American Academy of Pediatrics (AAP) and American College of Medical Genetics (ACMG) recently provided two recommendations about predictive genetic testing of children. The Clinical Sequencing Exploratory Research Consortium's Pediatrics Working Group compared these recommendations, focusing on operational and ethical issues specific to decision making for children. Content analysis of the statements addresses two issues: (1) how these recommendations characterize and analyze locus of decision making, as well as the risks and benefits of testing, and (2) whether the guidelines conflict or (...) come to different but compatible conclusions because they consider different testing scenarios. These statements differ in ethically significant ways. AAP/ACMG analyzes risks and benefits using best interests of the child and recommends that, absent ameliorative interventions available during childhood, clinicians should generally decline to order testing. Parents authorize focused tests. ACMG analyzes risks and benefits using the interests of the child and other family members and recommends that sequencing results be examined for additional variants that can lead to ameliorative interventions, regardless of age, which laboratories should report to clinicians who should contextualize the results. Parents must accept additional analysis. The ethical arguments in these statements appear to be in tension with each other. (shrink)

In “Meeting the Moment: Bioethics in the Time of Black Lives Matter,” Camisha Russell calls for transforming “bioethics-as-usual” with help from “outsiders”. Prior scholars agree...

Answering important public health questions often requires collection of sensitive information about individuals. For example, our understanding of how HIV is transmitted and how to prevent it only came about with people's willingness to share information about their sexual and drug-using behaviors. Given the scientific need for sensitive, personal information, researchers have a corresponding ethical and legal obligation to maintain the confidentiality of data they collect and typically promise in consent forms to restrict access to it and not to publish (...) identifying data.The interests of others, however, can threaten researchers' promises of confidentiality when legal demands are made to access research data. In some cases, the subject of the litigation is tightly connected to the research questions, and litigants' interest in the data is not surprising. Researchers conducting studies on tobacco or occupational or other chemical exposures, for example, are relatively frequent targets of subpoenas. (shrink)

Researchers now commonly collect biospecimens for genomic analysis together with information from mobile devices and electronic health records. This rich combination of data creates new opportunities for understanding and addressing important health issues, but also intensifies challenges to privacy and confidentiality. Here, we elucidate the “web” of legal protections for precision medicine research by integrating findings from qualitative interviews with structured legal research and applying them to realistic research scenarios involving various privacy threats.

The revised Common Rule includes a new option for the conduct of secondary research with identifiable data and biospecimens: regulatory broad consent. Motivated by concerns regarding autonomy and trust in the research enterprise, regulators had initially proposed broad consent in a manner that would have rendered it the exclusive approach to secondary research with all biospecimens, regardless of identifiability. Based on public comments from both researchers and patients concerned that this approach would hinder important medical advances, however, regulators decided to (...) largely preserve the status quo approach to secondary research with biospecimens and data. The Final Rule therefore allows such research to proceed without specific informed consent in a number of circumstances, but it also offers regulatory broad consent as a new, optional pathway for secondary research with identifiable data and biospecimens. In this article, we describe the parameters of regulatory broad consent under the new rule, explain why researchers and research institutions are unlikely to utilize it, outline recommendations for regulatory broad consent issued by the Secretary's Advisory Committee on Human Research Protections, and sketch an empirical research agenda for the sorts of questions about regulatory broad consent that remain to be answered as the research community embarks on Final Rule implementation. (shrink)

Administraation of antiretroviral therapy to women during pregnancy, labor and delivery, and to infants postnatally can dramatidy reduce mother-to- child HIV transmission. However, pregnant women need to know that they are HIV-infected to take advantage of antiretroviral therapy, and many women do not know their HIV status. One-half of HIV-infected infants in the United States were bornto women who had not been tested for HIV or for whom the time of testing was not known. Although fewer than 400infants are infected (...) perinatally in the United States each year, that number could be reduced even further through policies aimed at HIV testing during pregnancy.The reasons toadopt such a policy are strong: the pathophysiology of perinatal transmission is clear, prophylaxis is effective and safe, and the intended beneficiaries of the intervention - babies - cannot protect themselves. (shrink)

