Johannes Persson
@lu.se
Professor, Department of Philosophy
Lund University
RESEARCH INTERESTS
Philosophy of science, risk communication, decision-making, ontology
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Barry Dewitt, Johannes Persson, and Annika Wallin
SAGE Publications
Background Evidence-based medicine recognizes that clinical expertise gained through experience is essential to good medical practice. However, it is not known what beliefs clinicians hold about how personal clinical experience and scientific knowledge contribute to their clinical decision making and how those beliefs vary between professions, which themselves vary along relevant characteristics, such as their evidence base. Design We investigate how years in the profession influence health care professionals’ beliefs about science and their clinical experience through surveys administered to random samples of Swedish physicians, nurses, occupational therapists, dentists, and dental hygienists. The sampling frame was each profession’s most recent occupational registry. Results Participants ( N = 1,627, 46% response rate) viewed science as more important for decision making, more certain, and more systematic than experience. Differences among the professions were greatest for systematicity, where physicians saw the largest gap between the 2 types of knowledge across all levels of professional experience. The effect of years in the profession varied; it had little effect on assessments of importance across all professions but otherwise tended to decrease the difference between assessments of science and experience. Physicians placed the greatest emphasis on science over clinical experience among the 5 professions surveyed. Conclusions Health care professions appear to share some attitudes toward professional knowledge, despite the variation in the age of the professions and the scientific knowledge base available to practitioners. Training and policy making about clinical decision making might improve by accounting for the ways in which knowledge is understood across the professions. Highlights Study participants, representing 5 health care professions—medicine, nursing, occupational therapy, dentistry, and dental hygiene—viewed science as more important for decision making, more certain, and more systematic than their personal clinical experience. Of all the professions represented in the study, physicians saw the greatest differences between the 2 types of knowledge. The effect of years of professional experience varied but tended to be small, attenuating the differences seen between science and clinical experience.
C. Palmér, A. Wallin, J. Persson, M. Aronsson, and K. Blennow
Elsevier BV
Johannes Persson, Annika Wallin, Barry Dewitt, and Lena Wahlberg
Elsevier BV
A. Kause, W. Bruine de Bruin, J. Persson, H. Thorén, L. Olsson, A. Wallin, S. Dessai, and N. Vareman
Springer Science and Business Media LLC
AbstractScientific assessments, such as those by the Intergovernmental Panel on Climate Change (IPCC), inform policymakers and the public about the state of scientific evidence and related uncertainties. We studied how experts from different scientific disciplines who were authors of IPCC reports, interpret the uncertainty language recommended in the Guidance Note for Lead Authors of the IPCC Fifth Assessment Report on Consistent Treatment of Uncertainties. This IPCC guidance note discusses how to use confidence levels to describe the quality of evidence and scientific agreement, as well likelihood terms to describe the probability intervals associated with climate variables. We find that (1) physical science experts were more familiar with the IPCC guidance note than other experts, and they followed it more often; (2) experts’ confidence levels increased more with perceptions of evidence than with agreement; (3) experts’ estimated probability intervals for climate variables were wider when likelihood terms were presented with “medium confidence” rather than with “high confidence” and when seen in context of IPCC sentences rather than out of context, and were only partly in agreement with the IPCC guidance note. Our findings inform recommendations for communications about scientific evidence, assessments, and related uncertainties.
Lennart Olsson, Henrik Thorén, David Harnesk, and Johannes Persson
American Geophysical Union (AGU)
The question whether a single extreme climate event, such as a hurricane or heatwave, can be attributed to human induced climate change has become a vibrant field of research and discussion in recent years. Proponents of the most common approach (probabilistic event attribution) argue for using single event attribution for advancing climate policy, not least in the context of loss and damages, while critics are raising concerns about inductive risks which may result in misguided policies. Here, we present six ethical predicaments, rooted in epistemic choices of single event attribution for policy making, with a focus on problems related to loss and damage. Our results show that probabilistic event attribution is particularly sensitive to these predicaments, rendering the choice of method value laden and hence political. Our review shows how the putatively apolitical approach becomes political and deeply problematic from a climate justice perspective. We also suggest that extreme event attribution (EEA) is becoming more and more irrelevant for projecting loss and damages as socio‐ecological systems are increasingly destabilized by climate change. We conclude by suggesting a more causality driven approach for understanding loss and damage, that is, less prone to the ethical predicaments of EEA.
