Human germline gene editing is often debated in hypothetical terms: if it were safe and efficient, on what further conditions would it then be ethically acceptable? This paper takes another course. The key question is: how can scientists reduce uncertainty about safety and efficiency to a level that may justify initiation of first-time clinical trials? The only way to proceed is by well-designed preclinical studies. However, what kinds of investigation should preclinical studies include and what specific conditions should they satisfy in order to be considered well-designed? It is argued that multispecies and multigenerational animal studies are needed as well as human embryo editing without implantation. In order to be possible to translate to first-time clinical trials, animal studies need to satisfy strict conditions of validity. Moreover, embryo studies intended for translation to first-time clinical trials need to correspond to the animal studies in experimental design (with exception of implantation). Only in this way can uncertainty about risk for harm (safety) and prospect of benefit (efficiency) in first-time clinical trials be reduced to a modest level. If uncertainty is not reduced to such a level, first-time clinical trials in germline gene editing should not be initiated.

Chronobiologists argue that their scientific findings have implications for prevention of sleep problems. They claim that some sleep problems are caused by the fact that people live against their individual body clock rather than adjusted to it. They also claim that by taking the findings of chronobiology seriously in policy-making some sleep problems can be prevented. I investigate applications of chronobiology in two social areas—school schedules and shift work—and show that in order for these applications to be justified certain implicit presumptions have to be justified. The first presumption is explanatory, namely that a chronobiological explanation is an adequate explanation of the sleep problems at hand. In addition I analyse three ethical presumptions. The first ethical presumption is that sleep is of vital value. The second is that sleep is not an exclusively private issue. The third ethical presumption is that the preventive measures to be undertaken are ethically acceptable. My main point is that it is not possible to simply “read off” policy measures from the empirical findings of chronobiology.

I IKK:s strategiska arbete ingår satsningar på både forskningsrelaterade och pedagogiska frågor. Relevant för detta är högskolelagens betoning av att ”verksamheten skall bedrivas så att det finns ett nära samband mellan forskning och utbildning” (SFS 1992:1434, 3§). Frågan inställer sig hur en sådan koppling mellan forskning och grundutbildning kan se ut mer konkret. För att få svar på detta har jag samtalat med några erfarna forskande lärare och sammanställt deras och mina egna reflektioner till ett diskussionsunderlag. För att begränsa projektet har fokus lagts på forskning och utbildning inom filosofisk fakultet (inte utbildningsvetenskap). Huvudfrågan har varit: Hur kan forskning gagna grundutbildning och grundutbildning forskning? Tyngdpunkten ligger på den första delfrågan.

Sleep problems are extremely serious from a societal point of view. A substantial portion of the population in many countries suffers from sleep problems. Sleep problems may directly or indirectly cause health problems. They may have harmful consequences in terms of accidents and reduced productivity. The economic costs in society are immense. However, the causal background to sleep problems is often complex. Various determinants contribute and interact. This does not exclude that some determinants are more crucial than others in particular cases. In some cases sleep problems are caused by distinct medical disorders. In other cases they have psychosocial causes related to, for example, personal economic problems or stress at work. A special category of social determinants consists of societal activities that disturb people’s normal sleep rhythms such as shift work. In these cases there is a discrepancy between an individual’s body clock (a biological determinant) and the social clock (a social determinant). Given this plurality of determinants of sleep problems, a plurality of potential remedies emerges. However, what is considered to be a key determinant may vary from one case to another, and this suggests in turn that the key remedy may also vary from one case to another. In my philosophical discussion of these issues I make three proposals. First, I propose an explanatory pluralism. Different explanations are adequate in different contexts given the epistemic interests in those particular contexts. No explanation of sleep problems is the most adequate in every context. Second, I propose a kind of interactionism that recognizes that biological determinants sometimes limit social malleability. The variation in sleep patterns among different cultures and within particular societies indicates the existence of some malleability in how and when we meet our sleep needs, but the existence and function of body clocks indicate that there are certain limits to malleability. Third, I propose that in searching for ethically acceptable remedies for sleep problems we should take this explanatory pluralism and this kind of interactionism seriously.

In this article I analyse and discuss guidelines for priority setting in crisis management at a regional level in Sweden. The guidelines concern three types of crises: pandemics, large losses of electric power and interruptions in water supply. Pandemics are typical public health issues. Large losses of electric power and interruptions in water supply are in themselves not, but may have serious public health consequences. These guidelines are compared with guidelines for priority setting in health care. This is done because of the central position of health care in the management of many different types of crises. The comparison shows clear differences. In the analysis, I use a distinction between substantive principles of priority setting and process-oriented principles. Regarding substantive principles, I have found that the guidelines point in different directions. This seems acceptable, however, since they focus on different problems. Moreover, it seems possible to integrate the various context-dependent principles by relating them to higher order principles. Regarding process-oriented principles, I have found that how and to what extent these principles are applied in the guidelines vary. If we want to apply these principles in a more satisfying way, this would require a more systematic approach.

The concept of privacy by design is becoming increasingly popular among regulators of information and communications technologies. This paper aims at analysing and discussing the ethical implications of this concept for personal health monitoring. I assume a privacy theory of restricted access and limited control. On the basis of this theory, I suggest a version of the concept of privacy by design that constitutes a middle road between what I call broad privacy by design and narrow privacy by design. The key feature of this approach is that it attempts to balance automated privacy protection and autonomously chosen privacy protection in a way that is context-sensitive. In personal health monitoring, this approach implies that in some contexts like medication assistance and monitoring of specific health parameters one single automatic option is legitimate, while in some other contexts, for example monitoring in which relatives are receivers of health-relevant information rather than health care professionals, a multi-choice approach stressing autonomy is warranted.

There are an increasing number of medical research studies involving children, including many long-term birth cohort studies. Involving children raises many issues, and little is known about childrens own views. This study explored childrens views (N = 5,851) on participation in a long-term screening study for type 1 diabetes. The results show that children 10 to 13 years of age have in general a positive attitude to pediatric research and emphasized trust in researchers. The children stressed the importance to receive information and to be involved in decisions. The children also reported feeling concerned about blood sampling and disease risk. Researchers involved in long-term pediatric research need to address these issues to promote involvement and decrease worry.

In this paper, I investigate ethical and policy aspects of the genetic services and web-rhetoric of companies offering genetic information direct to consumer, and I do so with a special focus on genetic risk information. On their websites, the companies stress that genetic risk testing for multifactorial complex medical conditions such as cardiovascular disease and cancer may empower the consumer and provide valuable input to personal identity. Critics maintain, on the other hand, that testing can be psychologically harmful, is of limited clinical and preventive value, and vulnerable to misinterpretation. I stress the importance of empirical studies in assessing the pros and cons of direct-to-consumer testing and point out that recent empirical studies indicate that this testing is neither as harmful as feared by critics nor as empowering as promised by the companies. However, the testing is not entirely harmless. Remaining problems include testing of third parties without consent and ownership of genotypic and phenotypic information. Moreover, the testing, although not particularly empowering, may still provide input to self-understanding that some people find valuable. Regarding policy-making, I suggest that self-regulation in terms of best practice guidelines may play an important role, but I also stress that national and international regulation may be necessary.