility. (shrink)

Risk preferences of Australian academics are elicited by analyzing the aggregate distribution of their retirement funds across available investment options. Not more than 10 % of retirement funds are invested as if their owners maximize expected utility under the assumption of constant relative risk aversion with an empirically plausible level of risk aversion. An implausibly high level of risk aversion is required to rationalize any investment into bonds when stocks are available. Not more than 36.54 (...) % of all investments can be rationalized by a model of loss averse preferences. Moreover, the levels of loss aversion typically reported in the experimental studies imply overinvestment in bonds, which is not observed in the data. Up to 67.18 % of all investments can be rationalized by rank-dependent utility or Yaari’s dual model with empirically plausible parameters. A median Australian academic behaves as if maximizing rank-dependent utility with parameter γ∈[0.76,0.79]\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\gamma \in [0.76, 0.79]$$\end{document} in a Tversky and Kahneman probability weighting function. (shrink)

We study the conditions under which increasing risk raises the optimal control variable when the budget constraint is nonlinear. In contrast to the case when the budget constraint is linear, nonlinearities alter the risk attitudes of the economic agent; that is, the agent’s risk behavior is driven by the interaction between the shape of the utility function and the shape of the budget constraint. This paper complements the classical literature with linear payoff functions in two important ways. (...) First, we derive necessary and sufficient conditions for unambiguous comparative statics of changes in risk when the budget constraint is nonlinear. Second, we highlight the critical role of the coefficients of technological improvement and cross-prudence in technology derived from the nonlinear budget constraint in a similar form to that in which the coefficient of relative risk aversion and the coefficient of relative prudence are derived from the utility function. We show several applications of this theory, including the worker’s decision to work in-person during a pandemic. (shrink)

ObjectivesThe purpose of this study was to identify risk factors for delirium after total joint arthroplasty and provide theoretical guidance for reducing the incidence of delirium after TJA.MethodsThe protocol for this meta-analysis is registered with PROSPERO. We searched PubMed, the Cochrane Library and Embase for observational studies on risk factors for delirium after TJA. Review Manager 5.3 was used to calculate the relative risk or standard mean difference of potential risk factors related to TJA. STATA (...) 14.0 was used for quantitative publication bias evaluation.ResultsIn total, 25 studies including 3,767,761 patients from 9 countries were included. Old age has been widely recognized as a risk factor for delirium. Our results showed that the main risk factors for delirium after TJA were patient factors, comorbidities, surgical factors and drug factors.ConclusionsMultiple risk factors were associated with delirium after TJA. These results may help doctors predict the occurrence of delirium after surgery and determine the correct treatment.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42020170031. (shrink)

BackgroundWith advances in sequencing technologies, increasing numbers of people are being informed about a genetic disease identified in their family. In current practice, probands are asked to inform at-risk relatives about the diagnosis. However, previous research has shown that relatives are sometimes not informed due to barriers such as family conflicts. Research on family communication in genetic diseases aims to explore the difficulties encountered in informing relatives and to identify ways to support probands in this.Main bodyResearch on family communication (...) may also reveal that participants did not inform their relatives about the risk of a serious genetic condition, even when preventive and treatment options are available. Researchers may then face a dilemma: Do they need to warn at-risk relatives about the finding? Or do they keep silent due to prior confidentiality agreements with study participants?ConclusionsWe believe that the absolute confidence promised to research participants outweighs the interests of their relatives, even though it can be claimed that relatives at risk of a genetic disease do, in principle, have a right to know information collected about their health. Not respecting confidentiality agreements could cause distrust between researchers and research participants and possibly harm the relationship between probands and relatives. Relatives' health interests can still be taken into account without jeopardizing participant trust, by considering alternative scenarios, including sharing general study findings on the barriers participants experience with their healthcare professionals and by offering participants psychosocial support for family communication. (shrink)

This article analyzes the conditions under which any change in a multiplicative background risk induces a more cautious behavior. We give necessary and sufficient conditions under which any change in the multiplicative background risk with respect to the Nth-degree stochastic dominance raises local risk aversion. Surprisingly, decreasing relative risk aversion of any order up to N in the sense of Pratt coupled with decreasing relative risk aversion in the sense of Ross are sufficient (...) to guarantee an increase in local risk aversion after any deterioration of the multiplicative background risk thanks to the Nth-degree stochastic dominance. We link our results concerning second-order stochastic dominance with the concept of multiplicative risk vulnerability. (shrink)