Henrik Thorén, Johannes Persson, and Lennart Olsson
Springer Science and Business Media LLC
AbstractIn recent years, a dispute has arisen within detection and attribution science concerning the appropriate methodology for associating individual weather events with anthropogenic climate change. In recent contributions, it has been highlighted that this conflict is seemingly misconstrued even by those participating in it and actually concerns a mixture of first and second order so-called inductive risk considerations—in short, it is about values and the role values should have in science. In this paper, we analyze this methodological conflict and examine the inductive risk considerations and argue that there is also another dimension to consider with respect to values that have to do with what detection and attribution science is for. We suggest a framework for understanding this as a kind of problem-feeding situation and thus an issue of problem–solution coordination between different contexts, where the problem is solved versus where the solution is put to use. This has important implications, not least for whether we should understand this conflict as a genuine methodological one or not.
Kristina Blennow, Erik Persson, and Johannes Persson
MDPI AG
A rationale for an individuals-oriented landscape approach to sustainable land-use planning based on an analysis of bio-geo-physical components as well as the human components of the landscape is presented. A toolbox for analysing individuals’ decision-making and valuations in the landscape is described. The toolbox can provide evidence on the drivers of individuals’ decision-making in the landscape and the decision strategies they apply. This evidence can be used to identify communication needs and to design guidelines for effective communication. The tool for value elicitation separates the instrumental values (means) and end values (goals) of individuals with respect to locations in the landscape. This distinction, and knowledge of the end values in the landscape, are critical for the achievement of policy goals and for spatial planning from a democratic point of view. The individuals-oriented landscape approach has roots in geography and draws on behavioural decision research together with a model for integrating “science and proven experience” that is widely used in public decision-making in the Nordic countries. The approach differs from other scholarly disciplines addressing sustainable land-use planning. It is suitable for application on decision-making problems that include trade-offs between values. An overview of empirical studies is provided in which the individuals-oriented landscape rationale is applied to climate change.
Barry Dewitt, Johannes Persson, Lena Wahlberg, and Annika Wallin
Public Library of Science (PLoS)
Clinical expertise has since 1891 a Swedish counterpart in proven experience. This study aims to increase our understanding of clinicians’ views of their professional expertise, both as a source or body of knowledge and as a skill or quality. We examine how Swedish healthcare personnel view their expertise as captured by the (legally and culturally relevant) Swedish concept of “proven experience,” through a survey administered to a simple random sample of Swedish physicians and nurses (2018, n = 560). This study is the first empirical attempt to analyse the notion of proven experience as it is understood by Swedish physicians and nurses. Using statistical techniques for data dimensionality reduction (confirmatory factor analysis and multidimensional scaling), the study provides evidence that the proven experience concept is multidimensional and that a model consisting of three dimensions–for brevity referred to as “test/evidence”, “practice”, and “being an experienced/competent person”–describes the survey responses well. In addition, our results cannot corroborate the widely held assumption in evidence-based medicine that an important component of clinical expertise consists of experience of patients’ preferences.
Kristina Blennow and Johannes Persson
MDPI AG
Why do citizens’ decisions made because they favour the mitigation of climate change outnumber those made because they favour adaptation to its impacts? Using data collected in a survey of 338 citizens of Malmö, Sweden, we tested two hypotheses. H1: the motivation for personal decisions because they favour adaptation to the impacts of climate change correlates with the decision-making agent´s knowledge of specific local impacts of climate change, and H2: the motivation for personal decisions because they favour mitigation of climate change correlates with the risk perception of the decision-making agent. While decisions made because they favour mitigation correlated with negative net values of expected impacts of climate change (risk perception), decisions made because they favour adaptation correlated with its absolute value unless tipping point behaviour occurred. Tipping point behaviour occurs here when the decision-making agent abstains from decisions in response to climate change in spite of a strongly negative or positive net value of expected impacts. Hence, the decision-making agents´ lack of knowledge of specific climate change impacts inhibited decisions promoting adaptation. Moreover, positive experiences of climate change inhibited mitigation decisions. Discussing the results, we emphasised the importance of understanding the drivers of adaptation and mitigation decisions. In particular, we stress that attention needs to be paid to the balance between decisions solving problems ‘here and now’ and those focusing on the ‘there and then’.
K Blennow, J Persson, L M S Gonçalves, A Borys, I Dutcă, J Hynynen, E Janeczko, M Lyubenova, J Merganič, K Merganičová,et al.
