ABSTRACT. This presentation explores the relationship between values in scientific and technological research, on the one hand, and features of the organizations that conduct that research, on the other. There are at least three different levels at which the nature and role of values can be examined. One is at the level of the individual, which is the level that most philosophers of science have emphasized (e.g., Brown 2020; Douglas 2009). At a much higher level, one might examine the ways in which societal considerations – including regulatory decisions, national funding strategies, and political priorities – impact values embedded in research (e.g., Biddle 2013, 2014; Douglas 2015). The focus here is at an intermediate level – namely, the level of the organization. I will draw upon literatures in philosophy of science and organization theory to provide a framework for examining how organizational features impact values in science and technology, with a focus on data sciences and machine learning.

There are at least three aspects of organizations that can significantly impact values embedded in research: organizational aims, organizational structure, and organizational culture. Organizational aims include financial profit (e.g., for-profit firms), provision of public services (e.g., government agencies), and fostering social or political change (e.g., NGOs). Organizational aims can impact values in several ways, including by impacting decisions about problem framing – which problems it considers to be worthy of pursuit and how it frames those problems. Organizational aims also impact the framing of ethical issues – which ethical issues are prioritized and which are not (e.g., Schiff et al. 2021).

Organizational structure concerns the relations that hold between different intra-organizational entities, such as offices and individuals. Organizational structure – in particular, the division of labor between researchers or research activities – influences the range of values brought to bear on research decisions. In the case of research conducted by organizations with strict divisions of labor, values that influence one set of decision tasks will tend to remain unexamined by those involved in other decisions tasks (e.g., Walsh, Li, and Tang 2019). The impact of division of labor on values is particularly significant in research that involves different organizations with distinct organizational aims, as is the case in many data-driven systems (e.g., Biddle 2020; Richardson, Schultz, and Crawford 2019).

Organizational culture includes the norms, values, and assumptions that operate in an organization and impact social relations and decision making. An organization’s culture impacts which behaviors are incentivized and which are sanctioned, as well as who is included in decision making. I distinguish between inclusive culture (c.f., Kanter 1988; Longino 2002) and cut-throat culture (c.f., Pisano 2019) and show how the culture of an organization impacts how it manages epistemic risks, which in turn reflects value judgments about the permissibility of various types of impacts and their distribution over different groups.

The relationship between values and organizations is under-studied by philosophers, and the framework developed in this presentation can provide a starting point for further research into organizational levers for the management of values in science and technology.

References:

Biddle, Justin (2013). “Institutionalizing Dissent: A Proposal for an Adversarial System of Pharmaceutical Research.” Kennedy Institute of Ethics Journal 23: 325-353.

Biddle, Justin (2014). “Can Patents Prohibit Research? On the Social Epistemology of Patenting and Licensing in Science.” Studies in History and Philosophy of Science 45: 14-23.

Biddle, Justin (2020). “On Predicting Recidivism: Epistemic Risk, Tradeoffs, and Values in Machine Learning.” Canadian Journal of Philosophy. DOI: http://doi.org/10.1017/can.2020.27

Brown, Matthew. 2020. Science and Moral Imagination: A New Ideal for Values in Science. Pittsburgh: University of Pittsburgh Press.

Douglas, Heather (2009). Science, Policy, and the Value-Free Ideal. Pittsburgh: University of Pittsburgh Press.

Douglas, Heather (2015). “Reshaping Science: The Trouble with the Corporate Model in Canadian Government.” Bulletin of the Atomic Scientists 71: 88-97.

Kanter, Rosabeth Moss (1988). “When a Thousand Flowers Bloom: Structural, Collective, and Social Conditions for Innovation in Organizations.” Research in Organizational Behavior 10: 169-211.

Longino, Helen (2002). The Fate of Knowledge. Princeton: Princeton University Press.

Pisano, Gary (2019). “The Hard Truth about Innovative Cultures.” Harvard Business Review.

Richardson, Rashida, Schultz, and Kate Crawford (2019). “Dirty Data, Bad Predictions: How Civil Rights Violations Impact Police Data, Predictive Policing Systems, and Justice.” New York University Law Review 94: 192-233.

Schiff, D., J. Borenstein, J. Biddle, and K. Laas (2021). “AI Ethics in the Public, Private, and NGO Sectors: A Review of a Global Document Collection.” IEEE Transactions on Technology and Society 2(1): 31-42. DOI: http://dx.doi.org/10.1109/TTS.2021.3052127

Walsh, John, You-Na Lee, and Li Tang (2019). “Pathogenic Organization in Science: Division of Labor and Retractions.” Research Policy 48: 444-461.

