Christof Tannert

The ethics of uncertainty: In the light of possible dangers, research becomes a moral duty

Uncertainty touches most aspects of life, especially when we make decisions that have consequences that we cannot predict. Leaving the house without an umbrella carries a risk because it could start to rain; investing in the stock market carries the risk of losing money. It is therefore natural that, whenever we make decisions with unpredictable outcomes, we weigh up the possible results and their risks and benefits. Of course, some decisions carry more severe risks than getting wet or losing money; the decision to approve a new drug or to ban certain chemicals in products can have far‐reaching consequences for health, the environment, society and economies. In such cases, where the lives of others are at stake, decision‐making and the handling of uncertainties have important ethical dimensions. A prudent strategy to deal with this ethical challenge is to diminish uncertainty by acquiring knowledge of the issue. When it comes to decisions that affect peoples lives and health—the regulation of potentially harmful substances or diagnostic tests to predict an individuals propensity to develop a severe disease—carrying out research to diminish uncertainty and, consequentially, risks can become an ethical duty. If this is not possible—because decision‐makers cannot wait for the relevant research or the gaps in our knowledge are not accessible to scientific investigation—the precautionary principle is increasingly advocated and used as an alternative strategy to make decisions in light of uncertainties. However, the application of the precautionary principle itself can create dangers (Wiedemann & Schutz, 2005) that have to be weighed against the benefits of adopting it—so‐called iatrogenic risks (Wiener, 1998)—and therefore also has a serious ethical dimension that needs to be considered. In this viewpoint, we investigate the role of uncertainty in the field of practical ethics. This is a relatively new issue on the ethical research agenda, which began …

Stem-cell research: the state of the art

Future regulations of embryonic-stem-cell research will be influenced more by economic interests and cultural history than by ethical concerns

The future of stem‐cell research in Germany

The controversial issue of stem‐cell research encompasses a truly interdisciplinary field that involves not only various scientific disciplines, but also medical, ethical, political, legal, societal and economic aspects. It is no surprise then that this research—in particular when using human embryonic stem cells (hESCs)—has led to an intense debate about the possible medical and economic benefits as well as the ethical and societal problems of using human embryos in biomedical research. These debates have affected various countries, most notably the USA and Germany, and have led to different legal regulations and limitations of stem‐cell research. > Although the current discussions mainly revolve around therapeutic applications, it is important to note that stem‐cell research is, for the most part, still at the stage of basic research We have conducted a study among leading German stem‐cell experts on the future of embryonic and adult stem‐cell research in this country to assess its scientific, therapeutic and social prospects. It revealed that, in addition to ethical problems, different expectations about the scientific and therapeutic prospects of embryonic and adult stem‐cell research account for the current German preference for adult stem cells. Nevertheless, the majority of German experts expect an increasing open‐mindedness towards embryonic stem‐cell research in this country, as well as a relaxation of legal restrictions. Based on their origin, stem cells are broadly categorized into either adult (syn. somatic), or embryonic stem cells. Both cell types can—to different degrees—differentiate into various specialized cells and tissues, which has created considerable scientific and medical interest. Biologists in basic research hope to gain insight into the fundamental processes of human cell development, whereas biomedical researchers want to use stem cells to replace failing cells, and eventually whole tissues, as a therapy for various—as yet incurable—diseases. Although the current discussions mainly revolve around therapeutic applications, it is important …

Mobile phones and health: Media coverage study of German newspapers on possible adverse health effects of mobile phone use

The scientific debate about potential risks from the radio frequency electromagnetic fields (RF-EMFs) of mobile telecommunication is ongoing, accompanied by considerable media discussion about whether electromagnetic fields from mobile phones cause adverse health effects. Since most people do not make use of scientific databases, the print media are key actors in informing the public about scientific developments concerning potential health risks from mobile telecommunication. In order to analyse the kind of information German print media provide to the public, a media analysis of a sample of German newspapers during the years 2002–2007 was performed: 17 regional and national daily newspapers were analysed along with weekly journals. The results indicate that, besides ambiguous media coverage, there are remarkable differences among the various newspapers in their approach to the topic. Most newspapers highlight unspecified, potentially adverse effects and link mobile phone use to the development of cancer, which is not supported by current scientific knowledge. However, in recent years, a slight shift in the foci of reporting can be observed. As these results show, newspapers increasingly acknowledge the existence of scientific uncertainty and provide more detailed information on the topic.