IOP Publishing
Abstract Beliefs, expectations and values are often assumed to drive decisions about climate change adaptation. We tested hypotheses based on this assumption using survey responses from 508 European forest professionals in ten countries. We used the survey results to identify communication needs and the decision strategies at play, and to develop guidelines on adequate communications about climate change adaptation. We observed polarization in the positive and negative values associated with climate change impacts accepted by survey respondents. We identified a mechanism creating the polarization that we call the ‘blocked belief’ effect. We found that polarized values did not correlate with decisions about climate change adaptation. Strong belief in the local impacts of climate change on the forest was, however, a prerequisite of decision-making favoring adaptation. Decision-making in favor of adaptation to climate change also correlated with net values of expected specific impacts on the forest and generally increased with the absolute value of these in the absence of ‘tipping point’ behavior. Tipping point behavior occurs when adaptation is not pursued in spite of the strongly negative or positive net value of expected climate change impacts. We observed negative and positive tipping point behavior, mainly in SW Europe and N-NE Europe, respectively. In addition we found that advice on effective adaptation may inhibit adaptation when the receiver is aware of effective adaptation measures unless it is balanced with information explaining how climate change leads to negative impacts. Forest professionals with weak expectations of impacts require communications on climate change and its impacts on forests before any advice on adaptation measures can be effective. We develop evidence-based guidelines on communications using a new methodology which includes Bayesian machine learning modeling of the equivalent of an expected utility function for the adaptation decision problem.
Annika Wallin, Lena Wahlberg, Johannes Persson, and Barry Dewitt
Elsevier BV
Johannes Persson, Kristina Blennow, Luísa Gonçalves, Alexander Borys, Ioan Dutcă, Jari Hynynen, Emilia Janeczko, Mariyana Lyubenova, Simon Martel, Jan Merganic,et al.
MDPI AG
The role of values in climate-related decision-making is a prominent theme of climate communication research. The present study examines whether forest professionals are more driven by values than scientists are, and if this results in value polarization. A questionnaire was designed to elicit and assess the values assigned to expected effects of climate change by forest professionals and scientists working on forests and climate change in Europe. The countries involved covered a north-to-south and west-to-east gradient across Europe, representing a wide range of bio-climatic conditions and a mix of economic–social–political structures. We show that European forest professionals and scientists do not exhibit polarized expectations about the values of specific impacts of climate change on forests in their countries. In fact, few differences between forest professionals and scientists were found. However, there are interesting differences in the expected values of forest professionals with regard to climate change impacts across European countries. In Northern European countries, the aggregated values of the expected effects are more neutral than they are in Southern Europe, where they are more negative. Expectations about impacts on timber production, economic returns, and regulatory ecosystem services are mostly negative, while expectations about biodiversity and energy production are mostly positive.
Johannes Persson, Niklas Vareman, Annika Wallin, Lena Wahlberg, and Nils-Eric Sahlin
Informa UK Limited
Abstract A key question for evidence-based medicine (EBM) is how best to model the way in which EBM should ‘[integrate] individual clinical expertise and the best external evidence’. We argue that the formulations and models available in the literature today are modest variations on a common theme and face very similar problems when it comes to risk analysis, which is here understood as a decision procedure comprising a factual assessment of risk, the risk assessment, and the decision what to do based on this assessment, the risk management. Both the early and updated models of evidence-based clinical decisions presented in the writings of Haynes, Devereaux and Guyatt assume that EBM consists of, among other things, evidence from clinical research together with information about patients’ values and clinical expertise. On this A-view, EBM describes all that goes on in a specific justifiable medical decision. There is, however, an alternative interpretation of EBM, the B-view, in which EBM describes just one component of the decision situation (a component usually based on evidence from clinical research) and in which, together with other types of evidence, EBM leads to a justifiable clincial decision but does not describe the decision itself. This B-view is inspired by a 100-years older version of EBM, a Swedish standard requiring medical decision-making, professional risk-taking and practice to be in accordance with ‘science and proven experience’ (VBE). In the paper, we outline how the Swedish concept leads to an improved understanding of the way in which scientific evidence and clinical experience can and cannot be integrated in light of EBM. How scientific evidence and clinical experience is integrated influences both the way we do risk assessment and risk management. In addition, the paper sketches the as yet unexplored historical background to VBE and EBM.
