When Risk Factor Patterns Change Due to New Scientific Evidence - Ethical Dilemmas

If oral infection causes CVD, there is a moral imperative to avoid CVD by reducing oral infections. But what if it is not clear whether oral infection causes CVD? Then we are faced with conceptual, methodological and moral challenges. The literature, as the rest of this book, is focusing on methodological challenges, trying to show that and how oral infections cause CVD. However, there has been little or no attention on the conceptual and moral challenges, which are the topics for this chapter. A closer analysis of the scientific basis for claiming that oral infection causes CVD reveals a series of moral issues. These stem from a) how to choose between the many conceptions of causality, and from b) the moral challenge of preventing harm when there is an unclear or weak causal relationship between oral infection and CVD or c) when various kinds of uncertainty prevail. The challenge of how to act under uncertain circumstances comes out as questions of resource allocation and prioritization, but it also poses issues of medicalization and not causing unnecessary health anxiety. Hence, although the literature is void of discussing moral challenges with the relationship between oral infection and CVD, the challenges are ample.