Mickey Gjerris

A religious perspective on climate change

The aim of this article is to argue that religions can contribute to fight climate change. It is argued that religions can contribute with ethics. Religions can contribute with reflections concerning fundamental ethical principles as well as practical ethical instructions concerning sustainable lifestyles. But it is also argued that religions can contribute with a world-view that underpins ethics in a very fruitful way. We can want to protect the world because it is beautiful, not simply because it is useful. A religious worldview is articulated very clearly in praise and celebration. Here all of creation is praised and celebrated as the works of an all loving God or Spirit. This implies that the universe, planet Earth and all life on it are seen as creations which all have an intrinsic value. They are not just accidental matter or means for human beings, but magnificent creations which are commendable in themselves, no matter what their utility value may be. According to this religious interpretation ethics are thus grounded in a cosmic love. The motivation for taking care of the environment is love and not rational calculation and duty. A motivation based on positive, elevated feelings such as love, respect, devotion and an experience of beauty is much more vigorous than a motivation based on cool calculations and cold-hearted duty. Religion can engage people at a deeper level than economics and policy, and a deep engagement is extremely important for the success of fighting climate changes, because it is going to take decades.

Ethical aspects of insect production for food and feed

Given a growing global human population and high pressures on resources, interest in insects as a source of protein for human food (entomophagy) and for animal feed is growing. So far, the main issues discussed have been the embedded technical challenges of scaling up the production. The use of insects as a major human food and feed source is thought to present two major challenges: (1) how to turn insects into safe, tasty socially acceptable feed and food; and (2) how to cheaply yet sustainably produce enough insects? Entomophagy, however, as any utilisation of animals and the rest of nature also entails ethical issues – both regarding the impact on human health, the environment and climate change and regarding production methods such as intensification and biotechnology. The aim of the paper is to give a systematic overview of ethical aspects embedded in the notion of utilising insects as protein providers in the Western food and feed production chains. We identify five areas where ethical questions are...

Primo non nocere or maximum survival in grade 2 gliomas? A medical ethical question

BackgroundMaximum safe resection is the “gold standard” in surgical treatment of grade 2 gliomas (G2Gs), aiming to achieve maximal survival benefit with minimal risk of functional deficit.ObjectiveTo investigate the attitude of patients and experts towards more extensive surgery with a trade-off between neurological function and survival time.MethodsEight patients and seven experts participated in semi-structured focus group interviews.ResultsBoth patients and experts accepted the premise of balancing neurological function versus longevity. Some patients would accept an increased risk of permanent neurological deficits in order to obtain a chance of increased survival. There was a significant variance in what constituted “quality of life” both between patients and for the individual patient over time.ConclusionsIn important life-changing decisions there is no “one size fits all”. We find that it is ethically acceptable to offer more extensive surgery than is possible within the concept of maximal safe surgery as a treatment option, when balancing the principles of beneficence, non-maleficience, autonomy and justice supports the decision. At the same time it must be remembered that even when the patients have made a well-informed decision, some will regret it. In that situation it will be our job as healthcare professionals to support them and help carry some of this burden.

Including ethical considerations in models for first-trimester screening for pre-eclampsia

Recent efforts to develop reliable and efficient early pregnancy screening programmes for pre-eclampsia have focused on combining clinical, biochemical and biophysical markers. The same model has been used for first-trimester screening for fetal aneuploidies i.e. prenatal diagnosis (PD), which is routinely offered to all pregnant women in many developed countries. Some studies suggest combining PD and pre-eclampsia screening, so women can be offered testing for a number of conditions at the same clinical visit. A combination of these tests may be practical in terms of saving time and resources; however, the combination raises ethical issues. First-trimester PD and pre-eclampsia screening entail qualitative differences which alter the requirements for disclosure, non-directedness and consent with regard to the informed consent process. This article explores the differences related to the ethical issues raised by PD and pre-eclampsia in order to elucidate which factors are relevant to deciding the type of information and consent required in each context from the perspective of the ethical principles of beneficence and autonomy. Furthermore, it argues that ensuring respect for patient autonomy is context dependent and, consequently, pre-eclampsia screening and PD should be performed independently of one another.