Administraation of antiretroviral therapy to women during pregnancy, labor and delivery, and to infants postnatally can dramatidy reduce mother-to- child HIV transmission. However, pregnant women need to know that they are HIV-infected to take advantage of antiretroviral therapy, and many women do not know their HIV status. One-half of HIV-infected infants in the United States were bornto women who had not been tested for HIV or for whom the time of testing was not known. Although fewer than 400infants are infected (...) perinatally in the United States each year, that number could be reduced even further through policies aimed at HIV testing during pregnancy.The reasons toadopt such a policy are strong: the pathophysiology of perinatal transmission is clear, prophylaxis is effective and safe, and the intended beneficiaries of the intervention - babies - cannot protect themselves. (shrink)

This study examined how research conducted at several federally funded institutions designated as Clinical Research Centers or Specialized Programs of Research Excellence addressed the issues of consent, control over biological materials, confidentiality, and disclosure of results in protocols and consent forms for genetic research with stored biological materials. Although a majority of the documents reviewed addressed most of the issues raised in the research ethics literature, topics identified in the literature that were missing include the return of research results, the (...) right to withdraw from research involving biological materials, and the consent of children when they become legal adults. If typical, these findings suggest greater educational efforts may be needed to prompt investigators and IRBs to consider these and other issues that were either not addressed in the protocols or consent forms or were addressed inadequately. (shrink)

Sexual Violation in Islamic Law: Substance, Evidence, and Procedure By AzamHina, xi + 270 pp. Price HB £60.00. EAN 978–1107094246.

This book should be read by anyone with an interest in American Islam. After a brief introduction by the editor, Edward E. Curtis IV, twelve chapters explore va.

The pandemic creates unprecedented challenges to society and to health care systems around the world. Like all crises, these provide a unique opportunity to rethink the fundamental limiting assumptions and institutional inertia of our established systems. These inertial assumptions have obscured deeply rooted problems in health care and deflected attempts to address them. As hospitals begin to welcome all patients back, they should resist the temptation to go back to business as usual. Instead, they should retain the more deliberative, explicit, (...) and transparent ways of thinking that have informed the development of crisis standards of care. The key lesson to be learned from those exercises in rational deliberation is that justice must be the ethical foundation of all standards of care. Justice demands that hospitals take a safety‐net approach to providing services that prioritizes the most vulnerable segments of society, continue to expand telemedicine in ways that improve access without exacerbating disparities, invest in community‐based care, and fully staff hospitals and clinics on nights and weekends. (shrink)

Capitalizing on the hype surrounding stem cell research, numerous clinics around the world offer “stem cell therapies” for a variety of medical conditions. Despite questions about the safety and efficacy of these interventions, anecdotal evidence suggests a relatively large number of patients are traveling to receive these unproven treatments — a practice called “stem cell tourism.” Because these unproven treatments pose risks to individual patients and to legitimate translational stem cell research, stem cell tourism has generated substantial policy concern and (...) inspired attempts to reduce these risks through the development of guidelines for patients and medical practitioners. This paper examines the roles and responsibilities of physicians in patients' home countries with respect to patients' decisions to try unproven stem cell therapies abroad. Specifically, it examines professional guidance from two organizations — the American Medical Association and the International Society for Stem Cell Research — and assesses physicians' professional and legal obligations to patients considering unproven stem cell therapies. Then, drawing on qualitative interviews conducted with patients who traveled abroad for unproven stem cell treatments, it explores the roles that physicians actually play in patients' decisions and compares these actual roles with their professional and legal responsibilities. The paper concludes with a discussion of strategies to help improve the guidance physicians provide to patients considering unproven treatments. (shrink)

Stem cell science, using both embryonic and a variety of tissue-specific stem cells, is advancing rapidly and offers promise to improve medical care in the future. Yet, with the notable exception of hematopoietic stem cell transplantation, a long-established approach to treating certain cancers of the blood system, this promise is long term and most stem cell research focuses on basic scientific questions or the collection of pre-clinical data. Although some clinical trials are underway, most are focused on safety, and novel (...) effective therapy is likely a long way off. Despite the preliminary nature of most stem cell research, however, numerous clinics around the world offer stem cell “therapies” to patients today outside the context of a clinical trial. Although the number of patients who have received these stem cell-based interventions is unknown, anecdotal reports suggest a substantial population of patients is willing to try them, despite unresolved questions about their safety and efficacy. (shrink)