Future trends and challenges in pathogenomics

The difficult thing about the future is that it is so hard to predict. After the Second World War, the availability of vaccines and antibiotics and the successes of improved hygiene and public health policies led to such a dramatic fall in mortality that in 1969 the US Surgeon General claimed that “we can close the book on infectious diseases.” In hindsight, his prediction of the future was utterly wrong—infectious diseases are back with a vengeance. Nearly 25% of the annual deaths worldwide are directly related to pathogens (Morens et al , 2004); multidrug‐resistant tuberculosis and HIV/AIDS are on the rise worldwide; and Staphylococcus and Enterococcus strains in Western hospitals are becoming increasingly resistant to antibiotics. In addition, the rapid spread of new pathogens, such as the SARS (severe acute respiratory syndrome) and West Nile viruses, has shown the frailty of global public health, which is further affected by tourism and trade. Experts in security and public health also worry that publicly available scientific information and advanced genetic technologies could be misused to create weapons for bioterrorism. To overcome these threats to human health, research on pathogenic microbes and the development of new diagnostics, vaccines and therapeutic strategies remains an important task at the beginning of the twenty‐first century. It is in this context that we conducted our Foresight study, ‘Future Trends and Challenges in Pathogenomics’, as part of the EU‐funded ERA‐NET project PathoGenoMics, to provide an overview of current and future trends and challenges in the field of genomic research on pathogenic microorganisms. Clearly, a Foresight study is not a crystal ball to peek into the future, but it does allow the identification of important trends in science, as well as perceived gaps in research, and places them in the context of future challenges for public health. > …trends and developments …

The Autonomy Axiom and the Cloning of Humans

Many people all over the world are convinced that cloning human beings is unethical and should be outlawed through prohibitions in criminal law. In spite of this, debate flares up repeatedly whenever experiments with human embryonic cells are carried out somewhere in the world. This will continue to happen as long as the conviction that cloning human beings is unethical lacks a logical philosophical-ethical foundation, which is still the case1,2. In addition, a foundation that could be more permanent against the background of different cultural traditions is particularly absent.

Online-Diskurs zu den ethischen Fragen der Biomedizin

Eine zunehmend heterogene Zivilgesellschaft bildet kontextabhängig verschiedene Öffentlichkeiten heraus, deren Einbindung transparente Entscheidungsprozesse einerseits und Diskurskompetenz andererseits voraussetzt. Das Projekt verfolgte mit der Offerte eines elektronischen Forums deshalb methodisch die Frage, inwieweit elektronische Plattformen genutzt werden können, um neben hochrangigen Interessenvertretern auch ressourcenschwache in Diskurse einzubinden. Dies ist quantitativ nur unzureichend gelungen. Es wird angenommen, daß vor allem die Einbindung eines solchen Verfahrens in politische Entscheidungsfindungsprozesse über tragfähige und transparente neue Strukturen die Motivation der Teilnehmer erhöhen und damit die Anwendbarkeit und die Qualität dieser Methode entscheidend verbessern könnte. Inhaltlich hat sich gezeigt, daß die Schnittstelle zwischen Forschung und klinischer Anwendung beziehungsweise klinischen Standards von allen Beteiligten, also von Forschern, Medizinern, Betroffenen, Politikern und Begleitforschern, als zentraler Aspekt in der Debatte um medizinische Innovation, ihren Beitrag zu neuen Therapien und ihrer gesellschaftlichen Akzeptanz gesehen wird. Die Bewertung neuer Therapiechancen darf nicht nur innerhalb eines medizinischen Paradigmas erfolgen, sondern muß darüber hinaus sowohl lebensweltliche Aspekte der zu Behandelnden als auch gesellschaftliche Ansprüche an die ethisch-soziale Akzeptierbarkeit zu befriedigen wissen. Die Ergebnisse dieses Online-Diskurses regen zum Nachdenken darüber an, wie man der Schnittstelle Forschung – Anwendung eine breitere Wissensund Erfahrungsbasis zur Verfügung stellen kann. Grundsätzlich muß die Frage beleuchtet werden, inwieweit der zur Zeit weitgehend exklusiv kontrollierte Bereich der Anwendung von medizinischer Grundlagenforschung größerer Transparenz bedarf und wie diese erreicht werden könnte. Aufgrund dieser Überlegungen empfehlen wir den Ausbau von qualitativ hochwertigen Diskursverfahren zum besseren Verständnis der Interessenlandschaft. Nicht zuletzt aus Gründen der Praktikabilität und Ressourcenersparnis sollten dabei auch elektronische Medien verstärkt zum Einsatz kommen.