ABSTRACT. Recent work on inquiry has by and large focused on individual inquiries. However, many of the inquiries we most care about – scientific research, jury trial, medical diagnosis, to name a few – are carried out by institutions or individuals working within an institution.  If we want to understand and critique scientific inquiry, which predominantly takes place within institutions, then our theories of inquiry had better offer some insight into how institutional inquiry works.   I argue, using scientific research and medical diagnosis as case studies, that existing theories of inquiry struggle to account for institutional inquiry. I then reflect on what institutionally inquiry can teach us about inquiry more generally? Why think that institutional inquiry is distinctive? It may seem obvious that a research lab's inquiry differs from my frantic search for my keys. The lab is a group of people, while I'm an individual, and they are subject to strictures that I am not. However, neither of these features distinguish institutional inquiry.  A single doctor might examine a patient, yet her inquiry is institutional.  A ragtag group of barflies might inquire into where Lone Star is made, but their inquiry is not institutional. Similarly, non-institutional inquiries can follow strict protocols. I might impose all manner of strictures on my inquiry into which brand of coconut milk is best. No matter how many double-blind taste tests I do, however, my inquiry is not institutional.  The features that distinguish institutional inquiry are deeper than the number of people inquiring or the rules they follow.  First, the conditions under which institutional inquiries are resolved differ.  Individual inquiry resolves successfully when the inquirer achieves belief or knowledge of an answer to their question. However, institutional inquiries do not necessarily resolve even when everyone involved with the inquiry believes or even knows an answer to the question at hand.  For instance, suppose the FDA undertakes an inquiry into whether a sunscreen filter, Tinosorb M, is safe.  Tinosorb M has already been approved by the FDA's counterparts around the world and there is abundant evidence for its safety.  Everyone at the FDA, then, may know full well that Tinosorb M is safe.  Their knowledge alone, however, is not sufficient to conclude their inquiry– they have to inquire until the institution's goals are met. Second, what it takes to count as inquiring at all is different between individual inquiries and institutional inquiries. Jane Friedman (2019) argues that inquiring requires the inquirer to have an interrogative attitude, like curiosity or wondering, towards the question at hand. However, individuals inquiring within an institution need not (and often do not) have interrogative attitudes towards questions they are inquiring into.   For instance, a burnt out doctoral student might genuinely inquire into the question his lab is working on, even if he neither wonders nor is curious about what the answer is. So, whatever the conditions under which individuals inquire on behalf of institutions, they differ from the conditions on non-institutional inquiry. Institutional inquiry, then, is a poor fit with many existing theories of inquiry.  However, medical diagnosis, scientific studies, and jury trials are core cases of inquiry.  It is crucial, then, that we amend our theories of inquiry to capture institutional inquiry.

ABSTRACT. Within disability studies and the philosophy of disability, the frameworks for understanding disability center around the medical, social, and political models of disability. However, a fourth framework, largely neglected by these scholars, features significantly in health policy—namely, the economic model of disability. The economic model of disability presumes that disabled people are unable, in virtue of their impairments, to engage in gainful employment and are thus relegated to participation in the need-based welfare economy. Medical professionals certify individuals’ level of disability, and confirm that they are deserving of aid. Many persons with disabilities are willing and able to work, yet find their access to needed social supports threatened when they seek paid employment. Furthermore, ableist prejudice and discrimination often prevent persons with disabilities from finding or keeping jobs which they would otherwise be qualified for. CHRIL researchers conducted a series of 30 semi-structured interviews with a group of working aged disabled individuals. These interviews queried participants about their experiences with the US healthcare system, their access to health coverage, and how these factors affected their ability to work and live independently. An analysis of these interviews showed that institutional forces and attitudes helped shape the values of disabled individuals, and also impeded them in realizing their desire to live and work independently and take part in their community. First person accounts are an essential tool in disability research. As demonstrated by these interviews, the economic model, US health policy, and the policies of disability benefits institutions shape the life experiences of disabled healthcare recipients in powerful ways. Kennedy and Blodgett have observed that many disabled individuals seek disability benefits as a way of attaining health insurance. However, given the adversarial nature of the benefits enrollment process, and the presumption of deception, Social Security Disability benefits administrators deploy a poverty test to ensure as few people as possible leave the work-based economy. Only if enrollees are willing to live in poverty are they considered genuinely disabled and deserving of benefits. In addition to the poverty test, disabled individuals must face supposedly objective medical gatekeepers to attain benefits. But the measures of disability that they deploy are frequently not fit for purpose and pretend to a level of precision that cannot be justified. Diagnosis is a poor predictor of function, yet it continues to serve as the touchstone of disability benefits evaluation. This paper aims to show that judgments about whether disabled individuals are deserving of aid are inevitably value laden, and that the values of benefits administrators and health policy makers are frequently at odds with those of the disability community.

