I. Introductory Comments Â Â The Human Genome Project will be completed within 2 years, and â€œtargetedâ€ sequence data from the most promising sections of the genome will be released even sooner.Â Based on this wealth of information, at least 400 new genetic tests will become available within the next decade.Â The blending of microelectronic and genetic technology will make the â€œgenetic report cardâ€ an affordable and routine part of medical care.Â The implicit assumption driving much of this push for (...) genetic testing is that information is inherently good and patients should have the right to any information about themselves they desire.Â However, the informational content of genetic tests for most conditions is not known and may in fact be very low.Â Under such circumstances, it seems prudent to treat access to genetic testing the same way we currently treat access to other new medical procedures and drugs â€“ that is, access is afforded onlyÂ 1) in the context of a clinical trial or Â 2) after the safety and effectiveness of the treatment has been established.Â The fact is, genetic â€œinformationâ€ of uncertain quality is not innocous. II. The Difficulty with Genetic Testing Â Â Everyone is familiar with one difficulty posed by genetic testing: the possibility that a test may show either a â€œfalse positiveâ€ or a â€œfalse negativeâ€.Â Â This is the problem of the analytic accuracy of testing.Â However, as our analytic techniques become more sophisticated, the incidence of such errors will steadily decline.Â If nothing else, administration of multiple tests is often (though not always) a simple and effective way of boosting analytic accuracy. Â Â There is, however, a much more serious accuracy problem which has been largely overlooked in the literature.. (shrink)
Â Â What exactly is a genetic disease?Â For a phrase one hears on a daily basis, there has been surprisingly little analysis of the underlying concept.Â Medical doctors seem perfectly willing to admit that the etiology of disease is typically complex, with a great many factors interacting to bring about a given condition.Â On such a view, descriptions of diseases like cancer as genetic seem at best highly simplistic, and at worst philosophically indefensible.Â On the other hand, there is (...) clearly some practical value to be had by classifying diseases according to their predominant cause when this can be accomplished in a theoretically satisfactory manner.Â The question therefore becomes exactly how one should go about selecting a single causal factor among many to explain the presence of disease.Â When an attempt to defend such causal selection is made at all, the standard accounts offered (Kochâ€™s postulates, Hillâ€™s epidemiological criteria, manipulability) are all clearly inadequate.Â I propose, however, an epidemiological account of disease causation which walks the fine line between practical applicability and theoretical considerations of causal complexity and attempts to compromise between patientcentered and population-centered concepts of disease.Â The epidemiological account is the most basic framework consistent with our strongly held intuitions about the causal classification of disease, yet it avoids the difficulties encountered by its competitors. (shrink)
Modern medicine emphasizes treatment of the sick. It is often said that the widespread genetic testing soon to follow the completion of the Human Genome Project will usher in a new era of preventive medicine. Such changes require new ways of thinking, however. For example, there may be nothing clinically wrong with a healthy patient who requests genetic testing, even if the tests reveal disease genes. Since all individuals have genetic skeletons in their closets, it is important to be careful (...) not to confuse having disease genes with having the diseases that they cause. Unfortunately, many in the public have adopted a kind of genetic determinism that sees genes as destiny: for example, having the gene associated with colon cancer means they will develop colon cancer. Physicians tend to be more careful, yet even they are not immune to subtle versions of genetic determinism. One example of this is the uncritical categorization of certain diseases as “genetic”. In fact, an adequate concept of genetic disease is extremely difficult to come by. The simplest notion would require a 1:1 correspondence between a disease and its genes, but this is the exception rather than the rule. For example, cystic fibrosis (CF) is often put forward as a good example of a genetic disease, since it seems to result from mutations in a single gene, CFTR. Even in this case, however, the exact relationship between CFTR mutations and disease is not clear, as virtually every possible combination of sweat chloride test results, genetic test results, and symptoms has been observed. If a patient presents with the classic symptoms of CF and is found to have a mutation in the CFTR gene, the physician might understandably infer that the mutation caused the disease. But if an asymptomatic patient is tested and it is discovered that he or she has a CFTR mutation, it is unclear what this means. The doctor might tell the patient the gene is abnormal and that he or she is likely to develop pulmonary problems, etc., but it’s not really known whether even this qualified prognosis is true.. (shrink)
Proposal in Brief : I have been invited by Michael Ruse, editor of the Cambridge Studies in Philosophy and Biology series for Cambridge University Press, to submit a book proposal on the Philosophy of Developmental Biology. This is both a great honor and a magnificent opportunity for a relatively junior professor, especially since the field is new - done well, this book could help set the basic parameters of an emerging discipline.