The U.S. Department of Health and Human Services has proposed substantial changes to the current regulatory system governing human subjects research in its Advanced Notice of Proposed Rulemaking, entitled “Human Subjects Research Protections: Enhancing Protections for Research Subjects and Reducing Burden, Delay, and Ambiguity for Investigators.” Some of the most significant proposed changes concern the use of biospecimens in research. Because research involving biological materials begins with an initial interaction with an individual, such research falls squarely within the human subjects (...) research regulatory framework known as the “Common Rule,” which applies to research conducted or funded by the HHS and the other signatory agencies and departments. However, as described in detail below, much biospecimen research may fall within exemptions and exceptions under the Common Rule and, thus, may be conducted without consent. The ANPRM proposes requiring written consent for research use of biospecimens, even if the biospecimens were initially collected for a purpose other than research or have been stripped of identifiers. (shrink)

In this thorough compendium, nineteen accomplished scholars explore, in some manner the values they find inherent in the world, their nature, and revelence through the thought of Frederick Ferré. These essays, informed by the insights of Ferré and coming from manifold perspectives—ethics, philosophy, theology, and environmental studies, advance an ambitious challenge to current intellectual and scholarly fashions.

In this thorough compendium, nineteen accomplished scholars explore, in some manner the values they find inherent in the world, their nature, and revelence through the thought of Frederick FerrZ. These essays, informed by the insights of FerrZ and coming from manifold perspectives—ethics, philosophy, theology, and environmental studies, advance an ambitious challenge to current intellectual and scholarly fashions.

This article reviews recent developments in health care law, focusing on the engagement of law as a partner in health care innovation. The article addresses: the history and contents of recent United States federal law restricting the use of genetic information by insurers and employers; the recent federal policy recommending routine HIV testing; the recent revision of federal policy regarding the funding of human embryonic stem cell research; the history, current status, and need for future attention to advance directives; the (...) recent emergence of medical–legal partnerships and their benefits for patients; the obesity epidemic and its implications for the child’s right to health under international conventions. (shrink)

This article reviews recent developments in health care law, focusing on the engagement of law as a partner in health care innovation. The article addresses: the history and contents of recent United States federal law restricting the use of genetic information by insurers and employers; the recent federal policy recommending routine HIV testing; the recent revision of federal policy regarding the funding of human embryonic stem cell research; the history, current status, and need for future attention to advance directives; the (...) recent emergence of medical–legal partnerships and their benefits for patients; the obesity epidemic and its implications for the child’s right to health under international conventions. (shrink)

This article reviews recent developments in health care law, focusing on controversy at the intersection of health care law and culture. The article addresses: emerging issues in federal regulatory oversight of the rapidly developing market in direct-to-consumer genetic testing, including questions about the role of government oversight and professional mediation of consumer choice; continuing controversies surrounding stem cell research and therapies and the implications of these controversies for healthcare institutions; a controversy in India arising at the intersection of abortion law (...) and the rights of the disabled but implicating a broader set of cross-cultural issues; and the education of U.S. health care providers and lawyers in the theory and practice of cultural competency. (shrink)

Excellence in sport performance is normally taken to be a matter of superior performance of physical movements or quantitative outcomes of movements. This paper considers whether a wider conception can be afforded by certain kinds of nature based sport. The interplay between technical skill and aesthetic experience in nature based sports is explored, and the extent to which it contributes to a distinction between different sport-based approaches to natural environments. The potential for aesthetic appreciation of environmental engagement is found to (...) be strongly dependent on whether or not environmental engagement is exploited for the end of producing a quantifiable result or enhancing technical skill. It is also argued that an existential rather than spectatorial attitude to aesthetic experience is offered by specifically nature oriented sport. Aesthetic experience achieved in this way is therefore neither passive nor detached, but extends Berleant's concept of participatory environmental aesthetics and underpins both an alternate (wide) conception of excellence in sport activity and a richer experience of aesthetic engagement than more objectivised standpoints. (shrink)