ABSTRACT. The interplay between science and society is usually examined in the context of Western democracies. Scholars have shed light on various aspects of democratic engagement with science, commercial and political pressures upon science, and the proper place of science in democratic societies. However, focusing on the interaction between democratic societies and science does not consider that significant amounts of research are done in anti-democratic societies and that scientists have played important roles in catalyzing democratization of some authoritarian societies. In this presentation, I examine one instance of scientists’ involvement in public life that helped transition former Moldavian Soviet Socialist Republic (MSSR) to democracy. In September 1988, 66 intellectuals, most of whom were PhDs in Philology, Physics, Mathematics, History, Pedagogy, Psychology, addressed an open letter to the interdepartmental committee of the MSSR legislature tasked with the study of problems of history and issues of development of Moldovan language. The letter urged the committee to pursue these tasks: 1) reject the theory of two Romance languages north of Danube, and implicitly recognize that a Moldovan language does not exist; 2) re-introduce the Latin alphabet to replace the Cyrillic; 3) make the language of Moldovans an official language; 4) adopt an interdisciplinary and comprehensive set of measures to create the necessary conditions for the unrestricted functioning of the language of Moldovans; and 5) consider that those measures will diminish the tense interethnic relationships due to the subpar status of the language. This letter catalyzed the transition to democracy in MSSR. Demands 1) and 2) challenged the official Soviet line that had asserted for decades that Moldovan is a language distinct from Romanian, although similar, and that it should use the Cyrillic alphabet. The Communist Party of MSSR held the authority to decide what was scientific and what scientists (and other citizens) could say in public, which represented a direct intrusion of the political into the scientific. By challenging the official dogma, scientists who signed the letter contested the authority of the Party to prescribe scientific truths, claimed the autonomy of science, and asserted the separation of powers, which characterizes democracies. Demands 4) through 5) raised issues of linguistic justice because the language of the indigenous majority was seen as oppressed by Russian, language of a minority in MSSR that yielded immense political, economic, and social power. That the editor of a newspaper agreed to publish scientists’ letter was an act of defying party control and asserting a free press. That scientists challenged the Party in public was an act of asserting freedom of speech. Citizens followed suit and forced public debates on those issues, bringing about social change. The letter suggests that the role of science in society is neither that of passive, on demand resource, nor of technocratic ruler, but of an autonomous branch of power that can challenge the political. Additionally, the letter aligns with other efforts by Soviet and non-Soviet scientists to refuse unacceptable political intrusion into science and press politicians to uphold human rights and act on social issues.

Selected Bibliography: Atwoli, L., Baqui, A. H., Benfield, T., Bosurgi, R., Godlee, F., Hancocks, S., ... & Vázquez, D. (2021). “Call for emergency action to limit global temperature increases, restore biodiversity, and protect health.” The British Medical Journal, 374:n1734. http://dx.doi.org/10.1136/bmj.n1734 Brown, M.B., (2009). Science in democracy: Expertise, institutions, and representation. MIT Press: Cambridge, MA.

Collins, H., & Evans, R. (2017). Why democracies need science. John Wiley & Sons: Cambridge, UK.

Douglas, H., (2021). The Rightful Place of Science: Science, Values, and Democracy: The 2016 Descartes Lectures. Consortium for Science, Policy & Outcomes.

Feyerabend, P., (1978). Science in a free society. Verso Books: New York.

Gilligan, E. (2004). Defending human rights in Russia: Sergei Kovalyov, dissident and human rights commissioner, 1969-2003. Routledge.

Hartl, P. and Tuboly, A.T. eds., 2021. Science, Freedom, Democracy. Routledge: New York and London.

Jasanoff, S. (1998). The fifth branch: science advisers as policymakers. Harvard University Press: Cambridge, MA.

Joravsky, D. (2010). The Lysenko affair. University of Chicago Press: Chicago.

Istru, Bogdan, et al. (1988). Open Letter (Scrisoare Deschisă), Învățământul Public, September 18, p. 4.

Jimulev, I. F., & Dubinina, L. G. (2005). New Information about “The Letter of Three hundred” – a massive protest from 1955 of Soviet scientists against Lysenkoism, Vavilov Journal of Genetics and Breeding, 9(1), 13-33) (Жимулев, И. Ф., & Дубинина, Л. Г. (2005). Новое о «Письме трехсот»—массовом протесте советских ученых против лысенковщины в 1955 г. Вестник ВОГиС, 9(1), 13-33).