Ethical Issues Related to Screening for Preeclampsia

The implementation of new methods of treating and preventing disease raises many question of both technical and moral character. Currently, many studies focus on developing a screening test for preeclampsia (PE), a disease complicating 2-8% of pregnancies, potentially causing severe consequences for pregnant women and their fetuses. The purpose is to develop a test that can identify pregnancies at high risk for developing PE sufficiently early in pregnancy to allow for prophylaxis. However, the question of implementing a screening test for PE does not only involve an evaluation of technical feasibility and clinical efficacy, it also requires an analysis of how the test influences the conditions and choices for those tested. This study evaluates state-of-the-art techniques for preeclampsia screening in an ethical framework, pointing out the central areas of moral relevance within the context of such screening activity. Furthermore, we propose ethical guidelines that a screening programme for PE should meet in order to become an uncontroversial addition to prenatal health care.

The stigmatization dilemma in public health policy-the case of MRSA in Denmark

BackgroundMulti-resistant bacteria pose an increasing and significant public health risk. As awareness of the severity of the problem grows, it is likely that it will become the target for a range of public health interventions. Some of these can intentionally or unintentionally lead to stigmatization of groups of citizens.DiscussionThe article describes the phenomenon of stigmatization within the health care area by discussing the concept in relation to AIDS and psychiatric diagnosis. It unfolds the ethical aspects of using stigmatization as a public health instrument to affect unwanted behaviours e.g. smoking. Moreover it discusses stigmatization as an unintended albeit expected side effect of public health instruments potentially used to counter the challenge of multi-resistant bacteria with particular reference to the Danish case of the growing problems with Methicillin-resistant Staphylococcus aureus (MRSA) within pig production.SummaryWe argue that using stigmatization as a direct means to achieve public health outcomes is almost always ethically illegitimate. Autonomy and dignity considerations count against it, and the cost-benefit analysis that might by some be taken to outweigh these considerations will be fundamentally uncertain. We further argue that interventions where stigmatization is a side-effect need to fulfil requirements of proportionality, and that they may fall prey to ‘the stigmatization dilemma’, i.e. the dilemma that arises when all policy options are potentially stigmatizing but stigmatize different groups. When this dilemma obtains the decision-maker should choose the intervention that does not lead to permanent stigmatization and that stigmatizes as few as possible, as briefly as possible, and as little as possible.

The Three Teachings of Biotechnology

Publisher Summary This chapter discusses what nanotechnology can learn from biotechnology. Answer to this question depends on why it is asked and who is asking it. This chapter highlights three teachings that are important from the biotechnology experience. These teachings concern the importance of knowing what is discussed, whether disagreements are about factual stuff or values and whether the concept of dialogue is used correctly when all it points to is an “information” campaign. It all depends on the perspective from which one sees the emerging debate, and especially the outcome one hope for. In future it is most likely that nanotechnology will play a growing role. It is therefore crucial that one figures out ways in which to discuss what kind of future one would like to live in and how to bring it about.

What do we do when attenuation of cerebral function goes hand in hand with maximally effective surgery

