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Odd Borgar Jølstad

Postdoctoral Fellow - Centre for Medical Ethics

Email o.b.jolstad@medisin.uio.no

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Visiting address Gaustadalléen 21 Forskningsparken Hus C Plan 1 0349 Oslo

Postal address Postboks 1130 Blindern 0318 Oslo

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Academic interests

I work on priority setting in health, distributive ethics, well-being, and methods in moral philosophy. More specifically I have worked on severity as a priority setting criterion, the relationship between well-being and health, and the relationship between empirical and normative ethics. As a postdoctoral fellow at the Ethics of Mortality Measurements project (ETHME), I now work on the value of future lives and valuing IVF, population ethics more generally, and the relationship between empirical and normative ethics.

Background

2012: Bachelor of Philosophy, University of Bergen

2019: Cand. Psychol (six-year degree in clinical psychology), University of Oslo

2023: PhD in medical ethics, University of Oslo

Appointments

Member of the clinical ethics committee, Ringerike Hospital

Partners

I also work as a researcher and supervisor on the Clinical Priority Setting project (CLINPRI) at Akershus University Hospital.

Jølstad, Odd Borgar; Stenmarck, Mille Sofie & Barra, Mathias (2024). Preparing popular views for inclusion in a reflective equilibrium: A case study on illness severity. Social Science and Medicine. ISSN 0277-9536. 348. doi: 10.1016/j.socscimed.2024.116794. Full text in Research Archive
Jølstad, Odd Borgar; Juth, Niklas; Solberg, Carl Tollef & Barra, Mathias (2024). When Should Popular Views be Included in a Reflective Equilibrium? Erkenntnis: An International Journal of Scientific Philosophy. ISSN 0165-0106. doi: 10.1007/s10670-024-00805-8. Full text in Research Archive Show summary
It has become increasingly common to conduct research on popular views on ethi- cal questions. In this paper, we discuss when and to what extent popular views should be included in a reflective equilibrium process, thereby influencing norma- tive theory. We argue that popular views are suitable for inclusion in a reflective equilibrium if they approximate considered judgments and examine some factors that plausibly contribute to the consideredness of popular views. We conclude that deliberation and familiarity contribute to the consideredness of popular views, whereas prevalence does not. Furthermore, we raise the “fair trial” objection: that expert deliberation on popular views might fail to respect the consideredness of these views. Eliciting views approximating considered judgments directly from par- ticipants is therefore preferable to refining popular views or treating them as “bare” intuitions in the reflective process. These conclusions have important implications for which research methods will likely elicit popular views suitable for a reflective equilibrium process. Research focusing on the prevalence of views is unlikely to yield popular views suitable for a reflective equilibrium, whereas deliberative and in-depth work is more promising.
Amri, Michelle; Jølstad, Odd Borgar & Bump, Jesse Boardman (2024). Health equity and distributive justice: views of high-level African policymakers. BMC Medical Ethics. 25(1). doi: 10.1186/s12910-024-01154-5. Full text in Research Archive Show summary
Health equity matters, but there is no universally accepted definition of this or associated terms, such as inequities, inequalities, and disparities. Given the flexibility of these terms, investigating how policymakers understand them is important to observe priorities and perhaps course correct. Accordingly, this study analyzed the perceptions high-level policymakers within the WHO African Region. An online survey was distributed to attendees of the WHO’s Fifth Health Sector Directors’ Policy and Planning Meeting for the WHO African Region by email. After responses were collected, both inductive and deductive coding were applied. Inductive coding was undertaken to glean central concepts from free-form responses on understandings of health equity and deductive coding was used to assess alignment with four theories of distributive justice using a coding framework. In analyzing central concepts, three became apparent: access to health services and/or health care, financial protection, and recognizing subgroups. And when we investigated alignment with theory, most respondents’ understandings of health equity aligned with Rawls’ ‘Theory of Justice’ (95%). Of these responses, 70% were exclusively aligned with Rawls’ ‘Theory of Justice’ and 30% aligned also with another theory (this 30% was split 55% utilitarianism and 45% Sen’s Capabilities Approach). Respondent understandings of health equity showed limited alignment with other theories