I examine the positive and negative features of synthetic biology (‘SynBio’) from a utilitarian ethical perspective. The potential beneficial outcomes from SynBio in the context of medicine are substantial; however it is not presently possible to predict precise outcomes due to the nascent state of the field. Potential negative outcomes from SynBio also exist, including iatrogenesis and bioterrorism; however it is not yet possible to quantify these risks. I argue that the application of a ‘precautionary’ approach to SynBio is ethically (...) fraught, as is the notion that SynBio-associated knowledge ought to be restricted. I conclude that utilitarians ought to support a broadly laissez-faire stance in respect of SynBio. (shrink)
Recent work suggests that people predict how objects interact in a manner consistent with Newtonian physics, but with additional uncertainty. However, the sources of uncertainty have not been examined. In this study, we measure perceptual noise in initial conditions and stochasticity in the physical model used to make predictions. Participants predicted the trajectory of a moving object through occluded motion and bounces, and we compared their behavior to an ideal observer model. We found that human judgments cannot be captured by (...) simple heuristics and must incorporate noisy dynamics. Moreover, these judgments are biased consistently with a prior expectation on object destinations, suggesting that people use simple expectations about outcomes to compensate for uncertainty about their physical models. (shrink)
Students in an undergraduate legal and ethical issues course continually told the authors that they did not have time to study for the course because they were busy studying for their clinical courses. Faculty became concerned that students were failing to realize the value of legal and ethical concepts as applicable to clinical practice. This led the authors to implement a transformational learning experience in which students applied legal and ethical course content in a high-fidelity human simulation (HFHS) scenario. A (...) preliminary evaluation compared the new HFHS experience with in-person and online student groups using the same case. Based on both student and faculty perceptions, the HFHS was identified as the best of the three approaches for providing a transformational learning experience regarding legal and ethical content. (shrink)
In opposition to the premises of Against Homeopathy – a Utilitarian Perspective, all four respondents base their objections on the central claims that homeopathy is in fact scientifically plausible and is supported by empirical evidence. Despite ethical aspects forming the main thrust of Against Homeopathy, the respondents’ focus on scientific aspects represents sound strategy, since the ethical case against homeopathy would be weakened concomitant with the extent to which any plausibility for homeopathy could be demonstrated. The trouble here is that (...) the respondents are attempting to perpetuate a sterile debate. The notion that homeopathic preparations could have any biological effects represents a fringe viewpoint, one not entertained by serious scientists nor supported by reason and evidence.In the present article, I shall endeavour to explain why the respondents do not have a valid case. I will deal firstly with their general approach to scientific plausibility and evidence, and then consider some of the specific claims they have made. Finally, I will answer the philosophical arguments some of the respondents have raised. (shrink)
Voluntary participation is connected to cultural, political, religious and social contexts. Social and societal factors can provide opportunities, expectations and requirements for voluntary activity, as well as influence the values and norms promoting this. These contexts are especially central in the case of voluntary participation among students as they are often responding to the societal demands for building a career and qualifying for future assignments and/or government requirements for completing community service. This article questions how cultural values affect attitudes towards (...) volunteerism, using data from an empirical research project on student volunteering activity in 13 countries in North America, Europe, the Middle East, and the Asia Pacific region. The findings indicate that there are differences in motivation between countries which represent different cultural values. This article sets these findings in context by comparing structural and cultural factors which may influence volunteerism within each country. (shrink)
Why is the academy in general, and philosophy in particular, not more involved in the fight against the creationist threat? And why, when a response is offered, is it so curiously ineffective? I argue, by using an analogy with the battle against the Black Knight from the movie Monty Python and the Holy Grail, that the difficulty lies largely in a failure to see the nature of the problem clearly. By modifying the analogy, it is possible to see both why (...) large sections of the academy have remained unmoved and also why many of the reactions to the threat have been so unsuccessful. Finally, I offer some very broad suggestions as to how to modify our approach in light of this new perspective. (shrink)