Lacey, H. (2005). Is science value free?: Values and scientific understanding. Routledge: London.

Pringle, P. (2008). The murder of Nikolai Vavilov: The Story of Stalin's persecution of one of the great scientists of the twentieth century. Simon and Schuster: New York.

Ripple, W. J., Wolf, C., Newsome, T. M., Galetti, M., Alamgir, M., Crist, E., ... & 15,364 Scientist Signatories from 184 Countries. (2017). World scientists’ warning to humanity: a second notice. BioScience, 67(12), 1026-1028.

Smith, H. (2020). Yuri Orlov, physicist who became a symbol of Soviet dissent, dies at 96, Washington Post, September 30.

ABSTRACT. In this paper, I argue that conceptual modeling practices used in management contexts in ecology challenge the stability of the constitutive/contextual (also, epistemic/non-epistemic) values distinction that is upheld in much philosophy of science. Conceptual modeling strategies demonstrate two things about scientific practice that lend support to this claim. First, conceptual modeling strategies provide further grounds for a heavily pluralistic interpretation of science in which practices are tailored to achieve a diversity of aims. Second, the use of conceptual models offers an interesting case for interrogating how values influence scientific work, as a main aim in the modeling process is incorporating societal values. Conceptual models and modeling strategies are deployed in a number of sciences—e.g., ecology and geology—to grapple with the causal links between elements of large-scale systems. Conceptual models in ecology are often used in management contexts, in which the control or removal of some toxic substance(s) is the primary aim. The models are often quite simple prima facie, employing diagrammatic structure with boxes and arrows used to represent components of the system and the ways in which they interact. One team of ecologists, Gentile et al. explicitly call for “[r]egional- and landscape-scale assessments, involving cumulative risks from multiple stressors affecting a diversity of ecological resources…” but acknowledge that these assessment styles, “pose unique regulatory as well as scientific challenges” (2001, p. 232). They rely heavily on conceptual modeling to achieve these aims. While some will be used to make predictions or offer explanations, conceptual models also provide a scaffolding from which further scientific investigation can proceed. The aims associated with conceptual modeling include (though are not limited to) generating hypotheses, forming consensus among researchers, uniting seemingly separate research programs, and identifying and communicating locales of intervention or management. The role of conceptual models is to provide an impression of large causal systems from which scientists can explore the answers to epistemic and practical questions, with explicit interrogation of societal values. Conceptual models have yet to see much attention in the philosophy of science, but they offer an insightful case for those interested in science as a pluralistic endeavor: science as constitutive of many diverse practices and aims, beyond a narrow theory-centrism. Once we accept that science is populated with a diversity of practices—including management—it becomes easier to see traditionally non-epistemic or contextual values as constitutive of some scientific practices, breaking down the distinction. Societal values do not merely provide the context in which management is done but are constitutive of the process of developing effective models. The more formal work that is inspired by these models is then necessarily tied to gaining a theoretical understanding of societally important phenomena. This implies that the categories of epistemic and non-epistemic values may have different conditions in different domains of science, weakening the distinction as broadly applicable to science generally.

References Gentile, J.H. et al. 2001. “Ecological conceptual models: a framework and case study on ecosystem management for South Florida sustainability.” Science of the Total Environment 274. pp. 231-253.

ABSTRACT. I am proposing a lightning talk with 2-4 slides. I will describe the Engineering Ethics class I am teaching, which has been designed as part of a collaborative research grant from NSF's IUSE program. I will pay special attention to the key assignment of the class, a field exercise in listening to residents of Newark, NJ. However, I will also discuss the project as a whole and what we hope to learn from it.

ABSTRACT. One opposite of the values of honesty and fair play is cheating. Cheating happens in schools, workplaces, research, and sports. This is a proposal for a traditional individual 20-minute presentation or a short-form presentation (poster session) about the game of chess as a case study for in-person and online cheating. Both in-person and online chess cheating utilize technology, such as chess engines which are stronger than humans at playing chess.

While playing chess online has been around for a few decades, during the pandemic homebound players have grown the game exponentially. CBS News quoted Grandmaster Maurice Ashley as saying “the pandemic has driven people indoors, and they’re looking for something incredible, constructive, educational to do.”

Moreover, the Netflix hit series The Queen’s Gambit has sparked increases in searches for learning chess. For the most part, the mainstream media portrays chess as a worthy, honest game. A CNN article stated, “Chess is a game of intellect. Remember intellect? In a world where every news development seems more implausible than the last, there is something infinitely reassuring in retreating to a series about a cerebral game, in which (this is not spoiling anything, I think) nobody cheats.”