The current study provides data about the immediate risk perceptions and psychological effects of the COVID-19 pandemic among Italian participants. A sample of 1034 volunteers answered a web-based survey which aimed to investigate the many facets of risk perceptions connected to COVID-19 (health, work, economy, social and psychological), and risk-related variables such as knowledge, news seeking, perceived control, efficacy of containment measures, and affective states. Socio-demographic characteristics were also collected. Results showed that although levels of general concern (...) are relatively high among Italians, risk perceptions are highest with regards to the economy and work, and lowest concerning health. Cognitive and affective risk-related variables affected the several risk perception domains differently. COVID-19 knowledge did not affect any risk perception while the perceived control decreased health risk likelihood. The other risk-related variables amplified risk perceptions: News seeking increased work-economy risk; efficacy of containment measures increased all perceived risks; negative affective states of fear, anger and sadness increased health and psycho-social risks; anxiety increased only health risk, and uncertainty increased work-economy and psycho-social risk perceptions. Finally, positive affective states increased health risk perception. Socio-psychological implications are discussed. (shrink)

We analyze the results from three different risk attitude elicitation methods. First, the broadly used test by Holt and Laury, HL, second, the lottery-panel task by Sabater-Grande and Georgantzis, SG, and third, responses to a survey question on self-assessment of general attitude towards risk. The first and the second task are implemented with real monetary incentives, while the third concerns all domains in life in general. Like in previous studies, the correlation of decisions across tasks is low and (...) usually statistically non-significant. However, when we consider only subjects whose behavior across the panels of the SG task is compatible with constant relative risk aversion, the correlation between HL and self-assessed risk attitude becomes significant. Furthermore, the correlation between HL and SG also increases for CRRA-compatible subjects, although it remains statistically non-significant. (shrink)

The article investigates the resources of contractualist moral theory to make sense of the ethics of risk imposition. In some ways, contractualism seems well placed to explain how it can be reasonable to accept exposure to risk of harms whose direct imposition would not be acceptable. However, there are difficulties getting clear about what directness comes to here, especially given the difficulty of adequately motivating traditional views that assign ethical significance to what the agent intends as opposed to (...) merely foreseeing. The article considers two principles which might help the contractualist: the Redistribution Principle, which, while attractive, is perhaps somewhat too restrictive, and the Aim Consistency Principle, which grants ethical significance to the aims with which our actions are in principle consistent whatever our actual intentions may be. The article also considers the relative significance of ex ante and ex post perspectives from which to evaluate actions and principles. Key Words: contractualism • Doctrine of Double Effect • ethics • intention • justice • risk • T.M. Scanlon • utilitarianism. (shrink)

Biological kin share up to half of their genetic material, including predisposition to disease. Thus, variants of clinical significance identified in each individual’s genome can implicate an exponential number of relatives at potential risk. This has renewed the dilemma over family access to research participant’s genetic results, since prevailing US practices treat these as private, controlled by the individual. These individual-based ethics contrast with the family-based ethics – in which genetic information, privacy, and autonomy are considered to be familial (...) – endorsed in UK genomic medicine and by participants in a multi-method study of US research participants presented here. The dilemma reflects a conflict between US legal and ethical frameworks that privilege “the individual” and exclude “the family” versus actual human genetics that are simultaneously individual and familial. Can human genetics succeed in challenging bioethics’ hegemonic individualism to recognize and place the family at the center of the room where bioethics happens? (shrink)

SummaryThe variability of three behavioural risk factors for heart disease—heavy alcohol and tobacco consumption and physical inactivity—was assessed in an Australian Aboriginal community, where heart disease death rates were high. Prevalence levels were assessed by comparison with those experienced by all adult Australians and by evaluating whether Aboriginal rates were influenced by underlying sociodemographic conditions. Relative risk ratios, odds ratios and logistic regression analysis were used.A total of 159 males and 114 females participated. Compared to all Australians, (...) Aborigines are significantly more likely to drink five or more drinks on a drinking day, to be current smokers, and not to participate in vigorous exercise. In the Aboriginal community, univariate analysis indicates that: the odds of being a heavy drinker are significantly higher for those in unsatisfactory health; odds of being a current smoker are significantly higher for those in unsatisfactory health or unemployed; odds of not participating in vigorous exercise are significantly higher for those in unsatisfactory health, unemployed or without secondary education. Multivariate analysis shows that risk of being a heavy drinker is independently associated with sex, age, and health status; risk of being a current smoker is associated with health and employment status. The risk of not participating in vigorous exercise is significantly related to all sociodemographic variables examined. Reasons for these associations are discussed. (shrink)

A natural view in distributive ethics is that everyone's interests matter, but the interests of the relatively worse off matter more than the interests of the relatively better off. I provide a new argument for this view. The argument takes as its starting point the proposal, due to Harsanyi and Rawls, that facts about distributive ethics are discerned from individual preferences in the "original position." I draw on recent work in decision theory, along with an intuitive principle about risk-taking, (...) to derive the view. (shrink)

