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This article examines the challenges encountered during a collaborative project involving research and practice in a Norwegian municipality. The objective of the project was to apply co-creation by involving users, employees and researchers in the development of coordinated, flexible and knowledge-based services, with a strong emphasis on user-centeredness. However, the project faced several obstacles that hindered its progress. In this article, we adopt a ‘what if’ perspective to explore alternative scenarios, identifying pivotal moments in the project and envisioning how alternative realities could have facilitated some of the fulfilment of its initial intentions. We argue that co-creation represents a mindset shift within the public sector, emphasising relational practices and embracing the inherent uncertainty associated with welfare service provision. By engaging in second-level inquiry, we propose that organisations can develop a co-creative logic that prioritises flexibility, innovation, involvement and ongoing evaluation, moving away from traditional reliance on routines, manuals and measurable outputs.

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This study set out to gain a better understanding of how family meetings are facilitated and experienced in an Irish rehabilitation hospital setting from the perspectives of interdisciplinary team (IDT) members, patients and their family members. This article reports the findings from IDT members’ perspectives. A critical-realist action-research approach was utilised that involved medical social workers (N = 15) and a social work academic. A quantitative, descriptive study design was adopted, which utilised a cross-sectional survey of IDT members. A total of 85 clinical staff responded to the questionnaire, of which 69 were fully completed. Four key themes emerged: pre-meeting engagement and preparation – a critical step; the impact of organisational structures; supporting participation; and mechanisms for effective family meetings. Findings indicate the importance of pre-meeting preparation, the mutuality of the relationships between participants, a standardised approach and the use of patient-centred and inclusive practices to achieve truly participatory family meetings. Family meetings involve complex processes in which mutual influence, context, preferences, values, information shared, the nature of the relationships involved and the communicative style of participants all play significant roles in both the process and decision-making outcomes. This study concluded that social workers are perhaps in a unique position to work with IDTs in clarifying the reality of the limits of choice and the involvement of the patient and family in rehabilitation hospital settings. In preparation for the role of family-meeting facilitation, the implementation of education and training programmes for IDT members is strongly recommended.

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The Decisions, Assessment and Risk Special Interest Group of the European Social Work Research Association (DARSIG) dedicated a pre-conference event at the 2023 European Conference for Social Work Research in Milan, Italy, to the application of innovations using big data and machine-learning algorithms in social work risk assessment and decision-making processes. Here, we share some ideas from these discussions.

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Gnatola ma no kpon sia, eyenabe adelan to kpo mi sena’ (‘Until the lion has his or her own storyteller, the hunter will always have the best part of the story’) (Ghanian proverb, available at: http://thelionandthehunter.org/). Historically, both the discipline and profession of social work have been imagined and constructed by those who oversee social work services – ‘the hunters’, according to the aforementioned Ghanaian proverb. Thus, it has been predominantly white, middle-class, non-disabled, mainly female, Global North voices that have determined what social work looks like and how it is carried out across the world. However, this is changing. Today, many more ‘lions’ are telling their stories, as this article demonstrates. Through the curated narratives of Bob, Doug and Rose, as well as that of their storyteller/collaborator, Viv, we learn that growing up in care in Scotland in the 1940s and 1950s was ‘confused and confusing’ for the children at the heart of it. Contradictory discourses competed for dominance, and the children experienced unintended consequences from the ‘care’ they received. While not attempting to universalise on the basis of three people’s stories, we believe that they have much to teach social work.

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This chapter discusses implications for epigenetic responsibility that the application of artificial intelligence (AI) in the analysis of epigenetics gives rise to. AI technology has a capacity to see patterns in big datasets and can help to improve accuracy in epigenetic-based diagnostics, prognostics and therapy. However, characteristics of AI systems, such as their black-box character and their ability to act autonomously and to improve over time without any direct involvement of humans, have repercussions for ascription of responsibility. In the context of AI-based epigenetic analysis in the clinic, questions of epigenetic responsibility are interwoven with responsibility issues connected with AI in several ways that increase both individual and collective forward-looking responsibilities. This chapter illustrates the particular aspect of how healthcare professionals will have to take on certain forward-looking responsibilities to handle the relationship between AI-assisted epigenetic analysis and the patient.

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In this chapter, I discuss the usefulness of the concept of ‘forward-looking collective responsibility’ (FLCR) in ethical debates involving epigenetics. I start out by reviewing previous employments of the collective responsibility in general, and FLCR in particular, in an epigenetics context. I then suggest ways to integrate FLCR in a framework of responsibility for epigenetic justice. Drawing inspiration from intersectional feminism and disability studies, epigenetic injustice is characterized as an instance of historical–structural injustice. Finally, I introduce the example of a Mexico City neighbourhood to show how those concerned about epigenetic responsibility can resist calls for epigenetic eliminativism.

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Ethical Perspectives

EPUB and EPDF available Open Access under CC-BY-NC-ND licence.

We tend to hold people responsible for their choices, but not for what they can’t control: their nature, genes or biological makeup.

This thought-provoking collection redefines the boundaries of moral responsibility. It shows how epigenetics reveals connections between our genetic make-up and our environment. The essays challenge established notions of human nature and the nature/nurture divide and suggest a shift in focus from individual to collective responsibility.

Uncovering the links between our genetic makeup, environment and experiences, this is an important contribution to ongoing debates on ethics, genetics and responsibility.

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This chapter argues that a developmental view on life may shed light on the role bioethicists can play in research projects. In the first section, I look at the meaning of epigenetics. Epigenetics nowadays refers to the molecular mechanisms regulating gene expression. However, inspired by the legacy of Conrad Waddington, it also implies a developmental view of life. I give an overview of existing bioethical discussions regarding epigenetics, using the example of research into developmental diversity in general and autism specifically to suggest that such a developmental approach may imply focusing on dynamics, context and experiences in normative reflection. Finally, I  give some suggestions as to what the role of bioethicists could be in relation to the aims and subjects of responsible science.

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This chapter analyses the implications of findings in epigenetics for the ascription of moral responsibility for children. It contrasts shared understandings of procreative responsibility and discusses its extension to include all (individual or collective) actors who influence a child’s gene expression. It also problematizes the focus on biology in this process, using the example of epigenetics as a crossover between social and biological factors that contribute to a child’s life. Epigenetics blurs the boundary between biology and the environment, and thus allows an analysis of contributions to children’s lives that goes beyond classical dualistic categories such as genetic versus environmental or biological versus social. The analysis is undertaken against the broader background of the determination of moral responsibility for children.

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This chapter provides a short introduction to some important developments in epigenetics research. It summarizes debates on scientific and ethical epigenetic exceptionalism that revolve around the question of how unique the implications of insights from epigenetics for ethical issues are. Furthermore, the chapter introduces the concept of responsibility by addressing the various elements of responsibility relationships, and introduces the reader to the main positions in existing literature on epigenetic responsibility. Finally, it contains an overview of the chapters of this volume.

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