Ducks lay eggs' is a true sentence, and `ducks are female' is a false one. Similarly, `mosquitoes carry the West Nile virus' is obviously true, whereas `mosquitoes don't carry the West Nile virus' is patently false. This is so despite the egg-laying ducks' being a subset of the female ones and despite the number of mosquitoes that don't carry the virus being ninety-nine times the number that do. Puzzling facts such as these have made generic sentences defy adequate semantic treatment. (...) However complex the truth conditions of generics appear to be, though, young children grasp generics more quickly and readily than seemingly simpler quantifiers such as `all' and `some'. I present an account of generics that not only illuminates the strange truth conditions of generics, but also explains how young children find them so comparatively easy to acquire. I then argue that generics give voice to our most cognitively primitive generalizations and that this hypothesis accounts for a variety of facts ranging from acquisition patterns to cross-linguistic data concerning the phonological articulation of operators. I go on to develop an account of the nature of these cognitively fundamental generalizations and argue that this account explains the strange truth-conditional behavior of generics. (shrink)

My strategy is to examine a recent trend in philosophical discussions of responsibility, a trend that tries, but I think ultimately fails, to give an acceptable analysis of the conditions of responsibility. It fails due to what at first appear to be deep and irresolvable metaphysical problems. It is here that I suggest that the condition of sanity comes to the rescue. What at first appears to be an impossible requirement for responsibility---the requirement that the responsible agent have created her- (...) or himself---turns out to be the vastly more mundane and non controversial requirement that the responsible agent must, in a fairly standard sense, be sane. (shrink)

Bringing these two emergent areas of thought into direct conversation in Before the Law, Cary Wolfe fosters a new discussion about the status of nonhuman animals and the shared plight of humans and animals under biopolitics.

Bioethics has paid surprisingly little attention to the special problems faced by women and to feminist analyses of current health care issues other than ...

This research addresses the question of whether men and women in sales differ in their ethical attitudes and decision making. The study asked 209 subjects to respond to 20 ethical scenarios, half of which were "relational" and half "non-relational." The study concludes (1) that there are significant ethical differences between the sexes in situations that involve relational issues, but not in non-relational situations, and (2) that gender-based ethical differences change with age and years of experience. The implications of these finding (...) for sales organizations are discussed. (shrink)

Rooted in the field of cathedral studies, this paper draws into dialogue three bodies of knowledge: Edward Bailey’s notion of implicit religion that, among other things, highlights the continuing traction of the Christian tradition and Christian practice within secular societies; David Walker’s notion of the multiple ways through which in secular societies people may relate to the Christian tradition as embodied within the Anglican Church and John Fisher’s notion of spiritual wellbeing as conceptualised in relational terms. Against this conceptual background, (...) this paper draws on data provided by 1234 participants attending one of the Christmas Eve carol services in Liverpool Cathedral to explore the perceived impact of attendance on the spiritual health of people who do not believe in God and yet feel that Liverpool Cathedral is their cathedral, and it is this sense of belonging that brings them back at Christmas time.Contribution: Situated within the science of cathedral studies, this paper links in an original way three fields of discourse: Edward Bailey’s notion of implicit religion, David Walker’s notion of the four ways of belonging to God facilitated by the Anglican Church and John Fisher’s conceptualisation and operationalisation of the notion of spiritual wellbeing. The hypothesis developed from this original integration of theoretical perspectives is then tested empirically on data provided by 404 participants at carol services who do not believe in God. (shrink)

At the very beginning of L’Homme-Machine, La Mettrie claims that Leibnizians with their monads have “rather spiritualized matter than materialized the soul”; a few years later Pierre-Louis Moreau de Maupertuis, President of the Berlin Academy of Sciences and natural philosopher with a strong interest in the modes of transmission of ‘genetic’ information, conceived of living minima which he termed molecules, “endowed with desire, memory and intelligence,” in his Système de la nature ou Essai sur les corps organisés. This text first (...) appeared in Latin in 1751 under the title Dissertatio inauguralis metaphysica de universali naturae systemate, with the pseudonym Dr Baumann; it was translated by Maupertuis in 1754 as Essai sur la formation des corps organisés and was later included in his 1756 Œuvres under the title Système de la nature. Now, it is clear that Maupertuis was a kind of Leibnizian; and that his molecule possessed higher-level, ‘mental’ properties. In that sense he falls under the first category described by La Mettrie. But he was also involved in a debate on this issue with Diderot, who put forth a sustained critique of Maupertuis’ theory of the molecule in the additions to his 1753 Pensées sur l’interprétation de la nature. Where Maupertuis attributes higher-level properties to his living minima, Diderot argues that these properties are ‘organizational’, i.e., they can only be properties of the whole. At issue here is the degree of commitment to a form of materialism. (shrink)