Notwithstanding that CNN article’s positive interpretation of The Queen’s Gambit, there is a long history of over-the-board cheating in chess and more recent incidents of online chess cheating.

Increased cheating could derail the chess publicity train. Rather than being seen as a game that encourages intellect and truth, chess might be dismissed as a game for cheaters. Chess websites have stepped up their anti-cheating efforts, though perhaps with some unintended consequences. What can the game of chess, as a case study, tell us about cheating, both online and in-person?

The presentation will cover, with respect to chess: 1) Why people cheat 2) How people cheat 3) Anti-cheating protocols and their consequences, both intended and unintended.

A brief discussion of implications for other fields, such as cheating in schools, will be included.

ABSTRACT. When assessing the truth of simple declarative assertions, the identity of the speaker and their mental states do not seem relevant. For example, ​​the truth of the assertion “A two-dose regimen of BNT162b2 conferred 95% protection against Covid-19 in persons 16 years of age or older” should not hinge on the intentions of the speaker, even if our confidence about the assertion or the reasoning behind the assertion does (see Polack, et al. 2020). Yet, appeals to conflicts of interest and differing values frequently feature in arguments for vaccine hesitancy. One possible explanation is that ordinary truth assessments may be sensitive to the identity or mental states of the speaker, contrary to standard approaches to truth. Our work—bridging psychological and philosophical research on truth, trust, pragmatics, and moral reasoning—tests whether mental state inference underlies lay conceptions of truth. Specifically, across three preregistered studies (N = 1,925), we tested whether the intentions people attribute to information sources influence their classification of assertions as true or false. In each study, participants read real scientific findings and assessed reports of those findings. Participants were equally distributed across neutral, informative, and deceptive conditions, which were designed to signal the intent of the speaker. Participants in conditions that signaled intent to deceive were significantly more likely to classify the agents’ reports as false, despite seeing that the statement is strictly speaking true. This effect correlated in the predicted direction both across and within conditions. Yet, what is signaled by intent such that participants alter their assessments of the truth of a claim? At this point, we hypothesize that intent communicates values alignment or misalignment. If this is correct, then changes in truth assessments are plausibly tracking changes in trust (see Siegrist 2021). Adapting Siegrist et al.’s (2000) model of values similarity and trust, we argue for a conceptualization of trust that is sensitive to a number of factors, including care, confidence, procedural fairness, and values similarity, which, in turn, affect assessments of truth. After presenting preliminary findings on this score, we conclude by considering the pluralistic nature of trust and its relationship to strategies for addressing values misalignment. In sum, we argue that understanding the ways in which values alignment influences trust and assessments of truth is central to the uptake of expert testimony.

For references and notes, please see attached PDF.

ABSTRACT. There is a kind of commonplace reasoning which attributes the failures of technology to adequately address the immediate needs of human societies to persistent problems of technological capacity in an abstract sense—that is to say, that technological development has not yet overcome scarcity because it is not yet able to, and the further expansion of its powers will eventually deliver on the unfulfilled promise of generalized wellbeing and prosperity. Such claims often amount to, among other things, a commitment to avoiding the question of political economy, and all the broader social and historical contexts from which the phenomenon of technology is inextricable. The accelerated development of technological capacity since the start of the Industrial Revolution has delivered higher yields, specialized machinery, and advanced cultivation techniques to the work fields of the world. But the spirit of the fief and the plantation has not so far been exorcised from the practice of agriculture in the Global South, and need, the devastation of the environment, and disenfranchisement prevail.

The aim of this intervention is to derive from historical and critical contributions a set of insights into the possibilities for redirecting the practice of agriculture in service to the needs of those most directly involved in the process of production, and further also to develop from this point a series of structural demands for agricultural practices globally. I will investigate the relationships between societal wellbeing, the environment, and the use of industrial technologies in agriculture in Latin American contexts, with a special focus on Haiti. I will then make the case that peasant-driven, localized and land-bound models that use technological advancement as a means of empowering and updating, but not displacing native forms and ancestral knowledge, are better suited to address the compounding crises of climate change, political unrest, and extreme scarcity than the top-down neoliberal approaches advocated by foreign powers and financial institutions.  

ABSTRACT. Although the prima facie conventional standard for clinical decision-making objectives, RCTs are never adequate to aid public health interventions, the level of statistical substance produced, notwithstanding. In reflecting on current projects in the field of CDHR, this article provides a theoretical discussion of the complexities of ethical issues that ethicists and health practitioners need to consider when making clinical interventions involving the autonomy of patients in biomedical research. At present, patients, to a greater extent, want to be actively involved in biomedical research, established in their own experiential reality, and context. As such, there is a growing demand for new and more inclusive research strategies, in which the collective experience of citizens will palpably impact the generation of medical knowledge production. Citizen-Science Driven Health Research (CDHR) - an active contribution of citizens in medical research - connects with community participation and asset-based frameworks that are key components in modern health promotion. This entry provides a theoretical discussion of the potentiality for innovative medical research and the emerging consent-driven therapies for clinical interventions hitherto unknown to the health community.