Dear Editor, We have read with interest the editorial by Hugues Duffau [1] regarding our article in Acta Neurochirurgica titled BPrimo non nocere or maximum survival in grade 2 gliomas? A medical ethical question^ [2]. In our article we address the ethical dilemma that we as neurosurgical treatment teams face when there is a choice to be made between maximal oncological resection resulting in neurological deficits and less radical resection with a lower risk of inducing new neurological deficits. In our article we present empirical data obtained by semistructured interviews with a group of grade 2 glioma (G2G) patients and a group of experts. We analysed the data inspired by the principalistic approach used by Beauchamp and Childress [2]. In this approach we balance beneficence, nonmaleficience, autonomy and justice. The conclusion of our study was that some of our patients would opt for maximal resection of their G2G, knowing that this would result in neurological deficits in order to gain a chance of extended survival time. Duffau argues that this dilemma does not exist. Either because we can offer the patients repeated resection that will not lead to neurological deficits or because we can treat them with chemotherapy resulting in significant increase in survival time without risk of cognitive decline [1]. Our use of repeated resections guided by functional borders may be gleaned from the table in our article, where six out of eight patients hadmore than one resection performed [2]. However, we frequently experience that our G2G patients progress to high-grade gliomas within the tumour volume not resected in order to spare neurological function. This was indeed the case for three of the patients in our article. For these patients the dilemma must seem very real in retrospect: BHad I had the option of more radical surgery, could I then have postponed this change?^ One of our patients expressed this exact sentiment in the study. It is inferred in the editorial that we are not honest with our patients and that wemight be leading them to believe that they will be cured by extensive surgery. This is absolutely untrue. We make it very clear to them that G2G is a deadly disease that we cannot cure, but that we do have an array of treatment options, including varying degrees of surgical resection. And we make it very clear that there is a relationship between the degree of resection and the expected survival time. In short, they are informed that extensive surgery is likely to prolong their life, but not to cure them. Not to inform the patients of the option of extended surgery would to us be to take away the autonomy of the patient in an unacceptable paternalistic fashion. It is likely that the extent of the de facto autonomy of the patients varies between different cultures, even within Europe. Geert Hofstede [3], in his classical cultural theory, demonstrated marked differences in the cultural setting between France and Denmark [3]. On factors such as Buncertainty avoidance^ and Bpower distance^ France scores high and Denmark low. This indicates that Danes in general cope better with uncertainty and less well with an authoritarian approach. Hence, the expression Bone size fits all^ does neither apply to the choice J. Brennum (*) :K. Almdal : C. M. Engelmann Copenhagen Neurosurgery, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 København Ø, Denmark e-mail: jannick.brennum@regionh.dk

Closer to nature: the ethics of ‘green’ representations in animal product marketing

Empirical cases from the Danish food market are examined in order to critically discuss the respective modes of communication in light of the premises of socially responsible consumer marketing. This analysis suggests that specific marketing instruments are used to sell animal products by blurring the difference between the paradigms of animal welfare used by producers, and the paradigms of animal welfare implicit in the public understanding of the concept. These instruments rely on the ethical, political and sustainable consumption discourses in order to sell one image of animal welfare in intensive animal production while the production at the same time presupposes a quite different paradigm of animal welfare. Two cases are used to illustrate this: (1) the Danish dairy company Arla Foods’ campaign with the tagline ‘Closer to nature’; and (2) selected ‘quality brands’ that present themselves as welfare-oriented alternatives to conventionally produced animal products, but with only marginal improvements. The rhetoric of both cases specifically manifests a deep coherence between nature, farm, animal and end product, and thereby creates associations of production tied to lives living in nature - thus attempting to display a green, eco-, climate-, and animal friendly production. The tension between marketing and the idea of ethical consumerism is apparent as the need for independent information to make value-based choices is challenged by the liberal rules of the market and more specifically by the lack of a restrictive food labelling policy. The relationship between the ways in which animal welfare is communicated and emphasized through food marketing, and commonly held perceptions of acceptable standards for animal welfare, is discussed and the need for transparency in the area of animal welfare stressed.

Role of Joy in Farm Animal Welfare Legislation

While animal welfare is commonly invoked in legal debates regarding non-human animals kept for food purposes, the concept of animal joy is rarely mentioned in such contexts. This paper analyzes the relationship between welfare and joy in the German animal protection law ( GAPL ) and in the EU directive 98/58/ EC . Based on a review of scientific and philosophical approaches towards animal welfare, joy is argued to be a part of welfare. Nevertheless, joy is ignored in the German and EU legal provisions. While there may be economic disadvantages of legally protecting animal joy, it is argued that overlooking elements of joy cannot be justified from any ethical perspective that claims to take animal welfare into consideration. In order to clarify the aims of the legal provisions, decision-makers need to define the role joy ought to play in welfare legislation.