Leslie Stephen (1832–1904) was a writer, philosopher and literary critic whose work was published widely in the nineteenth century. As a young man Stephen was ordained deacon, but he later became agnostic and much of his work reflects his interest in challenging popular religion. This two-volume work, first published in 1876, is no exception: it focuses on the eighteenth-century deist controversy and its effects, as well as the reactions to what Stephen saw as a revolution in thought. Comprehensive and (...) full of detailed analysis, this is an important work in the history of ideas. Volume 2 focuses on eighteenth-century moral philosophy, political philosophy and literature, and on the literary and religious reactions to the revolution in thought. Utilitarianism is discussed at length, as well as the work of thinkers such as Shaftesbury, Mandeville, Burke and Adam Smith. (shrink)

Quantum mechanics and probability theory share one peculiarity. Both have well established mathematical formalisms, yet both are subject to controversy about the meaning and interpretation of their basic concepts. Since probability plays a fundamental role in QM, the conceptual problems of one theory can affect the other. We first classify the interpretations of probability into three major classes: inferential probability, ensemble probability, and propensity. Class is the basis of inductive logic; deals with the frequencies of events in repeatable experiments; describes (...) a form of causality that is weaker than determinism. An important, but neglected, paper by P. Humphreys demonstrated that propensity must differ mathematically, as well as conceptually, from probability, but he did not develop a theory of propensity. Such a theory is developed in this paper. Propensity theory shares many, but not all, of the axioms of probability theory. As a consequence, propensity supports the Law of Large Numbers from probability theory, but does not support Bayes theorem. Although there are particular problems within QM to which any of the classes of probability may be applied, it is argued that the intrinsic quantum probabilities are most naturally interpreted as quantum propensities. This does not alter the familiar statistical interpretation of QM. But the interpretation of quantum states as representing knowledge is untenable. Examples show that a density matrix fails to represent knowledge. (shrink)

Over three previous editions, Ten Theories of Human Nature has been a remarkably popular introduction to some of the most influential developments in Western and Eastern thought. This thoroughly revised fourth edition features substantial new chapters on Aristotle and on evolutionary theories of human nature; the latter centers on Edward O. Wilson but also outlines the ideas of Emile Durkheim, B. F. Skinner, Nikolaas Tinbergen, Konrad Lorenz, Noam Chomsky, and recent evolutionary psychology. This edition also includes a rewritten introduction that (...) invites readers (even if inclined toward fundamentalism, or to cultural relativism) to careful, critical thought about human nature; a useful new section that summarizes the history of ideas from the Stoics to the Enlightenment; and a new conclusion that suggests a way to synthesize the various theories. Lucid and accessible, Ten Theories of Human Nature, 4/e, compresses into a small space the essence of such ancient traditions as Confucianism, Hinduism, and the Old and New Testaments as well as the theories of Plato, Immanuel Kant, Karl Marx, Sigmund Freud, and Jean-Paul Sartre. The authors juxtapose the ideas of these and other thinkers and traditions in a way that helps readers understand how humanity has struggled to comprehend its nature. To encourage readers to think critically for themselves and to underscore the similarities and differences between the many theories, the book examines each one on four points--the nature of the universe, the nature of humanity, the diagnosis of the ills of humanity, and the proposed cure for these problems. Ideal for introductory courses in human nature, philosophy, religious studies, and intellectual history, Ten Theories of Human Nature, 4/e, will engage and motivate students and other readers to consider how we can understand and improve both ourselves and human society. (shrink)