ABSTRACT. The Black Death had noteworthy implications in the East as it did in the West, yet the majority of plague-related scholarship focuses on the Western world. In my research paper, I study the overlap and compatibility between religion and the medical response to the plague in the 14th century Middle East. While there were known conventions such as the enforcement of quarantine to help curb the spread of diseases, it was the responses directly tied to the Islamic faith that ended up gaining the most influence and shaping public health guidelines in the Middle East during the Black Death.

My research expands upon the ideas that medical responses were altered to fit religious ideals and specifically explore whether or not in doing so, the Muslims had a more effective way to curb the plague in comparison to the Westerners. Despite not following the European conventions of stopping the spread of plague, Muslims did not believe a strong adherence to religion and good health were exclusive of each other, but rather believed they depended on one another. Muslims had to stay true to their religion while trying to remain healthy in the midst of an epidemic and this meant that they had to alter their public health guidelines to accommodate Islamic principles. The goal of my paper is to produce a more in-depth analysis of Middle Eastern plague response and demonstrate how guidelines and policies that stem from a religious basis cannot automatically be classified as non-scientific or ineffective.

ABSTRACT. Though the phrase “obesity epidemic” is commonly used in medicine and public health, it is arguably a harmful term because of the way it perpetuates anti-fat biases and assumptions. Many fat activists (e.g., Lindy West, Aubrey Gordon) and fat justice scholars (e.g., Abigail Saguy, Jantina de Vries, Alison Reiheld) argue that the interests and values of fat people are not acknowledged or accepted within medical practice and public health campaigns. Yet such concerns are often sharply contested, given the presumptive link between fat and ill health. Who could be in favor of recognizing and protecting identities that are clearly unhealthy?

In support of a broader argument in favor of fat justice, in this paper I focus on the ways that illegitimate values infiltrate obesity research in the guise of the medical model of fatness. For example, one medical model dogma that researchers presuppose when collecting and interpreting data, is that being overweight or heavier is a result of not eating healthy enough and/or getting enough exercise. This assumption, however, is motivated by illegitimate value judgments that stem from anti-fat biases (e.g., fat people are lazy, gluttonous, ignorant, lack self-discipline).

To show this, I first argue that the medical model of fatness relies on insufficient evidence, influenced by illegitimate social and political values that have led to inaccurate but widespread dogmas. Second, I outline how this problematic medical model shapes how future evidence is collected and interpreted in ways that further entrench the assumptions of the medical model. In other words, I show how the medical model functions in a way that self-vindicates itself in an epistemically illegitimate way. My argument reveals that the “concern for health” objection to fat justice that is often assumed to be impartial and factual and therefore, undeniable, should be questioned and reevaluated. In doing so, I remove one of the major objections to arguments for fat justice, which I think makes it more tenable.

ABSTRACT. I argue that a public health approach to so-called ‘behavioral addictions’ makes for bad science and bad policy.

Behavioral addictions are controversial in psychiatry. The DSM-5, for instance, only recognizes one, gambling disorder, though it suggests further research into others such as internet gaming disorder. Even these decisions continue to be contested by psychiatrists. This cautious approach to behavioral addictions by psychiatric professionals isn’t mirrored in public discourse. Headlines like “Social Media Is a Public Health Crisis” (US News and World Report, July 20, 2021) and “Does society have a sex addiction problem?” (Mayo Clinic, June 27, 2018) are common. Worryingly, some governments are more in tune with the headlines than the experts. The UN, for example has declared video game addiction a “public health crisis,” and since 2016 the state of Utah has recognized pornography consumption as a “public health crisis.”

Framing behavioral addictions as public health issues is a bad idea.

Public health approaches to medicine have lots of benefits. They can address problems on a systemic level, with less stigma for individual patients, and use big data to provide prevention-focused rather than treatment-only solutions. These benefits justify public health approaches to many medical issues, including substance addictions.

