Bodily rights and property rights.

Whereas previous discussions on ownership of biological material have been much informed by the natural rights tradition, insufficient attention has been paid to the strand in liberal political theory represented by Felix Cohen, Tony Honoré, and others, which treats property relations as socially constructed bundles of rights. In accordance with that tradition, we propose that the primary normative issue is what combination of rights a person should have to a particular item of biological material. Whether that bundle qualifies to be called "property" or "ownership" is a secondary, terminological issue. We suggest five principles of bodily rights and show how they can be applied to the construction of ethically appropriate bundles of rights to biological material.

Epistemic paternalism in public health.

Receiving information about threats to one's health can contribute to anxiety and depression. In contemporary medical ethics there is considerable consensus that patient autonomy, or the patient's right to know, in most cases outweighs these negative effects of information. Worry about the detrimental effects of information has, however, been voiced in relation to public health more generally. In particular, information about uncertain threats to public health, from-for example, chemicals-are said to entail social costs that have not been given due consideration. This criticism implies a consequentialist argument for withholding such information from the public in their own best interest. In evaluating the argument for this kind of epistemic paternalism, the consequences of making information available must be compared to the consequences of withholding it. Consequences that should be considered include epistemic effects, psychological effects, effects on private decisions, and effects on political decisions. After giving due consideration to the possible uses of uncertain information and rebutting the claims that uncertainties imply small risks and that they are especially prone to entail misunderstandings and anxiety, it is concluded that there is a strong case against withholding of information about uncertain threats to public health.

Implant ethics.

Implant ethics is defined here as the study of ethical aspects of the lasting introduction of technological devices into the human body. Whereas technological implants relieve us of some of the ethical problems connected with transplantation, other difficulties arise that are in need of careful analysis. A systematic approach to implant ethics is proposed. The major specific problems are identified as those concerning end of life issues (turning off devices), enhancement of human capabilities beyond normal levels, mental changes and personal identity, and cultural effects.

Extended antipaternalism.

Extended antipaternalism means the use of antipaternalist arguments to defend activities that harm (consenting) others. As an example, a smoker's right to smoke is often invoked in defence of the activities of tobacco companies. It can, however, be shown that antipaternalism in the proper sense does not imply such extended antipaternalism. We may therefore approve of Mill's antipaternalist principle (namely, that the only reason to interfere with someone's behaviour is to protect others from harm) without accepting activities that harm (consenting) others. This has immediate consequences for the ethics of public health. An antipaternalist need not refrain from interfering with activities such as the marketing of tobacco or heroin, boxing promotion, driving with unbelted passengers, or buying sex from "voluntary" prostitutes.

Disease recording systems and herd health schemes for production diseases.

Disease recording of cattle is compulsory in Sweden and Norway. Sweden and Denmark also have mandatory disease recording for swine, whereas Finland and Norway only have compulsory recording of infectious diseases. Both compulsory and voluntary systems are data based, the first ones developed in the 1970's. Disease recording at pig slaughtering is somewhat older. The veterinary practitioner, and often also the farmer, can report treated cases as well as fertility disturbances to the systems. Disease recording at slaughter is carried out by veterinarians and inspection officers. The data bases are handled by the veterinary authorities or the agricultural organisations in each country. Costs are defrayed by the authorities and/or the agricultural industry. The farmers receive periodic reports. Data are stored for three to ten years, often longer. Affiliation to animal health schemes for cattle or swine is voluntary. In Sweden and Denmark (cattle) they are run within the scope of government regulations. Affiliation to animal health programmes may also be demanded by organisations within the agricultural industry. These organisations are also responsible for the administration of the programmes. Costs to take part in herd health schemes are covered by the farmers them-selves. In certain cases, grants are received from agricultural organisations, authorities, or the European Union. Recording of diseases and the format of animal health schemes in the Nordic countries are described here in order to illustrate the possibilities to compare data between countries.

Critical effects and exposure limits.

The use of critical effects in the determination of occupational exposure limits (OELs) in Sweden is subjected to a statistical study. Many of the present OELs are high in relation to known no-effect levels and effect levels, and the degree of protection has a surprisingly weak correlation with the seriousness of the adverse effect. Several proposals for improved procedures are put forward. One of these is to supplement the concept of critical effects with that of dominant effects. A dominant effect of a substance is a health effect that is at some concentration the most serious health effect.

Can we reverse the burden of proof?

Ideally, one might wish to reverse the burden of proof in the regulation of chemical substances, so that a substance is regarded as hazardous unless proven non-hazardous. Due to the structure of toxicological knowledge, a full reversal is not practicable. Nevertheless, important steps in the direction of a reversal are both possible and desirable.

The detection level.

A statistical measure, the detection level, that conveys information about the risk of type II errors in a way that is easily understandable to the statistically unsophisticated decision maker is proposed. The detection level answers the question: "How big should an effect have been in order to be detected in this way?" Given a statistical test with the critical level (size) alpha*, the detection level of this test is the smallest effect that would, with at least probability 1-alpha*, lead to a significant outcome (P < alpha*) of the test. It is proposed that detection levels should be calculated as a standard procedure in toxicity reviews, and in particular in reports from toxicologists to decision makers.