Sten Anttila, Johannes Persson, Måns Rosén, Niklas Vareman, Sigurd Vitols, and Nils-Eric Sahlin
Informa UK Limited
Abstract In medical research, it is not unusual that risks are ruled out without any specification the exact risk that was ruled out. This makes it difficult to balance expected health benefits and risk of harm when choosing between alternative treatment options. International guidelines for reporting medical research results are sufficiently specific when it comes to establishing health benefits. However, there is a lack of standards for reporting on ruling out risks. We argue that transparency is needed, as in the case of non-inferiority trials. The Consolidated Standards of Reporting Trials and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements should be revised accordingly.
Robin Stenwall, Johannes Persson, and Nils-Eric Sahlin
Walter de Gruyter GmbH
We would like to thank D. H. Mellor for taking time to comment on our paper “A New Challenge for Objective Uncertainties and The Propensity Theorist” (Stenwall, Persson & Sahlin 2018).
Kristina Blennow, Erik Persson, and Johannes Persson
Public Library of Science (PLoS)
Values related to culture, identity, community cohesion and sense of place have sometimes been downplayed in the climate change discourse. However, they have been suggested to be not only important to citizens but the values most vulnerable to climate change. Here we test four empirical consequences of the suggestion: (i) at least 50% of the locations citizens' consider to be the most important locations in their municipality are chosen because they represent these values, (ii) locations representing these values have a high probability of being damaged by climate change induced sea level rise, (iii) citizens for which these values are particularly strongly held less strongly believe in the local effects of climate change, and (iv) citizens for which these values are particularly strongly held less strongly believe that they have experienced the effects of climate change. The tests were made using survey data collected in 2014 from 326 citizens owning property in Höganäs municipality, Sweden, and included values elicited using a new methodology separating instrumental values from end values, and using the former (which strictly speaking should be seen as estimates of usefulness rather than as aims in themselves) as stepping stones to pinpoint the latter, that represent the true interests of the respondents. The results provide the first evidence that, albeit frequent, values related to culture, identity, community cohesion and sense of place are not the values most vulnerable to climate change. This in turn indicates a need to further investigate the vulnerability of these values to climate change, using a methodology that clearly distinguishes between instrumental and end values.
Johannes Persson, Emma L. Johansson, and Lennart Olsson
Resilience Alliance, Inc.
The calls for evidence-based public policy making have increased dramatically in the last decades, and so has the interest in evidence-based sustainability studies. But questions remain about what “evidence” actually means in different contexts and if the concept travels well between different domains of application. Some of the most relevant questions asked by sustainability studies are not, and in some cases cannot be, directly answered by relying on research evidence of the kinds favored by the evidence-based movement. Therefore, sustainability studies must also harness other forms of knowledge, based on forms of practical experience. How to integrate these two sources of knowledge is one of the most fundamental epistemological and practical problems society is facing. Identifying what kind of practical experience and research evidence we need to integrate is another challenging question. We draw on examples from our research in the Global South and suggest an efficient principle, problem-feeding, for harnessing practical experience within an adapted version of evidence-based sustainability studies. (Less)
Johannes Persson, Alf Hornborg, Lennart Olsson, and Henrik Thorén
Resilience Alliance, Inc.
Interdisciplinary research within the field of sustainability studies often faces incompatible ontological assumptions deriving from natural and social sciences. The importance of this fact is often underrated and sometimes leads to the wrong strategies. We distinguish between two broad approaches in interdisciplinarity: unificationism and pluralism. Unificationism seeks unification and perceives disciplinary boundaries as conventional, representing no long-term obstacle to progress, whereas pluralism emphasizes more ephemeral and transient interdisciplinary connections and underscores the autonomy of the disciplines with respect to one another. Both approaches have their merits and pitfalls. Unification runs the risk of scientific imperialism, while pluralism can result in insurmountable barriers between disciplines. We made a comparison of eight distinct interdisciplinary attempts at integration of knowledge across social and natural sciences. The comparison was carried out as four pairwise comparisons: environmental economics versus ecological economics, environmental history versus historical ecology, resilience theory versus political ecology, and socio-biology versus actor-network theory. We conclude by showing that none of these prominent eight interdisciplinary fields in and of itself manages to provide, in a satisfactory way, such an integrated understanding of sustainability. We argue for pluralism and advocate complex ways of articulating divergent ontological assumptions. This is not equivalent to pursuing knowledge unification either through scientific imperialism or by catering to the requirements of narrow practical utility. It means prioritizing interdisciplinary integration by simultaneously acknowledging the role of societal and natural factors in accounting for sustainability issues.