In the case of behavioral addictions, however, these benefits become problems instead. Addressing behaviors on a systemic level creates a paternalistic system, where an individual’s behaviors can be seen as undesirable, even if that individual doesn’t judge that their use of social media/pornography/video games/etc. is detrimental to their quality of life. Not only does this infringe on individual’s autonomy, but it justifies stigmatizing potentially benign behaviors, rather than reducing stigma on patients. Additionally, public health approaches require collecting large amounts of data, and this surveillance raises extra concerns about privacy and safety when we’re collecting data on controversial, stigmatized behaviors, such as those labeled behavioral addictions. Finally, behavioral addictions are a case where treatment-focused rather than prevention-focused healthcare is preferable. We don’t want to be discouraging generally innocuous behavior. Instead, we want to make care available to people once they themselves have determined that their behavior has become something they’d like professional help managing.

For these reasons, we shouldn’t be thinking about behavioral addictions as public health issues, and I conclude by sketching a patient-driven, less-medicalized approach to behavioral addictions.

ABSTRACT. I carve out a middle path between genomicists and their critics in population health with regard to their discrepant views on finding a solution, or set of solutions, to racial health disparities, underscoring the fact that while this argument is often framed as empirical, it is actually based in the scientific values of each community. By reframing the debate as a value-based one, I emphasize the fact that both communities, population health and genomics, have something to learn from the other.

Racial health disparities continue to be a pervasive problem in the United States. While these disparities are mainly due to issues of structural racism, which are to be mainly addressed using population health interventions, genomicists attempt to find their biological underpinnings. Genomicists mark as their goals to look into disease etiology and to develop population-specific drugs (or pharmacogenomics), contending that both arms of research are vital to disrupting health inequities between different racial groups, but they leave behind any semblance of the tenets of population health. It’s not that those in population health have it right and the genomicists have it wrong, but rather that genomicists only capture a piece of the puzzle, ignoring the vast array of resources population health has cultivated, including social and environmental interventions.

Disparities in disease rate and outcomes for asthma and diabetes present good opportunities for analyzing the different techniques embodied by genomicists and population health experts, and serve as the focus for my inquiry. In so doing, I highlight what I’ve named racial drug disparities, a small subset of the larger group of racial health disparities, which might be targeted through pharmacogenomics. Whereas racial health disparities indicate inequities in disease morbidity and disease outcomes, racial drug disparities pick out the much more minute problem of disparities in reactions to different pharmaceuticals. Take, for example, platinum chemotherapies, widely used to treat many different types of cancer, it is known that certain individuals of East Asian descent tend to experience their toxic effects more strongly than their Western counterparts (see Khrunin, et al. 2012). Such a finding holds the potential to deliver safer and equally effective drugs to combat cancer to these populations. My assertion underscores the fact that individuals of all races, of all genetic ancestries deserve equal access to safe and effective pharmaceuticals.

The momentum in genomic and pharmacogenomic research is not going to be slowed, but the potential for harm that it may cause can be mitigated by integrating population health experts and approaches with genomic knowledge. This doesn’t mean accepting the race-as-biology just-so story which is revised and reiterated every other decade. Making them transparent, however, will allow genomics (and population health) to more properly understand how race has shaped science and society, and the intermingling of the two.

References

Khrunin, A., F. Ivanova, A. Moisseev, D. Khokhrin, et al. (2012). “Pharmacogenomics of cisplatin-based chemotherapy in ovarian cancer patients of different ethnic origins”. Pharmacogenomics 13(2):1-8.

ABSTRACT. The COVID-19 pandemic has not only been a challenge to global health but also to how science is regarded in a diverse and often polarized society, especially in the United States. The latter challenge specifically pertains to how science is utilized to inform public policies on tackling the pandemic. Two conflicting poles have emerged in response to COVID-19 vis-à-vis science’s public status. The first pole involves scientific experts who influence public policies in terms of individual and social behavior, such as masks, lockdowns, and vaccination, while the second includes those who espouse anti-science rhetoric and are generally labelled as anti-vaxxers. To address this challenge, I propose that a post-normal science approach represents an effective framework for bridging the two opposing poles. Specifically, post-normal science filters applied normal or mainstream science through expert professional consultancy that includes an ‘extended peer community’ of the public as stakeholders to provide the information needed to make public policy decisions when values are disputed, stakes are high, facts are uncertain, and decisions are urgent. Specifically, what has surfaced during the pandemic is the clash of values between the scientific and social sectors. The main scientific value is public health and involves obtaining precise information on the biology of the virus and its transmission and virulence. With such information, measures, such as vaccine development, can be developed to stem the spread and lethality of the virus. The chief social values of a dissident or skeptical public, such as anti-vaccine activists, pertain to individual freedom and autonomy or independence. Governmental measures, like mandatory vaccination based on science, have certainly clashed with these values. In other words, anti-vaccine activists bristle at the government’s directive for compulsory vaccination for returning to pre-2019 behavior. Post-normal science offers a framework in which the clash between these values can be addressed through an inclusive incorporation of relevant stakeholders in formulating policies that mitigate disproportional harm across society. Particularly, the framework provides a platform for discussing several known unknowns, such as vaccine efficacy and safety, innate immunological response to the virus, and behavioral response and economic impact to distancing and lockdowns. By incorporating an ‘extended peer community’ that includes disputing voices into a civil discourse concerning public policies, post-normal science provides the opportunity to implement responsible and effective policies for managing COVID-19 and future pandemics.