Sir Leslie Stephen (1832–1904), the founding editor of the Dictionary of National Biography, and a writer on philosophy, ethics, and literature, was educated at Eton, King's College London and Trinity College, Cambridge, where he remained as a fellow and a tutor for a number of years. Though a sickly child, he later became a keen and successful mountaineer, taking part in first ascents of nine peaks in the Alps. In 1871 he became editor of the Cornhill Magazine. During his (...) eleven-year tenure, he wrote two successful books on ethics, including The Science of Ethics in 1892, which was widely adopted as a standard textbook. This two-volume work, which was first published in 1896, brings together the lectures he gave to various ethical societies, mostly in London. Both volumes examine the ethical issues surrounding a range of topics including politics, morality, duty, and crime and punishment. (shrink)

This article provides an ecological theory of face perception that elucidates the basis of the various perceptions. It then reviews research on first impressions elicited by facial qualities that are associated with fitness, emotion, race, age, and sex, in each case making links to ecological theory. It aims to identify facial qualities that inform social perceptions and reflect the zeitgeist at the time in social psychology. The emphasis is on understanding the cognitive mechanisms engaged in social perception, and this is (...) typically accomplished by providing information about social qualities in lists of trait words. The article demonstrates face perception research pertinent to the detection of socially relevant qualities in faces—attractiveness, emotions, race, age, and sex—as well as associated behavioral affordances, which have typically been assessed by trait ratings. (shrink)

Smith, Glass, and Miller have reported a meta-analysis of over 500 studies comparing some form of psychological therapy with a control condition. They report that when averaged over all dependent measures of outcome, psychological therapy is. 85 standard deviations better than the control treatment. We examined the subset of studies included in the Smith et al. metaanalysis that contained a psychotherapy and a placebo treatment. The median of the mean effect sizes for these 32 studies was. 15. There was a (...) nonsignificant inverse relationship between mean outcome and the following: sample size, duration of therapy, use of measures of outcome other than undisguised self-report, measurement of outcome at follow-up, and use of real patients rather than subjects solicited for the purposes of participation in a research study. A qualitative analysis of the studies in terms of the type of patient involved indicates that those using psychiatric outpatients had essentially zero effect sizes and that none using psychiatric inpaticnts provide convincing evidence for psychotherapeutic effectiveness. The onty studies clearly demonstrating significant effects of psychotherapy were the ones that did not use real patients. For the most part, these studies involved small samples of subjects and brief treatments, occasionally described in quasibeliavioristic language. It was concluded that for real patients there is no evidence that the benefits of psychotherapy are greater than those of placebo treatment. (shrink)

Abstract (German version follows): -/- This paper develops a new proposal for a coherentist business ethic in which ethically justified and empirically supported proposed solutions to economic problems are developed through a coherentist process of adjustments between the three levels of (1) conception of problem and its solution, (2) positive economic theory, and (3) ethical theories. Using an example, it illustrates how in this framework, Homann's business ethics gains in validity and relevance but loses its claim to universality. // -/- (...) Diese Arbeit entwickelt eine kohärentistische Wirtschaftsethik, in der ethisch begründete und empirisch gestützte Lösungsvorschläge für ökonomische Probleme durch einen kohärentistischen Anpassungsprozess zwischen den drei Ebenen (1) Auffassung von Problem und Lösungsansatz, (2) positive ökonomische Theorie, sowie (3) ethischen Theorien erarbeitet werden. Anhand eines Beispiels wird illustriert, wie Homanns Wirtschaftsethik in diesem Rahmen an Validität und Relevanz gewinnt, jedoch ihren Universalitätsanspruch verliert. (shrink)

The Library of the Royal Society of London contains a large collection of manuscript material relating to Henry Oldenburg and his correspondents. Oldenburg was one of the two Secretaries of the Royal Society when it was founded in 1662. For many years he acted as intermediary between British and Continental philosophers: and scientists. He also edited the early volumes of the Royal Society's Philosophical Transactions . His contacts were accordingly very extensive. Nearly all the seventeenth-century pioneers of science were among (...) his correspondents. In his role of intermediary he was in the habit of sending extracts from some of his foreign letters to. (shrink)