Navigating complex trade-offs in public health interventions.

Public health, just as any policy-related field, faces the evergreen problem of turning knowledge into action. Among other problems, there is a clash between the inherent complexity of public health problems and the inevitable push, by decision-makers and the public, to simplify them. The Covid-19 pandemic has shown the insufficiencies of our current epistemological, methodological and normative apparatus to handle such crises in a timely manner. Despite this, several authors have been arguing for the importance of engaging global crises such as Covid-19 in ways that do not oversimplify key dimensions of the issues involved. In this paper, we contribute to this emerging scholarship. Building on existing work in the field of environmental problem-solving, we propose an integrative approach to navigating complex trade-offs in public health interventions. Briefly put, we propose that decision making should be informed by an analysis of any given problem from four distinct, but interrelated, lenses: (i) values and valuation, (ii) process and governance, (iii) power and inequalities and (iv) scientific evidence, methods and concepts. This normative framework, we argue, can help with spelling out the complexity of public health problems and with spelling out the rationale behind public health decision making to non-specialists and the general public. We illustrate our approach using the controversy over wearing face masks in the Covid-19 pandemic.

Valuation of ecosystem services of commercial shrub willow (Salix spp.) woody biomass crops.

The development of shrub willow as a bioenergy feedstock contributes to renewable energy portfolios in many countries with temperate climates and marginal croplands due to excessive moisture. However, to fully understand the potential of shrub willow as an alternative crop on marginal cropland, more research is needed to understand the potential of shrub willow for providing a variety of ecosystem services. At the same time, there is much need for research developing strategies to value ecosystem services beyond conventional valuation systems (e.g., monetary, intrinsic). In this context, this project investigates the ecosystem services of shrub willow woody biomass from an environmental science perspective, and proposes a new avenue to assess ecosystem services for management purposes based on the relative value of key ecosystem services under various land management strategies (i.e., willow vs. corn vs. hay). On marginal cropland in the US Northeast, shrub willow may be used to replace crops like corn or hay. Transitioning from conventional corn or hay to willow tends to reduce nutrient loss and erosion, improve biodiversity and adaptability to climate change, and increase access to recreational activities. However, it is unlikely to change soil carbon pools or greenhouse gas emissions at the soil-atmosphere interface. By encouraging decision makers to weigh the pros and cons of each management decision (i.e., willow vs. corn vs. hay) based on the situation, the ecosystems services valuation method used here provides a clear framework for decision making in a watershed management context.

Acknowledging conservation trade-offs and embracing complexity.

There is a growing recognition that conservation often entails trade-offs. A focus on trade-offs can open the way to more complete consideration of the variety of positive and negative effects associated with conservation initiatives. In analyzing and working through conservation trade-offs, however, it is important to embrace the complexities inherent in the social context of conservation. In particular, it is important to recognize that the consequences of conservation activities are experienced, perceived, and understood differently from different perspectives, and that these perspectives are embedded in social systems and preexisting power relations. We illustrate the role of trade-offs in conservation and the complexities involved in understanding them with recent debates surrounding REDD (Reducing Emissions from Deforestation and Degradation), a global conservation policy designed to create incentives to reduce tropical deforestation. Often portrayed in terms of the multiple benefits it may provide: poverty alleviation, biodiversity conservation, and climate-change mitigation; REDD may involve substantial trade-offs. The gains of REDD may be associated with a reduction in incentives for industrialized countries to decrease carbon emissions; relocation of deforestation to places unaffected by REDD; increased inequality in places where people who make their livelihood from forests have insecure land tenure; loss of biological and cultural diversity that does not directly align with REDD measurement schemes; and erosion of community-based means of protecting forests. We believe it is important to acknowledge the potential trade-offs involved in conservation initiatives such as REDD and to examine these trade-offs in an open and integrative way that includes a variety of tools, methods, and points of view.

Understanding bureaucracy in health science ethics: toward a better institutional review board.

Research involving human participants continues to grow dramatically, fueled by advances in medical technology, globalization of research, and financial and professional incentives. This creates increasing opportunities for ethical errors with devastating effects. The typical professional and policy response to calamities involving human participants in research is to layer on more ethical guidelines or strictures. We used a recent case-the Johns Hopkins University/Kennedy Kreiger Institute Lead Paint Study-to examine lessons learned since the Tuskegee Syphilis Study about the role of institutionalized science ethics in the protection of human participants in research. We address the role of the institutional review board as the focal point for policy attention.