Yvonne Cuijpers

Assessing the Sociocultural Impacts of Emerging Molecular Technologies for the Early Diagnosis of Alzheimer's Disease

Novel technologies for early diagnosis of Alzheimers disease (AD) will impact the way society views and deals with AD and ageing. However, such “sociocultural” impacts are hardly acknowledged in standard approaches of technology assessment. In this paper, we outline three steps to assess such broader impacts. First, conceptual analysis of the ideas underlying technological developments shows how these technologies redraw the boundary between Alzheimers disease and normal ageing and between biological and social approaches of ageing. Second, imaginative scenarios are designed depicting different possible futures of AD diagnosis and societal ways to deal with ageing and the aged. Third, such scenarios enable deliberation on the sociocultural impact of AD diagnostic technologies among a broad set of stakeholders. An early, broad, and democratic assessment of innovations in diagnostics of AD is a valuable addition to established forms of technology assessment.

Assessing the application of the 3Rs: a survey among animal welfare officers in The Netherlands.

Implementation of the 3Rs (Replacement, Refinement and Reduction) in animal studies is a legal requirement in many countries. In The Netherlands, animal welfare officers (AWOs) are appointed to monitor the welfare of laboratory animals. As part of this task, AWOs give advice to researchers and can therefore have an influential role in implementing 3R methods in research. A national survey was conducted to gain more insight into how Dutch AWOs obtain and apply 3R information in their daily work. Nearly half of the AWO population filled out the questionnaire (15/32; a response rate of 46.9%). Two-thirds of the respondents pointed out that finding 3R information is not an easy task and more than half of the respondents believed that information on possibilities to implement the 3Rs is regularly being missed. The respondents indicated that most 3R information is obtained directly from colleagues and other AWOs. Special online 3R databases are rarely used. All the responding AWOs feel that they contribute to Refinement (15/15), nearly one-third of the respondents feel they contribute to Reduction (4/15), and one AWO feels he/she contributes to Replacement (1/15). According to the respondents, better exchange of knowledge can contribute to more successful implementation of the 3Rs. How this knowledge exchange can best be established and facilitated needs further exploration. To this end, the authors make suggestions for a 3R-integrated evidence-based approach.

Quandaries of responsible innovation: the case of Alzheimer's disease

The interest in responsible innovation has led to various activities to include social, economic and moral concerns in the process of innovation. This ambition, however, brings along several fundamental questions. We encountered these in a project on responsible innovation in the case of new molecular early diagnostics for Alzheimer’s disease (AD). Currently, a number of novel technologies are being developed for in vivo early diagnosis of AD, by identifying and testing new molecular biomarkers. In our project, we study scientific and clinical uncertainties in technology development, analyze the social and cultural as well as the moral implications of existing and alternative ways to deal with them. In this chapter we summarize the fundamental questions about responsible innovation in terms of six ‘quandaries’: problematic, difficult and ambiguous conditions that somehow require fundamental and practical decisions.

Dikes and Dementia: How Multiple Framings of Dementia Coexist During the Development of a National Dementia Strategy

Currently, national dementia strategies are being developed worldwide. Since multiple approaches to dementia coexist, strategies to address dementia as a nation are not straightforward. Cuijpers provides a reconstruction and analysis of which framings of dementia are articulated in the course of development of a Dutch dementia strategy, and how stakeholders deal with the coexistence of multiple framings of dementia. The chapter delineates three models of coexistence: a model where different frames are considered ‘fragments of a whole’; one where they are in antagonistic positions; and a model where different frames move in different directions. The process of constructing a national dementia strategy and the surrounding discussions take different shapes, depending on the assumed model of how approaches to dementia coexist.