The definition of health is dependent on one’s perspective, be it lay, professional or from influences of specific cultures or social ideals and health policies of a particular time or place (Fleming & Parker 2012, p.30, Naidoo & Wills 2000).
One key area of socially relevant interdisciplinary science is riskassessment, which involves both research on the effects of varioussubstances or practices and the evaluation of those effects onceidentified. The idea is to gain an understanding of both positiveeffects and of negative effects and a method of evaluating these. Thisinvolves integrating the work of specialists in the kind of substancewhose risks are under assessment (geneticists, chemists, physicists),biomedical specialists, epidemiologists, statisticians, and so on. Inthese cases, we are dealing not only with the problems of trust andauthority among specialists from different disciplines, but also withthe effects of introducing new technologies or new substances into theworld. The risks studied are generally of harm to human health or tothe environment. Interest in applying philosophical analysis to riskassessment originated in response to debates about the development andexpansion of nuclear power-generating technologies. In addition, theapplication of cost-benefit analysis and attempts to understanddecision-making under conditions of uncertainty became topics ofinterest as extensions of formal modeling techniques (Giere 1991).These discussions intersect with debates about the scope of rationaldecision theory and have expanded to include other technologies aswell as applications of scientific research in agriculture and in themyriad forms of biological engineering. Essays on the relationbetween science and social values in risk research collected in thevolume edited by Deborah Mayo and Rachelle Hollander (1991) attempt tosteer a course between uncritical reliance on cost-benefit models andtheir absolute rejection. Coming from a slightly different angle, theprecautionary principle represents an approach shifting the burden ofproof in regulatory decisions from demonstration of harm todemonstration of safety of substances and practices. Carl Cranor(2004) explores versions of the principle and defends its use incertain decision contexts. Shrader-Frechette (2002) has advocatedmodels of ethically weighted cost-benefit analysis and greater publicinvolvement in risk assessment. Philosophers of science have alsoworked to make visible the ways in which values play a role in theresearch assessing the effects of technoscientifically producedsubstances and practices themselves, as distinct from the challengesof assigning values to identified risks and benefits. In addition toDouglas’s elaboration of inductive risk (Douglas 2000, Lacey (2005)delineates the values informing conventional agriculture andagroecology. In light of the potential impacts of technologicaldevelopments on communities, Shrader-Frechette (1994, 2002) has arguedfor including members of the public in deliberations about healtheffects of and reasonable exposure limits on environmental pollutants,especially radioactive materials.
Moore, M. (2012). The Global Dimensions of Public Health Preparedness and Implications for US Action. American Journal of Public Health, 102(6), e1. Retrieved from ProQuest
Natural gas has a variety of attractive attributes. In the current market, it is a relatively inexpensive and abundant fuel. When combusted for electricity generation, it emits fewer health-damaging contaminants and approximately 50% less carbon dioxide emissions compared with burning coal (). Yet, emerging scientific evidence suggests that there may be health risks associated with the development of shale gas.
Mental health policy is shaped fundamentally by the definition of associated with the policy. Changing policies reflect changing definitions. At various times, the definition may be narrow or broad with respect to the scope of conditions covered by a specific policy. The priority accorded to impairment severity is the most crucial and enduring policy issue related to the definition of and the scope of that definition. This paper explores the role of definitions in framing mental health policy, using examples from the history of policy making over the past half-century.
Philosophical study of the social dimensions of scientific knowledgehas been intensifying in the decades since 1970. Social controversiesabout the sciences and science based technologies as well asdevelopments in philosophical naturalism and social epistemologycombine to drive thinking in this area forward. Scholars in a numberof cognate disciplines continue to investigate the myriad socialrelations within scientific communities and between them and theirsocial, economic, and institutional contexts.
Attentionto the social dimensions of scientific knowledge and the consequentpotential for plurality has prompted philosophers to rethink thestructure of scientific knowledge. Many philosophers (includingGiere, Kitcher, and Longino) who advocate forms of pluralism invokethe metaphor of maps to explain how scientific representations can beboth partial and adequate. Maps only represent those features of theterritory mapped that are relevant for the purpose for which the mapis drawn. Some maps may represent the physical area bounded by stateboundaries, others may represent the population size, or the relativeabundance/poverty of natural resources. But the map metaphor is onlyone of several ways to rethink the structure of scientificknowledge.
We reviewed the body of evidence of potential environmental public health dimensions of shale gas development. Scientific modeling and field investigations have helped to illuminate the emerging environmental issues with which shale gas production may be associated. Several studies have suggested that shale gas development contributes to pollutants in ambient air at concentrations known to be associated with increased risk of morbidity and mortality (; ; , ). Similarly, some evidence supports theories of water contamination risks through a variety of pathways, most notably during wastewater transport and disposal and through failed cement in wells with poor structural integrity (; ; ). The existing peer-reviewed scientific data suggest that there are potential risks that could possibly influence public health. More research is needed to clarify the magnitude of these concerns. Because shale gas development activities have accelerated dramatically over the past decade, the need for well-designed empirical studies becomes increasingly apparent.
Limitations. In this review, we focused on the peer-reviewed scientific literature on the environmental public health dimensions of shale gas development. Although we used a broad search strategy, some publications and other relevant data could have been missed in our literature searches. However, we consider this to be a substantive summary of the currently available literature. Results of future studies will clarify the scientific understanding of the environmental public health concerns of shale gas development.
Even with full disclosure of the chemicals added to fracturing fluid, the ability to link chemicals to specific health outcomes remains difficult. Fracturing fluids and flowback and produced wastewaters are complex mixtures of chemicals with individual and possibly cumulative and synergistic properties. Many health outcomes are not specific to chemicals associated with shale gas development (e.g., headaches can be caused by a number of factors, rashes can be nonspecific, and asthma can be induced through a number of pathways), complicating the task of assessing associations between exposures and health outcomes. In turn, more exposure assessments and water and air monitoring should be undertaken to investigate the full suite of compounds emitted to the environment from these activities.
Krewski D, Jerrett M, Burnett RT, Ma R, Hughes E, Shi Y, et al. 2009. Extended follow-up and spatial analysis of the American Cancer Society study linking particulate air pollution and mortality. Res Rep Health Eff Inst 140:5–114.