Interventions to decrease acquisition and transmission of sexually transmitted diseases among African American women using text messages versus small-group delivery modalities pose distinct research risks and benefits. Determining the relative risk–benefit ratio of studies using these different modalities has relied on the expertise of investigators and their institutional review boards. In this study, African American women participated in focus groups and surveys to elicit and compare risks and benefits inherent in these two intervention delivery modalities, focusing on issues (...) such as convenience, privacy, and stigma of participation. Some risk/benefit variables were implicated in willingness to participate the two intervention modalities. (shrink)

The relatively new discipline of risk analysis promises to provide objective guidance in some of the most controversial issues in modern high‐technology societies. Four conditions are discussed that must be satisfied for this promise to be fulfilled. Since none of these conditions is satisfied, risk analysis does not keep its promise. In its attempts to reduce genuinely political issues to technocratic calculations, it neglects many of the factors that should influence decisions on risk acceptance. A list of (...) tentative guidelines is given for numerical decision support that encourages democratic decision‐making instead of trying to evade it. (shrink)

The literature concerning the possibility and desirability of using new pharmacological and possible future genetic techniques to enhance human characteristics is well-established and the debates follow some well-known argumentative patterns. However, one argument in particular stands out and demands attention. This is the attempt to tie the moral necessity of moral enhancement to the hypothesised risks that allowing cognitive enhancement will bring. According to Persson and Savulescu, cognitive enhancement should occur only if the risks they think it to poses are (...) mitigated by moral enhancement. By this they mean the compulsory and universal amplification of the disposition of altruism and the inflation of our sense of fairness, by chemical and/or genetic means. Their claim is important, intriguing and unsettling. This paper focuses on three central, but relatively neglected, features of their argument. First, there is a pernicious ambiguity in the language of ‘risk’ used by Persson and Savulescu where they tend to conflate ‘risk’ and ‘uncertainty’. Second, their use of the lottery analogy to render their position more plausible is unconvincing. It tends to distort rather than illuminate the relevant considerations. Third, Persson and Savulescu do not adequately take into account the social and individual benefits that enhancing cognition could have. If they did, it would be apparent that those benefits alone would outweigh the considerations used to justify accompanying CE with ME. (shrink)

Stem cells are likely to be used as an alternate source of biological material for neural transplantation to treat Parkinson’s disease in the not too distant future. Among the several ethical criteria that must be fulfilled before proceeding with clinical research, a favourable benefit to risk ratio must be obtained. The potential benefits to the participant and to society are evaluated relative to the risks in an attempt to offer the participants a reasonable choice. Through examination of preclinical (...) studies transplanting stem cells in animals and the transplantation of fetal tissue in patients with Parkinson’s disease, a current set of potential benefits and risks for neural transplantation of stem cells in clinical research of Parkinson’s disease are derived. The potential benefits to research participants undergoing stem cell transplantation are relief of parkinsonian symptoms and decreasing doses of parkinsonian drugs. Transplantation of stem cells as a treatment for Parkinson’s disease may benefit society by providing knowledge that can be used to help determine better treatments in the future. The risks to research participants undergoing stem cell transplantation include tumour formation, inappropriate stem cell migration, immune rejection of transplanted stem cells, haemorrhage during neurosurgery and postoperative infection. Although some of these risks are general to neurosurgical transplantation and may not be reduced for participants, the potential risk of tumour formation and inappropriate stem cell migration must be minimised before obtaining a favourable potential benefit to risk calculus and to provide participants with a reasonable choice before they enrol in clinical studies. (shrink)

In certain cases of sudden death, forensic experts may discover during an investigation or autopsy that family members of the deceased are also at risk of harm—from genetic disease, for instance. But do they have a duty to warn them? Looking at similar duties of physicians and researchers to warn third parties of risk suggests they do.

The article gives a graphical interpretation of the concept of risk vulnerability. It shows that in a specific context of binary lotteries the assumption of risk vulnerability adds to prudence what the assumption of decreasing absolute risk aversion adds to risk aversion. We end the presentation showing that results can be extended to the concept of multiplicative risk vulnerability.

The subsistence technology of forager communities has varied greatly over space and time. This paper (i) reviews briefly the main causal factors the literature identifies as responsible for this variation; (ii) analyzes in some detail the most prominent idea in the literature on spatial variation:Complex technology is an adaptive response to elevated risks of subsistence failure; (iii) it argues that the alleged empirical support for this hypothesis depends on dubious proxies of risk; (iv) it argues that it fails to (...) explain the subsistence technologies of desert foragers, who generally live with simple technologies in high‐risk environments; (v) it offers an alternative analysis, based on the reduced opportunity costs of complex technologies in highly seasonal environments, on the high value of typical forager targets in those environments and their relatively predictable location in space and time; and (v) the paper concludes with a conjecture about the role of environmental variation in toolkit change over deep time. (shrink)

The American Journal of Bioethics, Volume 11, Issue 6, Page W1-W3, June 2011.