This article seeks to reframe the ethical discussion of genetic enhancement, which is the use of genetic engineering to supply a characteristic that a parent might want in a child that does not involve the treatment or prevention of disease. I consider whether it is likely that enhancement can be successfully prohibited. If genetic enhancement is feasible, it is likely that there will be demand for it because parents compete to produce able children and nations compete to accumulate human capital (...) in skilled workers. If some parents or nations begin using genetic enhancement, this will change these competitions in ways that increase the incentives for others to use it. Therefore, a ban on genetic enhancement would be unstable, because once the ban was breached by defectors the motivation of others to uphold it would weaken, making the ban liable to collapse. The argument provides a new perspective on slippery slopes to dangerous technology. Keywords: genetic enhancement, slippery slope argumentation CiteULike Connotea Del.icio.us What's this? (shrink)

The Strange Situation procedure was developed by Ainsworth two decades agoas a means of assessing the security of infant-parent attachment. Users of the procedureclaim that it provides a way of determining whether the infant has developed species-appropriate adaptive behavior as a result of rearing in an evolutionary appropriate context, characterized by a sensitively responsive parent. Only when the parent behaves in the sensitive, species-appropriate fashion is the baby said to behave in the adaptive or secure fashion. Furthermore, when infants are (...) observed repeatedly in the Strange Situation,the pattern of behavior is said to be highly similar, and this pattern is said to predict the infants' future behavior in a diverse array of contexts. After an exhaustive review of the literature, it is shown that these popular claims are empirically unsupported in their strong form, and that the interpretations in terms of biological adaptationare misguided. There is little reliable evidence about the specific dimensions of parental behavior that affect Strange Situation behavior, although there does appear to be some relationship between these constructs. Temporal stability in security of attachment ishigh only when there is stability in family and caretaking circumstances. Likewise, patterns of Strange Situation behavior only have substantial predictive validity in similarly stable families. Implications for future research and theorizing — particularly as they relate to the use of evolutionary biology in psychological theory — are discussed. (shrink)

Objectives. To document the prevalence of ethical requirements in the instructions for authors of journals that published randomized clinical trials in 2005. Design. Using a validated computerized search strategy for retrieving abstracts of RCTs, we retrieved 13 184 references from 2056 journals. These journals were divided into journals that had published > 30 RCTs in 2005, and those that had published fewer. We included all the former and a random sample of the latter journals in the analysis. Measurements. Coders retrieved (...) the instructions for authors for each journal. The coders identified whether 15 ethical requirements were present in each of the instructions, calculated the age of the journal, and determined where it was published. Results. Only 51% of journals required that authors document review by an ethics committee, only 55% required declaration of conflicts of interest, and only 33% required documentation of informed consent. Overall, 48% of instructions required three or fewer of 15 ethics items. Journals publishing many RCTs each year had more ethical requirements, older journals had more requirements, as did journals published in the US. Journals published in Europe had fewer. However, in multiple regression analyses involving the journal's age, location of publication, and number of RCTs published, only publishing many RCTs was associated with having more ethical requirements. Conclusions. Many journals do not require important elements of research ethics in their instructions for authors. Ethical requirements are less common in the many journals that publish few clinical trials each year, journals that have often been overlooked in prior studies of journal ethics. Keywords: Randomized clinical trials, ethical instructions, publication ethics, journal requirements. (shrink)

Institutional review boards are almost universally considered to be overworked and understaffed. They also require substantial commitments of time and resources from their members. Although some surveys report average IRB memberships of 15 people or more, federal regulations require only five. We present data on IRB meetings at eight of the top 25 academic medical centers in the United States funded by the National Institutes of Health. These data indicate substantial contributions from primary reviewers and chairs during protocol discussions but (...) little from other members, which implies that it may be possible for smaller IRBs to accomplish the same tasks with no reduction in the quality of review. (shrink)

