Psychiatry is rapidly adopting digital phenotyping and artificial intelligence/machine learning tools to study mental illness based on tracking participants’ locations, online activity, phone and text message usage, heart rate, sleep, physical activity, and more. Existing ethical frameworks for return of individual research results (IRRs) are inadequate to guide researchers for when, if, and how to return this unprecedented number of potentially sensitive results about each participant’s real-world behavior. To address this gap, we convened an interdisciplinary expert working group, supported by (...) a National Institute of Mental Health grant. Building on established guidelines and the emerging norm of returning results in participant-centered research, we present a novel framework specific to the ethical, legal, and social implications of returning IRRs in digital phenotyping research. Our framework offers researchers, clinicians, and Institutional Review Boards (IRBs) urgently needed guidance, and the principles developed here in the context of psychiatry will be readily adaptable to other therapeutic areas. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

Bioethicists function in an environment in which their peers - healthcare executives, lawyers, nurses, physicians - assert the integrity of their fields through codes of professional ethics. Is it time for bioethics to assert its integrity by developing a code of ethics? Answering in the affirmative, this paper lays out a case by reviewing the historical nature and function of professional codes of ethics. Arguing that professional codes are aggregative enterprises growing in response to a field's historical experiences, it asserts (...) that bioethics now needs to assert its integrity and independence and has already developed a body of formal statements that could be aggregated to create a comprehensive code of ethics for bioethics. A Draft Model Aggregated Code of Ethics for Bioethicists is offered in the hope that analysis and criticism of this draft code will promote further discussion of the nature and content of a code of ethics for bioethicists. (shrink)

What methodology should philosophers follow? Should they rely on methods that can be conducted from the armchair? Or should they leave the armchair and turn to the methods of the natural sciences, such as experiments in the laboratory? Or is this opposition itself a false one? Arguments about philosophical methodology are raging in the wake of a number of often conflicting currents, such as the growth of experimental philosophy, the resurgence of interest in metaphysical questions, and the use of formal (...) methods. This outstanding collection of specially-commissioned chapters by leading international philosophers discusses these questions and many more. It provides a comprehensive survey of philosophical methodology in the most important philosophical subjects: metaphysics, epistemology, philosophy of language, philosophy of mind, phenomenology, philosophy of science, ethics, and aesthetics. A key feature of the collection is that philosophers discuss and evaluate contrasting approaches in each subject, offering a superb overview of the variety of methodological approaches - both naturalistic and non-naturalistic - in each of these areas. They examine important topics at the heart of methodological argument, including the role of intuitions and conceptual analysis, thought experiments, introspection, and the place that results from the natural sciences should have in philosophical theorizing. The collection begins with a fascinating exchange about philosophical naturalism between Timothy Williamson and Alexander Rosenberg, and also includes contributions from the following philosophers: Lynne Rudder Baker, Matt Bedke, Greg Currie, Michael Devitt, Matthew C. Haug, Jenann Ismael, Hilary Kornblith, Neil Levy, E.J. Lowe, Kirk Ludwig, Marie McGinn, David Papineau, Matthew Ratcliffe, Georges Rey, Jeffrey W. Roland, Barry C. Smith, Amie L. Thomasson, Valerie Tiberius, Jessica Wilson, and David W. Smith. (shrink)

The thesis of this book is to develop a theory of value covering all kinds of values, based on my unified utilitarian theory. It is unique and is different from all traditional and existing theories of value. Like the views of most psychologists and decision-scientists, value is asserted to be subjective in nature because value exists only for a subject. Value and value judgment are considered statistical in nature in three dimensions, namely in the dimensions of subject, object, and judge. (...) This theory covers a modified von Neumann-Morgenstern utility theory as an integral part. The three conceptions of utility held by philosophers, economicsts, and decision-scientists are unified. The traditional and conventional classification of value into intrinsic and instrumental, which may lead to confusion, misunderstanding, and circularity, is not used. Instead, a classification based on the classification of good things in life according to the principle of exchangeability and replaceability is emphasized and used. A decision-theoretic approach is taken for the study of actions in life. All the actions in a person's life are for the pursuit of values, and all the values pursued are related, directly or indirectly, closely or remotely, to a life plan. Thus, this utilitarian general theory of value eventually leads to a philosophy of life, which is also consequential, teleological, and utilitarian. (shrink)

This expanded edition of C L Hardin's ground-breaking work on colour features a new chapter, 'Further Thoughts: 1993', in which the author revisits the dispute ...

Taking organs from dead people seems, prima facie, to raise fewer ethical complications than taking organs from other sources. There are, however, serious ethical problems in taking organs from the dead unless there is premortem evidence that this is what the deceased would have wanted, or at least, not have objected to. In this paper we will look at a “strong” opting out policy as proposed by John Harris. We will argue that people can be harmed after their death and (...) that the posthumous removal of organs against their expressed wishes is one form that such harm might take. We also argue that Harris’s claim that we show “equality of concern” between the donor and recipient requires too much. (shrink)

The legal requirements and justifications for collecting patient-identifiable data without patient consent were examined. The impetus for this arose from legal and ethical issues raised during the development of a population-based disease register. Numerous commentaries and case studies have been discussing the impact of the Data Protection Act 1998 and Caldicott principles of good practice on the uses of personal data. But uncertainty still remains about the legal requirements for processing patient-identifiable data without patient consent for research purposes. This is (...) largely owing to ignorance, or misunderstandings of the implications of the common law duty of confidentiality and section 60 of the Health and Social Care Act 2001. The common law duty of confidentiality states that patient-identifiable data should not be provided to third parties, regardless of compliance with the DPA1998. It is an obligation derived from case law, and is open to interpretation. Compliance with section 60 ensures that collection of patient-identifiable data without patient consent is lawful despite the duty of confidentiality. Fears regarding the duty of confidentiality have resulted in a common misconception that section 60 must be complied with. Although this is not the case, section 60 support does provide the most secure basis in law for collecting such data. Using our own experience in developing a disease register as a backdrop, this article will clarify the procedures, risks and potential costs of applying for section 60 support. (shrink)

This detailed and sympathetic, but not uncritical, study of On Liberty' argues for the general consistency and coherence of Mill's defence of individual liberty, but maintains that there are significant non-utilitarian elements in his arguments.

One dark and rainy night, Yuso sexually assaults and tortures Zelan. In escaping from the scene of his crime, he falls heavily and becomes an impotent paraplegic. Instead of treating his fate as divine retribution for his wicked acts, Yuso sees it as sheer bad luck. He shows no remorse for what he has done, and vainly hopes that he will recover his powers, which he now treats as involuntarily hoarded resources to be used on less rainy days. In the (...) presence of others, he pretends that he has turned over a new leaf. He asks for religious and educational books, hoping to make up for his poor education and deprived social background. But he immediately discards them when he is alone in favor of the pornographic magazines which he has bribed a nurse to smuggle in for him. His deception and various obscene acts committed in the hospital are exposed; by the time he comes up for trial, everyone knows that he is still a lustful, sadistic, and unrepentant man. Most retributivists have a sufficient justification for punishing Yuso independently of the social consequences of his punishment. Two features of the case might cause some difficulties. First, Yuso has already experienced considerable suffering and deprivation both before and after his crime, and retributivists might disagree about the relevance of the suffering to his punishment. Secondly, Yuso is unrepentant, and it is unlikely that punishment will change him. This might, as we shall see, create a problem for those who think that the justifying aim of punishment is the moral reform of the offender. (shrink)