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risk management, sostenibilità
Sostenibilit e rischio sistemicoCaveant consules ne quid res publica detrimenti caperet
Pier Paolo Dal Monte, MD Bologna, Italy
Board member Associazione Italiana di Bioetica ChirurgicaBoard member Eurasian Colorectal Technologies AssociationMember Bioethic Commission, Italian Colorectal Surgery SocietyAssociazione Medicina Fondata sulla Persona
mercoled 6 novembre 2013
Considerate la vostra semenza: fatti non foste a viver come bruti,
ma per seguir virtute e canoscenzaDante, Inferno, XXVII, 118-120
mercoled 6 novembre 2013
Come conosciamo(cosa conosciamo, cosa crediamo di conoscere, cosa non
conosciamo)
EpistemologiaDal Greco Epi- Histomai: stare sopra
I principi che guidano la nostra conoscenza
mercoled 6 novembre 2013
Dallindoeuropeo -Dha: ci che stbilito and Sva-: s
Sanscrito: Svadha: ci che stabilito per se stessi, la via personale, fato, destino
La disciplina che concerne il retto comportamento
Dal greco Ethos: uso, costume, comportamento
Etica
mercoled 6 novembre 2013
Etica medicaLo scopo principale della pratica medica, nella storia, stato sempre definito in termini di benefici per i pazienti
Epistemologia medicaLa conoscenza pi appropriata (metodi) per perseguire
il beneficio per il singono paziente
mercoled 6 novembre 2013
Sostenibilit significa che un sistema dovrebbe soddisfare i bisogni del presente senza compromettere la possibilit
di soddisfare i bisogni del futuro
Sostenibilit
Brundtland, G.H. (ed.), (1987). Our Common Future: The World Commission on Environment and Development
mercoled 6 novembre 2013
Sostenibilit
mercoled 6 novembre 2013
Sistemi complessi
OlarchiaLa stabilit degli oloni di alto livello basata sulla stabilit
degli oloni di livello inferiore. A propria volta gli oloni di livello inferiore dipendono per la propria stabilit
strutturale dagli oloni di livello superiore
Un sistema adattativo complesso (olarchia) composto da diversi sotto-sistemi (oloni) che sono definiti dalle
modalit di con le quali interagiamo con il con il sistema (visione del mondo)
Rosen, R., (1977), Complexity as a system property, Int. J. Gen. Syst., 3, 227232
The Crash of Reductionism against the Complexity of Reality 5
context in which the scientist is operating. The possibility of multiple nonequivalent perceptions of thesame situation is one of the typical characteristics of complexity, and it is further elaborated in thefollowing section.
1.1.2 Looking at Nonequivalent Useful Pictures of a Person, Which One Is Right?
Before moving to the second example, this section discusses in more detail the impossibility of obtainingthe right picture of a given situation when dealing with complex systems organized in a nestedhierarchy. In this section I want to make the point that it is literally impossible to get the right pictureof a given complex system. Even when talking of real pictures (those printed on a paper or shown ona monitor), the complexity of the reality entails the unavoidable existence of multiple identities that, tobe represented, require the parallel use of nonequivalent pictures.
Imagine that we are requested to pick up a visiting scientist at the airport. We are given the name Dr. X but we do not know her or his face. The most obvious additional input needed to perform ourtask is a picture of Dr. X. Now imagine that we ask for a picture and what we get in the mail is thepicture given in Figure 1.2a with a note saying: Please find enclosed the picture of Dr. X that yourequested. Such a picture is completely useless for our task, even though we cannot say that such apicture does not contain relevant information about Dr. X. This picture makes it possible to study howDr. X digests nutrients to keep him or her alive. Therefore, this picture (which has been taken from anexperimental nutrition lab in my institute) reflects a very important option available to us for looking athuman beings. It should be considered a crucial piece of information to study human sustainability.
Getting back to our story, we ask for another picture of Dr. X, this time a picture taken at a largerscale. In response to our request we get another picture, that shown in Figure 1.2c, with a note saying:Fulfilling your request, please find enclosed a larger-scale picture of Dr. X, who is the one indicatedby the arrow. Also in this case, even if we cannot use this picture at the airport, this picture tells us
FIGURE 1.2 Nonequivalent views of the same person. (Photos by Andrea Ghiselli.)
a. b.
c. d.