Social scientists have drawn attention to the role of hype and optimistic visions of the future in providing momentum to biomedical innovation projects by encouraging innovation alliances. In this article, we show how less optimistic, uncertain, and modest visions of the future can also provide innovation projects with momentum. Scholars have highlighted the need for clinicians to carefully manage the expectations of their prospective patients. Using the example of a pioneering clinical team providing deep brain stimulation to children and young (...) people with movement disorders, we show how clinicians confront this requirement by drawing on their professional knowledge and clinical expertise to construct visions of the future with their prospective patients; visions which are personalized, modest, and tainted with uncertainty. We refer to this vision-constructing work as recalibration, and we argue that recalibration enables clinicians to manage the tension between the highly optimistic and hyped visions of the future that surround novel biomedical interventions, and the exigencies of delivering those interventions in a clinical setting. Drawing on work from science and technology studies, we suggest that recalibration enrolls patients in an innovation alliance by creating a shared understanding of how the “effectiveness” of an innovation shall be judged. (shrink)

1. An epistemological integration. Any proposition which is entertained in any mind will be represented by four points, one located on each of four scales, symbolizing truth, belief, probability, and conviction.

In 2013 the Nuffield Council on Bioethics launched their report Novel Neurotechnologies: Intervening in the Brain. The report, which adopts the European Commission’s notion of Responsible Research and Innovation, puts forward a set of priorities to guide ethical research into, and the development of, new therapeutic neurotechnologies. In this paper, we critically engage with these priorities. We argue that the Nuffield Council’s priorities, and the Responsible Research and Innovation initiative as a whole, are laudable and should guide research and innovation (...) in all areas of healthcare. However, we argue that operationalising Responsible Research and Innovation requires an in-depth understanding of the research and clinical contexts. Providing such an understanding is an important task for empirical ethics. Drawing on examples from sociology, science and technology studies, and related disciplines, we propose four avenues of social science research which can provide such an understanding. We suggest that these avenues can provide a manifesto for empirical ethics. (shrink)

The liberal conception of the state is marked by an insistence upon the equal civil and political rights of each inhabitant. Recently, though, a number of writers have argued that this emphasis on uniform rights ignores the fact that the populations of most states are culturally diverse, and that their inhabitants have significant interests qua members of particular cultures. They argue that liberals should recognize special, group-based cultural rights as a necessary part of a theory of justice in multicultural societies. (...) In this thesis I examine the idea of special cultural rights. In the first part, I begin by setting out some of the different conceptions of culture and multiculturalism that are involved in the debate over cultural rights. I then discuss three claims made by supporters of special cultural rights: that having culture is an essential part of individual autonomy; that people have morally significant interests qua members of particular cultures; and that these interests are inadequately protected by existing liberal conceptions of human rights. Although I conclude that is correct, I argue that both and are mistaken. Among other things, I suggest that the version of culture relied upon by supporters of special cultural rights is an implausible one and I outline what I take to be a more plausible, cosmopolitan conception of culture. In the second part, I begin by looking at specific instances of cultural rights-claims, and analyzing the concept of cultural rights qua rights. I consider the practical and conceptual difficulties with special cultural rights at great length. But the core of my thesis is that our interest in culture lies in its contribution of worthwhile goals and options, and that this interest lies in culture generally rather than in particular cultures. Hence, adopting a special or group-based distribution of any right to culture would seem to be inconsistent with liberal egalitarian principles. If there are such things as cultural rights, I argue, they are general rather than special rights. I conclude by offering a very preliminary account of what a cosmopolitan conception of cultural rights might involve in the case of the right to free association and language rights. (shrink)

A good deal of attention has been recently focused on the presumed advertising excesses of the healthcare industry in its promotion techniques to healthcare professionals, whether through offering gratuities such as gifts, honoraria, or travel support2-6 or through deception. Two basic concerns have been expressed: Does the acceptance of gratuities bias the recipient, tainting his or her responsibilities as the patient's agent? Does acceptance of the gratuity by the healthcare professional contribute to the high cost of healthcare products? The California (...) Society of Hospital Pharmacists was recently asked by its members to formulate a policy for an appropriate relationship between the Society and the healthcare industry, addressing these concerns. In formulating its policy, it became clear that the Society depended on healthcare industry support, gathered through journal advertising, fees for booths at its various educational events, and grants for speakers. (shrink)