Johannes Persson, Henrik Thorén, and Lennart Olsson
Resilience Alliance, Inc.
Interdisciplinary research in the fields of forestry and sustainability studies often encounters seemingly incompatible ontological assumptions deriving from natural and social sciences. The perceived incompatibilities might emerge from the epistemological and ontological claims of the theories or models directly employed in the interdisciplinary collaboration, or they might be created by other epistemological and ontological assumptions that these interdisciplinary researchers find no reason to question. In this paper we discuss the benefits and risks of two possible approaches, Popperian optimism and Kuhnian pessimism, to interdisciplinary knowledge integration where epistemological and ontological differences between the sciences involved can be expected.
Robin Stenwall, Johannes Persson, and Nils-Eric Sahlin
Walter de Gruyter GmbH
Abstract The paper is concerned with the existence of objective uncertainties. What would it take for objective uncertainties to exist, and what would be the consequences for our understanding of the world we live in? We approach these questions by considering two common theories on how we are to understand the being of propensities and how it pertains to possible outcomes that remain unmanifested. It is argued that both or these theories should be rejected, and be replaced with a theory we call unrestricted actualism according to which the possible outcomes of propensities (whether realized or unrealized) are denizens of the actual world.
Sten Anttila, Johannes Persson, Niklas Vareman, and Nils-Eric Sahlin
BMJ
One of the most widely used tools for assessing and communicating scientific uncertainty is Grading of Recommendations Assessment, Development, and Evaluation (GRADE), a system for rating the quality of evidence and grading strength of recommendations in healthcare. More than 100 organisations around the world—WHO included1—are using GRADE or have endorsed it.
In GRADE, a quantitative assessment of uncertainty is qualitatively communicated, so that a result obtained as a CI relative to a threshold is expressed as a finding in which assessors have low, moderate or high certainty, or certainty described with other such qualifiers. What these correspond to in quantitative terms, and how decision-makers interpret them, is our issue here. We confine our attention to GRADE’s decision rules for systematic reviews, and do not comment on the problem of multiple outcomes in guideline recommendations.
In a recent guideline article,2 GRADE introduced an idea that appears to undermine sound statistical reasoning in systematic reviews: the idea is that a result …
Lena Wahlberg and Johannes Persson
Brill
Abstract In Swedish law, the notion of ‘science and proven experience’ (in Swedish, vetenskap och beprövad erfarenhet) defines the gold standard for public decision-making and practice, especially in medicine. The notion is notoriously vague but nevertheless plays an important role in the distribution of rights and duties of patients and healthcare workers. For example, failure to provide care in accordance with this standard can lead to penal responsibility. The notion also helps to define Swedish patients’ right to reimbursement for cross-border healthcare. From a legal point of view, the notion is especially intriguing because it appears to import medical standards into the legal conceptual apparatus. The purpose of this article is to explore the mechanisms of this and kindred ‘importing notions’ by investigating the role that the notion of science and proven experience plays in Swedish law and in the transfer of information between the legal and medical fields.
David Chandler
Routledge
Sten Anttila, Johannes Persson, Niklas Vareman, and Nils-Eric Sahlin
Elsevier BV
Kristina Blennow, Johannes Persson, Erik Persson, and Marc Hanewinkel
Public Library of Science (PLoS)
Do forest owners’ levels of education or value profiles explain their responses to climate change? The cultural cognition thesis (CCT) has cast serious doubt on the familiar and often criticized "knowledge deficit" model, which says that laypeople are less concerned about climate change because they lack scientific knowledge. Advocates of CCT maintain that citizens with the highest degrees of scientific literacy and numeracy are not the most concerned about climate change. Rather, this is the group in which cultural polarization is greatest, and thus individuals with more limited scientific literacy and numeracy are more concerned about climate change under certain circumstances than those with higher scientific literacy and numeracy. The CCT predicts that cultural and other values will trump the positive effects of education on some forest owners' attitudes to climate change. Here, using survey data collected in 2010 from 766 private forest owners in Sweden and Germany, we provide the first evidence that perceptions of climate change risk are uncorrelated with, or sometimes positively correlated with, education level and can be explained without reference to cultural or other values. We conclude that the recent claim that advanced scientific literacy and numeracy polarizes perceptions of climate change risk is unsupported by the forest owner data. In neither of the two countries was university education found to reduce the perception of risk from climate change. Indeed in most cases university education increased the perception of risk. Even more importantly, the effect of university education was not dependent on the individuals' value profile.