Merryn E Ekberg

The Parameters of the Risk Society : A Review and Exploration

This article offers a review and exploration of the parameters of the risk society. The primary focus is on the theoretical works of German sociologist Ulrich Beck and British sociologist Anthony Giddens, and in particular, their claim that we are living in a second, reflexive age of modernity, or risk society, characterized by an omnipresence of low probability—high consequence technological risks. The article concludes that the theorists of the risk society succeed in their goal of raising important questions for reflection and for future research. The risk society thesis succeeds in describing the emergence of a risk ethos, the development of a collective risk identity and the formation of communities united by an increasing vulnerability to risk. It draws attention to how the essentialist nature of risk has been transformed and how the origins and impact of risk have been reassessed. The theory points to a reconfiguration in the way risk is identified, evaluated, communicated and governed. The risk society expands the traditional concept of risk understood as the sum of the probability of an adverse event and the magnitude of the consequences, to include the subjective perception of risk, the inter-subjective communication of risk and the social experience of living in a risk environment. Finally, the theorists of the risk society succeed in iterating that it is not just health and the environment that are at risk, but in addition, the fundamental sociopolitical values of liberty, equality, justice, rights and democracy are now at risk.

An empirical study to identify older adults’ engagement in productivity occupations

Abstract There is little knowledge of the current level of engagement in productivity occupations by older adults in the United Kingdom. The aim of this study, therefore, was to explore the current productivity occupations of adults over 60 years who consider themselves to be healthy and the motivations that underpin those occupations. Structured interviews were conducted with 70 adults with a mean age of 72. Content analysis was used to explain productivity, occupational choices and motivators. The participants identified five roles and occupations they considered to be work: home‐maker, volunteer, carer, paid employee and student, with most holding a home‐maker role. Altruism and pleasure were reported as the most important motivators for engaging in productivity occupations. Further research is required to explore the possible link between pre‐retirement work roles and the productivity choices made in later life.

Exploring the decision to participate in the National Health Service Bowel Cancer Screening Programme

Cancer is a leading cause of mortality and one of the most feared diseases in modern society. A combination of early detection, accurate diagnosis and effective treatment provides the best defence against cancer morbidity; therefore, promoting cancer awareness and encouraging cancer screening is a priority in any comprehensive cancer control policy. Colorectal cancer is the third most common form of cancer in the UK and in an effort to reduce the high incidence, prevalence, morbidity and mortality rates, the National Health Service (NHS) has introduced the NHS Bowel Cancer Screening Programme (NHS BCSP). For the NHS BCSP to succeed in its goal of reducing the incidence and prevalence rates for colorectal cancer, individuals need to be persuaded to complete the test. Since it was first introduced in 2007, however, participation rates have been low. In an effort to understand why participation rates remain low, this article reports on the findings of a series of focus groups conducted in the East Midlands of England. These focus groups were designed to explore the factors that influence an individual’s decision to participate in cancer screening. The findings revealed eight factors that affected participation in the NHS BCSP: (i) the association of screening with entry into old age; (ii) prior experience with health systems; (iii) the support of a significant other; (iv) individual perceptions of risk (and benefit); (v) fear of becoming a cancer patient after the screening test; (vi) lack of disease symptoms; (vii) embarrassment associated with completing the test and (viii) messages that adopt a paternalistic ethos. Overall, our results suggest that more people may participate in the screening programme if it was more sensitive to these psychosocial and contextual factors that shape an individual’s decision to be tested.

Student midwives' responses to reproductive ethics: A qualitative focus group approach using case scenarios

OBJECTIVE the aim of this study was to gain an understanding of how midwifery students respond to a range of ethical dilemmas which they may encounter in clinical practice in relation to the use of reproductive technologies. DESIGN during a series of focus groups, student midwives were asked to consider four novel scenarios, which highlighted some of the most controversial issues in contemporary reproductive ethics. These included assisted reproduction for older women, surrogacy and mental health, sex selection and reproductive cloning. SETTING a University in the East Midlands, England. PARTICIPANTS purposeful sampling was adopted which resulted in four focus groups with a total of 16 student midwives. FINDINGS a process of thematic analysis generated four key themes: choice and expectation, consumer society; distributive justice; parental rights and welfare of the child. CONCLUSIONS our results suggest that student midwives are sensitive to the range of ethical dilemmas associated with the increased use of technology in human reproduction, and construct distinct boundaries in relation to what is considered of benefit or good to the mother, parents, the child and to society and what is considered harmful to the individual, the child and society. They also expressed their opposition to the excessive use of technological intervention, preferring instead to maintain a more naturalistic approach to reproduction. This is especially significant where concerns about the welfare of the child are articulated.

