Online research in philosophy

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.

Background: Biomedical science is producing an avalanche of data about risk factors, often with a small predictive value, associated with a broad diversity of diseases. Prevention and screening are increasingly moving from public health into the clinic. Therefore, the question of which risk factors to investigate and disclose in the individual patient, becomes ethically increasingly urgent. In line with Wilson and Jungner's public health-related 10 principles for screening, it seems crucial to distinguish important from unimportant health risks.Aim: to explore the ways in which clinicians distinguish important from unimportant health risks.Methods: We interviewed 36 respondents (gastroenterologists and gynaecologists/obstetrics) in 5 focus group interviews and 15 open in-depth interviews on their interpretation of what makes a health risk important.Results: Physicians primarily interpreted importance as the severity of the possible harm, less often its probability. Possibilities of prevention or reassurance strongly influenced their judgment on importance.Discussion: It is not likely that interpreting ‘important’ as ‘severe’ will help in differentiating meaningful from meaningless risk knowledge. A more fundamental change in our ways of dealing with risk may be called for. We discuss existing literature on resilience as an alternative way to deal with risk. Balancing prevention and risk reduction with resilience could be a fruitful direction.

I argue that although the judgments required to reach statistical risk assessments may reflect policy values, it does not follow that the task of evaluating whether a given risk assessment is warranted by the evidence need also be imbued with policy values. What has led many to conclude otherwise, I claim, stems from misuses of the statistical testing methods involved. I set out rules for interpreting what specific test results do and do not say about the extent of a given risk. By providing a more objective understanding of the evidence, such rules help in adjudicating conflicting risk assessments. To illustrate, I consider the risk assessment conflict at the EPA concerning the carcinogenicity of formaldehyde.

The healing and preventive powers of people's health resources and self-assessed knowledge have so far been grossly underestimated in medicine. In this article, we call attention to ethical and epistemological dilemmas related to knowledge, values, communication, and autonomy embedded in the prevailing risk-oriented epidemiology, and suggest a patient-centred salutogenetic approach to promote a better balance between resources and risks in medicine. Identification and intervention upon risk factors can provide hypotheses about origins of disease and predict and sometimes prevent disease at a group level. However, there are several pitfalls related to this perspective concerning causal factors, group level based possibilities, adequate end points for intervention, informed consent, and medicalization, especially in the individualized context of the clinical encounter. By introducing a salutogenic perspective, we urge to shift the attention toward resources, agency and strength, which may counteract risk of disease and empower the patient. Talk can mediate oppression as well as empowerment. A communicative key question approach, and self-assessed health resources identified through this strategy, are briefly presented as examples of empowerment through dialogue.

The purpose of this presentation is to introduce both the concept of risk and the precautionary principle, that is a major policy principle in present-day risk management. Since risk has been the subject of many misconceptions I will do this in large part by criticizing seven views on risk that I believe to have caused considerable confusion both among scientists and policy-makers. But before looking at the seven myths of risk, let us begin with the basic issue of defining “risk”. The word “risk” often refers, rather vaguely, to situations in which it is possible but not certain that some undesirable event will occur. In addition, the word has several more specialized meanings. Let me illustrate this by making a few statements about the single most important preventable health hazard in non-starving countries. First: “Lung cancer is one of the major risks that affect smokers.” Here, we use “risk” in the following sense: (1) risk = an unwanted event which may or may not occur. 1 (15).

This paper analyses the nature of the relationship between risk and responsibility. Since neither the concept of risk nor the concept of responsibility has an unequivocal definition, it is obvious that there is no single interpretation of their relationship. After introducing the different meanings of responsibility used in this paper, we analyse four conceptions of risk. This allows us to make their link with responsibility explicit and to determine if a shift in the connection between risk and responsibility can be outlined. (1) In the engineer’s paradigm, the quantitative conception of risk does not include any concept of responsibility. Their relationship is indirect, the locus of responsibility being risk management. (2) In Mary Douglas’ cultural theory, risks are constructed through the responsibilities they engage. (3) Rayner and (4) Wolff go further by integrating forms of responsibility in the definition of risk itself. Analysis of these four frameworks shows that the concepts of risk and responsibility are increasingly intertwined. This tendency is reinforced by increasing public awareness and a call for the integration of a moral dimension in risk management. Therefore, we suggest that a form of virtue-responsibility should also be integrated in the concept of risk.

An approach to describing risk analysis, risk perception and risk interpretation under a single umbrella starting with a general definition of risk as "adverse consequences under uncertainty." The idea of risk representation is introduced as an omnibus term for many different ways of conceptualizing risk and deploying risk messages in science, government or society.

Statistics in public life .........................................................................................................5 Things and numbers................................................................................................................8 Representative samples.......................................................................................................8 Averages: meaning and relevance .....................................................................................9 Correlations........................................................................................................................10 Applied statistics ....................................................................................................................13 Relative risks ......................................................................................................................14 Relative risk versus absolute risk.....................................................................................16 Problems of classification and confounding factors....................................................17 Epidemiological research......................................................................................................19 Publication bias..................................................................................................................20 Statistical significance versus scientific relevance................................................................24 Relative risk again..............................................................................................................24 P-values...............................................................................................................................25 Confidence intervals .........................................................................................................26 Correlation is not causation .............................................................................................26 An infamous episode ........................................................................................................27 Terror, utopianism and power .............................................................................................29 Faith and science ...............................................................................................................29 Fear and power: the precautionary principle.................................................................30 Utopian salvation...............................................................................................................32....

Recent research has shown that psychological risk factors play an important role in the pathogenesis of cardiovascular diseases. The so-called coronary prone behaviour pattern predominates, an important part of which is the Type A behaviour pattern. This is characterized by a marked ambition, a constant feeling of being under pressure, due to latent aggression and to a striving to dominate. For cerebrovascular diseases the so-called pressured pattern as a risk factor has been found to be typical which is comparable to the Type A behaviour. Psychological risk factors and their components are not equally important for different vascular diseases. Besides the explanation of the question as to how far psychological processes really are involved in the development of vascular diseases, the research on psychological risk factors serves as a foundation for psychosomatic theories.

Risk is the probability that within a certain time some expected negative event will take place. In medicine risk can be related to a decision or to some intrinsic factors which are associated with the probability of the occurrence of a disease. Decisions can be necessary in the individual life with respect to the question of visiting a physician or performing a certain diagnostic or therapeutic procedure. The introduction of new pharmaceutical or technical products into medical use are another set of decisions which can generate certain risks. Intrinsic or inherent risk factors are a set of variables or signs and symptoms which indicate the presence of a certain probability that some disease or event, e.g., arteriosclerosis or sudden infant death syndrome, may occur. Risk is always related to judgement. In a decision process cost, effectiveness and profit can be used to estimate the magnitude of the risk to be taken. In a similar way the problems in connection with an inherent risk are primarily related to the recognition of the magnitude of risk and to the possibility of prophylactic measures.In our own area of research, the sudden infant death syndrome (SIDS) is an event where only risk factors can be observed. We point at two facts in this context: Highly complex patterns of symptoms like behaviour can better be classified by intuitive Gestalt perception. A medical procedure like induction of labour can itself become a risk factor.