of distributive justice, which were: utilitarianism (n = 7/39; 17.95%), Sen’s Capabilities Approach (n = 5/39; 12.82%), and libertarianism (n = 2/39; 5.13%). Our study demonstrates that alignment with certain theories is tied to specific themes (i.e., theoretical underpinnings may guide policymakers to favour certain policy approaches). For instance, a utilitarian-minded policymaker may be focused on a widespread vaccination campaign, whereas a Rawlsian-aligned policymaker may focus on a targeted approach to reach communities that have lower vaccination rates, and a Senian-aligned policymaker may focus on health literacy programs targeted at addressing vaccine-hesitant individuals within communities with lower vaccination rates. These findings can guide high-level policymakers and international organizations to optimize decision-making by clarifying ethical alternatives.
Stenmarck, Mille Sofie; Jølstad, Odd Borgar; Baker, Rachel; Whitehurst, David GT. & Barra, Mathias (2023). A severely fragmented concept: Uncovering citizens’ subjective accounts of severity of illness. Social Science and Medicine. ISSN 0277-9536. 330. doi: 10.1016/j.socscimed.2023.116046. Full text in Research Archive
Jølstad, Odd Borgar & Solberg, Carl Tollef (2023). Reciprocity as an Argument for Prioritizing Healthcare Workers for the COVID-19 Vaccine. De Ethica. 7(2), p. 28–43. doi: 10.3384/de-ethica.2001-8819.237228. Full text in Research Archive Show summary
During the recent debates on whether to prioritize healthcare workers for COVID-19 vaccines, two lines of argument were prevalent, namely arguments centered on maximizing health, either with or without a special emphasis on the worse off, and arguments centered on reciprocity. In this article, we scrutinize the arguments of reciprocity. The notions of fittingness and proportionality are fundamental for the act of reciprocating, and we consider the importance of these notions for various arguments from reciprocity, showing that the arguments are problematic. If there is a plausible argument for reciprocity during the COVID-19 pandemic, this is most likely one that centers on the risk that healthcare workers take on as part of their jobs. Furthermore, we argue that the scope of this argument should not be extended only to healthcare workers, other essential workers at risk are in a position to make the same arguments. We also consider whether reciprocating with vaccines, rather than by other means, is necessary. Allocating vaccines based on reciprocity will arguably conflict with utility-maximizing, concerns for the worse off, and equity concerns. Given the weak state of the reciprocity arguments, we conclude that overriding these concerns seems unreasonable.
Jølstad, Odd Borgar (2023). Adaptation and illness severity: the significance of suffering. Medicine, Health care and Philosophy. ISSN 1386-7423. 26, p. 413–423. doi: 10.1007/s11019-023-10155-x. Full text in Research Archive
Jølstad, Odd Borgar & Gustavsson, Erik (2023). Against tiebreaking arguments in priority setting. Journal of Medical Ethics. ISSN 0306-6800. doi: 10.1136/jme-2023-108972. Full text in Research Archive
Jølstad, Odd Borgar & Juth, Niklas (2022). Age and Illness Severity: A Case of Irrelevant Utilities? Utilitas. ISSN 0953-8208. 34(2), p. 209–229. doi: 10.1017/S0953820822000024. Full text in Research Archive
Horn, Sindre August; Jølstad, Odd Borgar; Barra, Georg Mathias Honoré & Solberg, Carl Tollef (2021). Er covid-19 alvorlig? Det norske alvorlighetskriteriet for helseprioriteringer i møte med en pandemi. Tidsskrift for velferdsforskning. ISSN 0809-2052. 24(2), p. 1–14. doi: 10.18261/issn.2464-3076-2021-02-01. Full text in Research Archive Show summary
Koronapandemien har synliggjort nødvendigheten av prioriteringer i helsetjenesten vår. Helseprioriteringer i Norge skal gjøres etter de tre kriteriene nytte, ressurs og alvorlighetsgrad. Nytte- og ressurskriteriene utgjør til sammen et kostnadseffektivitetskriterium: Høyere prioritet tilfaller tiltak som skaper mye helse med få ressurser. Alvorlighets- kriteriet innebærer at en mer alvorlig tilstand kan og skal prioriteres høyere enn kostnadseffektiviteten alene tilsier. I denne artikkelen undersøker vi det norske alvorlighetskriteriet for helseprioriteringer i møte med koronaepidemien i Norge. Vi beskriver utviklingen av alvorlighetskriteriet i den norske prioriteringsdiskursen. Videre diskuterer vi hvordan koronaepidemien fremhever uenigheter og tvetydigheter rundt begrepet «alvorlighet» hva gjelder dødsrisiko, komorbiditet og hastegrad. Vi drøfter også hvordan den norske pandemiberedskapen passer inn i dette landskapet og etterlyser en klarere forståelse av alvorlighet i skillet mellom behandling og forebygging av sykdom. Til sist drøfter vi om det norske alvorlighetskriteriet for helseprioriteringer også kan være relevant for prioriteringer utenfor helse- vesenet.