Influences motivating smokers in a radon-affected area to quit smoking

Aims: Domestic radon gas concentrations in parts of the UK are sufficiently high to increase lung cancer risk among residents, and recent studies have confirmed that the risk of smokers developing lung cancer is significantly enhanced by the presence of radon. Despite campaigns encouraging residents of radon-affected areas (RAEs) to test and remediate their homes, public response to the risks posed by radon remains relatively modest, particularly among smokers and young families, limiting the health benefits and cost-effectiveness achievable by remediation. The observation that smokers, who are most at risk from radon, are not explicitly targeted by current radon remediation campaigns prompted an assessment of the value of smoking-cessation initiatives in reducing radon-induced lung cancers by reaching at-risk subgroups of the population hitherto uninfluenced by radon-awareness programmes. This study addresses the motivation of current quitters in a designated RAE using a postal questionnaire administered around one year after the cessation attempt. Methods: Residents of the Northamptonshire RAE who had joined the smoking-cessation programme between July and September 2006 and who remained verifiably tobacco free at four weeks, were subsequently invited to participate in a questionnaire-based investigation into factors affecting their decision to cease smoking. From an initial population of 445 eligible individuals, 205 of those contacted by telephone after 12 months agreed to complete postal questionnaires, and unsolicited questionnaires were sent to a further 112 participants for whom telephone contact had proved impossible. One hundred and three completed questionnaires were returned and analysed, the principal tools being χ2, Mann-Whitney and Kruskal-Wallis tests. Results: Individuals decide to quit smoking from self-interest, principally on health grounds, and regard the effects of their smoke on others, particularly children and unborn babies, as less significant. The risk of developing respiratory, coronary/cardiac or cancerous conditions provides the greatest motivation to the decision to quit, with knowledge of radon among the lowest-ranked influences. Conclusions: This study confirms that quitters place risks to their personal health as the highest factors influencing their decision to quit, and health professionals should be aware of this when designing smoking-cessation initiatives. As radon risk is ranked very low by quitters, there would appear to be the potential to raise radon awareness through smoking-cessation programmes, with the objective of increasing the uptake and success rate of such programmes and encouraging participation in radon-remediation programmes.

Institute of Medical Ethics Guidelines for confirmation of appointment, promotion and recognition of UK bioethics and medical ethics researchers

This document is designed to give guidance on assessing researchers in bioethics/medical ethics. It is intended to assist members of selection, confirmation and promotion committees, who are required to assess those conducting bioethics research when they are not from a similar disciplinary background. It does not attempt to give guidance on the quality of bioethics research, as this is a matter for peer assessment. Rather it aims to give an indication of the type, scope and amount of research that is the expected in this field. It does not cover the assessment of other activities such as teaching, policy work, clinical ethics consultation and so on, but these will be mentioned for additional context. Although it mentions the UK’s Research Excellence Framework (REF), it is not intended to be a detailed analysis of the place of bioethics in the REF.

Assisted reproduction for postmenopausal women.

Abstract With increasing longevity, an ageing population and advances in assisted reproductive technologies (ART), a greater number of women are deciding to have a child and become a mother in their later years. With this social and demographic change, an important social and ethical debate has emerged over whether single and/or married postmenopausal women should have access to ARTs. The aim of this paper is to address this question and review critically the arguments that have been advanced to support or oppose the use of ART by older women. The arguments presented consider the consequences for the individual, the family and wider society. They cover the potential physical and emotional harm to the older woman, the possible impact on the welfare and wellbeing of the future child, and the impact on the norms, values, customs and traditions of society. After reviewing the evidence, and weighing the opposing arguments, this paper concludes that there is no moral justification for a restriction on the use of ART by postmenopausal women. Allowing access to ART for postmenopausal women is an extension of reproductive autonomy and procreative rights in an age where the promotion of agency, autonomy, individual choice and human rights is paramount.