The Crash of Reductionism against the Complexity of Reality 5
context in which the scientist is operating. The possibility of multiple nonequivalent perceptions of thesame situation is one of the typical characteristics of complexity, and it is further elaborated in thefollowing section.
1.1.2 Looking at Nonequivalent Useful Pictures of a Person, Which One Is Right?
Before moving to the second example, this section discusses in more detail the impossibility of obtainingthe right picture of a given situation when dealing with complex systems organized in a nestedhierarchy. In this section I want to make the point that it is literally impossible to get the right pictureof a given complex system. Even when talking of real pictures (those printed on a paper or shown ona monitor), the complexity of the reality entails the unavoidable existence of multiple identities that, tobe represented, require the parallel use of nonequivalent pictures.
Imagine that we are requested to pick up a visiting scientist at the airport. We are given the name Dr. X but we do not know her or his face. The most obvious additional input needed to perform ourtask is a picture of Dr. X. Now imagine that we ask for a picture and what we get in the mail is thepicture given in Figure 1.2a with a note saying: Please find enclosed the picture of Dr. X that yourequested. Such a picture is completely useless for our task, even though we cannot say that such apicture does not contain relevant information about Dr. X. This picture makes it possible to study howDr. X digests nutrients to keep him or her alive. Therefore, this picture (which has been taken from anexperimental nutrition lab in my institute) reflects a very important option available to us for looking athuman beings. It should be considered a crucial piece of information to study human sustainability.
Getting back to our story, we ask for another picture of Dr. X, this time a picture taken at a largerscale. In response to our request we get another picture, that shown in Figure 1.2c, with a note saying:Fulfilling your request, please find enclosed a larger-scale picture of Dr. X, who is the one indicatedby the arrow. Also in this case, even if we cannot use this picture at the airport, this picture tells us
FIGURE 1.2 Nonequivalent views of the same person. (Photos by Andrea Ghiselli.)
a. b.
c. d.
mercoled 6 novembre 2013
Sistemi complessi
Contesto semantico: BiofisicoSociale
Economico
Contesto olarchico:Mondo
Area geopoliticaNazioneDistretti
Realt localiOspedaleRepartoIndividuo
Contesto spazio-temporale
mercoled 6 novembre 2013
Cause di morte di un individuo
Orizzonte temporale Causa Contesto Azione
Brevissimo Arresto cardiaco terminale RianimazioneCome
Procedure rianimatorie
Breve Neoplasia polmonare OspedaleCome > perchCure (chirurgia,
oncologia)
lungo Forte fumatore Tecnico-PoliticoPerch > come
Prevenzione, politiche sanitarie
Molto lungo Tutti gli uomini devono morire
Filosofico Epistemologico
Economico
PerchDiscussione teorica sul concetto di sostenibilit
Contesto spazio-temporale: i domini descrittivi non-equivalenti
Tabella adattata da: M. Giampietro, Multi-scale integrated analysis of agro-ecosystem, CRC Press 2004
ComeCome
Perchmercoled 6 novembre 2013
I modelli descrittivi hanno valore temporaneo Anche quando validati in occasioni precedenti non sono necessariamente appropriati per predire futuri scenari.
Dobbiamo essere pronti ad aggiornare continuamente le identit che noi attribuiamo al sistema
Nessuna una singola descrizione pu esseresoddisfacente, neutrale e obiettiva per definire le propriet
significative di un sistema adattativo complesso
Le traiettorie evolutive di un sistema adattativo complesso hanno una scala spazio-temporale pi ampia di quella dei singoli osservatori
S. Salthe, Development and evolution: complexity and change in biology, MIT Press, Cambridge, MA 1993
Modelli predittivi nei sistemi complessi
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Il concetto di rischio utile quando si affrontano problemi 1) Facilmente classificabili
2) Facilmente misurabili
Incertezza: Situazione nella quale non possiile formulare una predizione
attendibile su eventi futuri (probabilistica)
Rischio, incertezza e ignoranza
Rischio:Situazione in cui possibile assegnare una distribuzione di
probabilit ad un assieme di possibili eventi futuri
Le informazioni derivanti dalla precedente esperienza possono essere solo parzialmente utili
Knight, F.H., (1964), Risk, Uncertainty and Profit, A.M. Kelley, New York.Rosen, R. (1985), Anticipatory Systems: Philosophical, Mathematical and Methodological Foundations,, New York
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1) Indeterminatezza
I problemi sono classificabili ma non interamen