View all works in NVA

Solberg, Carl Tollef & Jølstad, Odd Borgar (2025). WIP: Public health priority setting (PUBPRI). Full text in Research Archive
Barra, Georg Mathias Honoré & Jølstad, Odd Borgar (2024). The other sorts - exploring the underwood. Full text in Research Archive
Barra, Georg Mathias Honoré & Jølstad, Odd Borgar (2024). Presentasjon av SEVPRI - Alvorlighet og helseprioriteringer. Full text in Research Archive
Barra, Georg Mathias Honoré; Whitehurst, David G T; Sandman, Lars; Jølstad, Odd Borgar & Ehlert, Adam (2024). Severity – Ethics, Evidence, and Application. Full text in Research Archive
Stenmarck, Mille Sofie; Barra, Georg Mathias Honoré; Baker, Rachel; Whitehurst, David G T & Jølstad, Odd Borgar (2023). A severely fragmented concept: a Q-methodological investigation of subjective accounts of severity in priority setting. Full text in Research Archive
Jølstad, Odd Borgar & Juth, Niklas (2023). Irrelevant Utilities and Illness Severity. Full text in Research Archive
Jølstad, Odd Borgar; Stenmarck, Mille Sofie; Juth, Niklas; Solberg, Carl Tollef & Barra, Mathias (2023). Kan befolkningsperspektivet inkluderes i moralfilosofisk refleksjon? Full text in Research Archive
Barra, Mathias; Stenmarck, Mille Sofie; Jølstad, Odd Borgar & Horn, Sindre August (2023). Rådgiverpanelmøte for SEVPRI;. Full text in Research Archive
Stenmarck, Mille Sofie; Jølstad, Odd Borgar; Baker, Rachel; Barra, Georg Mathias Honoré & Whitehurst, David G T (2022). Severity as a in priority-setting criterion. Full text in Research Archive
Stenmarck, Mille Sofie; Jølstad, Odd Borgar; Baker, Rachel; Barra, Georg Mathias Honoré & Whitehurst, David G T (2022). A severely fragmented concept? A Q-methodological investigation of subjective accounts of severity in priority-setting. Full text in Research Archive
Stenmarck, Mille Sofie; Jølstad, Odd Borgar; Baker, Rachel; Whitehurst, David & Barra, Georg Mathias Honoré (2022). A severely fragmented concept? A Q-methodological investigation of subjective accounts of severity in priority-setting. Full text in Research Archive
Jølstad, Odd Borgar (2022). Severity and illness Adaptation. BMJ Global Health. doi: 10.1136/bmjgh-2022-ISPH.15. Full text in Research Archive
Jølstad, Odd Borgar (2022). Do population views on illness severity correspond to theories on health, well-being, and justice? Full text in Research Archive
Barra, Mathias; Stenmarck, Mille Sofie; Jølstad, Odd Borgar; Horn, Sindre August & Simonsen, Tone Breines (2022). Rådgiverpanelmøte. Full text in Research Archive
Jølstad, Odd Borgar (2021). Irrelevant Utilities and Severity. Full text in Research Archive
Barra, Mathias; Stenmarck, Mille Sofie; Jølstad, Odd Borgar; Torjusen, Marius Lamberg; Horn, Sindre August & Solberg, Carl Tollef [Show all 8 contributors for this article] (2021). SEVPRI Rådgiverpanelseminar. Full text in Research Archive
Barra, Mathias; Juth, Niklas; Solberg, Carl Tollef & Jølstad, Odd Borgar (2024). A Publicly Informed Objective Theory of Illness Severity. Universitetet i Oslo. ISSN 9788234803741. Full text in Research Archive Show summary
When allocating scarce medical resources, we strive to do the best we can with the available resources. However, while we aspire to provide as “much health” as possible, we also care about who the beneficiaries are. Severity criteria are operative in Norway, Sweden, The Netherlands, and the UK. These criteria, while differing in interesting ways, all dictate that we should be willing to accept a higher cost of helping those who are severely ill. But what does it mean to be severely ill? Severity is a thick and heterogeneous concept. It is, at least partly, a measure of health-related worse off-ness. Severity also seems to have a prescriptive aspect: we believe that we should do something when an illness is severe. The dissertation builds on and extends arguments from the four included papers, making the case for a fully aggregative objective theory of illness severity informed by popular views. In such a theory, some features of illness are subject-independent, while others are subject dependent.