1. Shared understanding Jouni Tuomisto, THL

2. Outline What is shared understanding? Main properties Examples of use How does it make things different? Rules of application Tasks typical for different roles Common practices that go against shared understanding

3. Open risk management: overview QRAQRA Mikko V Pohjola and Jouni T Tuomisto.. Environmental Health 2011, 10: 58 doiEnvironmental Health 2011, 10: 58doi

4. Purpose of shared understanding To give a theoretical framework and practical guidance to improve decisions about environmental health (and other topics). To turn knowledge into actions.

5. Shared understanding: definition There is shared understanding between two people about a topic, if both are able to explain what the other person thinks about the topic and why. This can be extended to a group: –Everyone is able to explain what thoughts and reasonings there are in the group about the topic. –There is no need to know all thoughts on individual level.

6. A test for shared understanding From Hitchhiker’s Guide to Galaxy: A discussion between the captain of a space ship and Ford Prefect, a space hitchhiker. –”There was a good reason why our space ship was predetermined to crash on the planet that is our destination.” –”That was because you are a bunch of useless idiots!” –”Ah, yes, that was the reason.”

7. Shared understanding: graph Pohjola MV et al: Food and Chemical Toxicology. 2011. In press.

8. Typical expert’s views on shared understanding Experts do not want to enter public discussions, because they think that –they will not have enough media time to make their point. –populists and interest groups that don’t stick with the truth will overwhelm the media coverage. –peer review is absolutely necessary but it is not possible in open discussions.  Experts limit their responsibility to publishing scientific reports, lecturing, and possibly press releases of an institute. Open discussion is very unpopular idea among experts.

9. Examples Swine flu in Finland http://en.opasnet.org/w/Assessment_of_the_health_ impacts_of_H1N1_vaccination http://en.opasnet.org/w/Assessment_of_the_health_ impacts_of_H1N1_vaccination –An assessment including models and discussion http://en.opasnet.org/w/Talk:Assessment_of_the_hea lth_impacts_of_H1N1_vaccination http://en.opasnet.org/w/Talk:Assessment_of_the_hea lth_impacts_of_H1N1_vaccination Radon in Europe http://en.opasnet.org/w/Health_impact_of_radon_in _Europe http://en.opasnet.org/w/Health_impact_of_radon_in _Europe –User can choose values (disability weights) –Defaults come from WHO http://en.opasnet.org/w/Disability_weights http://en.opasnet.org/w/Disability_weights

10. Assessment in its societal context Pohjola MV, Tuomisto JT, and Tainio M: The properties of good assessment - addressing use as the essential link from outputs to outcomes. Manuscript.

11. More traditional view on risk analysis

12. Shared understanding: graph Pohjola MV et al: Food and Chemical Toxicology. 2011. In press.

13. There are typically many decisions related to an environmental health issue One main decision: –City plan (by a city council) –Environmental permit for a factory (by an authority) –Environmental tax (by the Parliament) Compensatory decisions –Investment in the city (by a company) –Avoidance of the taxed product (by a consumer) –Moving to/from the city (by a citizen)  Do others behave as expected? This often drives the outcomes of decisions.  These things should be included in the assessment.

14. Roles of participants Decision makers: bring in their values, objectives, and decision criteria. Experts: bring in their knowledge (and values). Citizens and other stakeholders: bring in their values, intentions, objectives, and knowledge.  The success of a decision can be evaluated.  The decision is based on knowledge.  The decision leads action to acceptable directions.

15. Objective: a written synthesis The ultimate objective of shared understanding is to increase understanding of participants. The practical objective is to develop a written synthesis of the thinking and the knowledge of the group. This process is called trialogical approach.

16. How to develop shared understanding? 1.Focus on the topic, not on the speakers. 2.Focus on what is meant, not on what is said. 3.Don’t push for consensus. Just describe what is thought and understood about the topic. 4.Search for and require internal consistence even if participants themselves are inconsistent. 5.When under uncertainty, describe the situation as several possible worlds (probabilities!) 6.Base all rationale ultimately on observations about issues (what is?) and opinions (what should be?).

17. It is about changes in practices There is nothing fundamentally new. However, the current culture do not support the best practices.

18. Useful things to share Generic data: populations, background rates of diseases, intake fractions, exposure-response functions,… Generic values: disability weights of diseases, value of statistical life, willingness to pay to avoid harm,… Common decisions for individuals: choice of a trip mode, choice of a heating system in a new house, a heat pump investment,… Common decisions for municipalities: city planning, implementation of district heating, public transport subsidies,… Common decisions for national authorities: acceptability of a new chemical, limit values of noise for wind mill parks.,,, Many other things; there is always someone who can learn.

19. Opasnet: a web workspace for open assessments and shared understanding Opasnet wiki: a user interface for contributing and using all of the functionalities listed below. Opasnet Base: a database for all kinds of data with easy upload and use. R-tools: statistical software R for modelling and data presentation. Opasnet File: a file management system for sharing background documents, reports etc.

20. Conclusions Shared understanding is (hopefully) a simple concept to discuss practices of decision making in a democratic society. There is an urgent need for a major change in common practices, both among experts and among decision makers. –The change is already ongoing among citizens. There is a lot of potential for doing things in a more open and sharing way. This development is slowed down by old practices and ignorance rather than ”real” causes. There are enough practical tools to make a quantum leap in decision support. It is about learning to use them, and most importantly, learning to think in an open way. Spread the word! Join a group for open decision support! E.g. AvaryAvary Change your own routines!