ABSTRACT. Late on Sunday evening, March 22nd, 2020 Governor’s Office of Management and Budget (GOMB) called the Utah Department of Health (UDH) to pitch their plan to end the Covid-19 pandemic. This was just a few days before the planned activation of a multi-agency Unified Command on the then rapidly developing pandemic on March 26th. GOMB had contracted a consulting firm to produce a model that projected an end to the pandemic in 90 days. GOMB wanted State Government public health officials to get on board with their projection and join in the planning for the end of the pandemic. Epidemiologist, Sam LeFevre, director of the Bureau of Epidemiology at UDH was not on board, instead he set to work producing a model consistent with current modeling practice in epidemiology in an attempt to rebut the GOMB model and give the Governor more helpful information for enacting a plan for dealing with the pandemic. He began working closely with epidemiologist Lindsay Keegan at the University of Utah. The first version of the resulting model was up and running on April 12th, 2020 and Utah epidemiologists have been using this model, with regular updates, since.

Several papers have been published (between mid-2020 and today) that are highly critical of certain specific epidemiological models developed to make projections about the Covid-19 pandemic. My specific interest here is in papers that not only criticize these epidemiological models but criticize modelers for various moral failings. For example, such critics hold epidemiological modelers responsible for the implementation, and hence any ill effects, of non-pharmaceutical interventions such as mask mandates and lockdowns. I assume that all modeling practice is value-laden in many ways but I argue here that care is needed when attributing responsibility and blame to scientists. I appeal to a case study of the Utah State Government’s approach early in the Covid-19 pandemic in the hope of developing a better grasp of relations between modelers and public policy makers, which is just one strand of the complex tangle of relations between science and values in epidemiology during a public health crisis.

ABSTRACT. Should refusals to comply with COVID-19 vaccine mandates be considered a legitimate form of conscientious objection? Crucially, a refusal must be grounded in conscience to count as conscientious objection, which means that an objector must believe that the action is question is morally wrong and that performing it makes them morally responsible for that wrong. But these beliefs are subject to constraints; not just any belief about wrongness or responsibility, no matter unreasonable or poorly founded, can plausibly ground conscientious objection.

If a given refusal violates these constraints, then we do not need to accommodate it as a matter of protecting conscience. I articulate what these constraints look like for conscientious objection to COVID-19 vaccination, and argue that most refusals to receive do not meet these constraints and are thus should not be accommodated as a matter of conscience. For our collective projects to succeed, we all need to do our best to be minimally decent members of the social community. I propose that being a minimally decent community member involves fulfilling certain epistemic, relational, and normative competencies, which constrain which refusals are of the right sort to count as conscientious objections.

Epistemically competent people must make community-affecting decisions in a sensible way, based on their abilities and the evidence available to them. COVID-19 vaccine refusals violate this competency if someone’s conviction that the vaccines are morally wrong stems from demonstrably false empirical beliefs about vaccine safety or efficacy.

Relationally competent people must cooperate in whatever ways are necessary for living together and sustaining our joint projects, including avoiding free-riding and ensuring that your exercises of liberty do not harm others. Many who conscientiously object to vaccines appeal to individual liberty to claim that they are entitled to make any choice about their own body. But such appeals violate the prohibition on free-riding; a refusal to vaccinate gains the benefits of herd immunity while not paying any costs. And “my body, my choice” cannot justify decisions that increase the spread of a deadly virus risks harming others.

Finally, normatively competent citizens must have reasonable beliefs about what they are personally responsible for. Some people refuse COVID-19 vaccines because they were tested on cell lines derived from decades-old fetal tissue. But many who believe that abortion is morally wrong argue that the connection between COVID-19 vaccines and abortion is so distant and tenuous that receiving a vaccine does not make you morally complicit in wrongdoing. If this is correct, then such refusals violate the normative competency required of decent citizens.

In sum, many of the most common reasons why people refuse COVID-19 vaccines violate the epistemic, relational, and normative competencies required to participate in successful collective projects. We should not accommodate these refusals: not because they’re outweighed by more important moral concerns like ending the coronavirus pandemic and protecting the public, but because they are not reasons of the right kind to ground conscientious objection in the first place.