Cross-situational learning is a mechanism for learning the meaning of words across multiple exposures, despite exposure-by-exposure uncertainty as to the word's true meaning. We present experimental evidence showing that humans learn words effectively using cross-situational learning, even at high levels of referential uncertainty. Both overall success rates and the time taken to learn words are affected by the degree of referential uncertainty, with greater referential uncertainty leading to less reliable, slower learning. Words are also learned less successfully and more slowly (...) if they are presented interleaved with occurrences of other words, although this effect is relatively weak. We present additional analyses of participants’ trial-by-trial behavior showing that participants make use of various cross-situational learning strategies, depending on the difficulty of the word-learning task. When referential uncertainty is low, participants generally apply a rigorous eliminative approach to cross-situational learning. When referential uncertainty is high, or exposures to different words are interleaved, participants apply a frequentist approximation to this eliminative approach. We further suggest that these two ways of exploiting cross-situational information reside on a continuum of learning strategies, underpinned by a single simple associative learning mechanism. (shrink)
I examine the positive and negative features of homeopathy from an ethical perspective. I consider: (a) several potentially beneficial features of homeopathy, including non-invasiveness, cost-effectiveness, holism, placebo benefits and agent autonomy; and (b) several potentially negative features of homeopathy, including failure to seek effective healthcare, wastage of resources, promulgation of false beliefs and a weakening of commitment to scientific medicine. A utilitarian analysis of the utilities and disutilities leads to the conclusion that homeopathy is ethically unacceptable and ought to be (...) actively rejected by healthcare professionals. (shrink)
This manuscript describes the responses and correlates of outpatients with schizophrenia spectrum disorders to a tool designed to measure comprehension before obtaining informed consent for research participation. We used the Evaluation to Sign Consent form to document comprehension in 100 outpatients as part of their consent to participate in an ongoing study of an exercise intervention. The findings suggest that using this form is a feasible and acceptable approach to documenting comprehension of research procedures prior to obtaining informed consent. Age (...) 49 years and older and the receipt of intramuscular antipsychotic medication predicted the need for additional assistance to complete the Evaluation to Sign Consent form successfully (χ2 = 8.29, P = 0.016). Nurse researchers should consider documenting comprehension with this tool owing to its availability, time efficiency and utility. (shrink)
The embodied simulation of smiles involves motor activity that often changes the perceivers' own emotional experience (e.g., smiling can make us feel happy). Although Niedenthal et al. mention this possibility, the psychological processes by which embodiment changes emotions and their consequences for processing other emotions are not discussed in the target article's review. We argue that understanding the processes initiated by embodiment is important for a complete understanding of the effects of embodiment on emotion perception.
Preliminaries : the context of modern matter. The visible and the intelligible ; Plato's early and late methods ; Matter and division -- Analysis. Analysis and clarity and distinctness ; A general theory of clarity and distinctness ; The general theory continued ; Enumeration, quantity, and measurement -- Synthesis. Synthesis and system building ; Synthesis and the principle of addition ; Metaphysics, mathematics, and metaphor ; Material structure and calculating machines ; How analysis and synthesis are related -- Sensible and (...) intelligible matter. Is matter real? ; Empirical ideality, reality, and matter ; Empirical reality and intelligible matter ; Transcendental matter -- Tying up the loose ends : closing remarks. (shrink)
In A Secular Age, Taylor introduces the idea of porous subjectivity by way of elucidating the mode of being typical of the enchanted pre-modern world, and juxtaposes it to the buffered self typical of the disenchanted modern world. The framing of the problem in this way, with the argument so clearly oriented as an attack on the latter position, risks a polarization that defaults to the former as the preferred option. These, though, are not our only choices. There is much (...) to recommend Taylor’s notion of porous subjectivity as distinct from the buffered self of atomistic individualism. But Taylor associates the emergence of the disenchanted world with disengaged reason, and the existence of an enchanted world with a deeper mode of engagement in the world. If we instead focus upon modes of engagement with the world separate from the question of enchantment, we can perhaps further our understanding of human subjectivity and relations with others. (shrink)
Elizabeth Anderson’s “pluralist–expressivist” value theory, an alternative to the understanding of value and rationality underlying the “rational actor” model of human behavior, provides rich resources for addressing questions of environmental and animal ethics. It is particularly well-suited to help us think about the ethics of commodification, as I demonstrate in this critique of the pet trade. I argue that Anderson’s approach identifies the proper grounds for criticizing the commodification of animals, and directs our attention to the importance of maintaining social (...) practices and institutions that respect the social meanings of animals. Her theory alone, however, does not adequately address the role of the state in this project. Drawing on social contract theory to fill this gap, I conclude that the state’s role in regulating the pet trade should be limited to ensuring the welfare of animals in the stream of commerce, not prohibiting their mass marketing altogether. (shrink)
Using historical data from the Utah Population Database, this analysis finds significant, consistent, but small adverse mortality effects for mothers after age 50 who had mostly sons. Examination of age-dependent effects indicates that this association increases with mother’s age. Additionally, mothers who had mostly daughters faced mortality risks that increased with age. Offspring sex composition did not have a significant effect on paternal mortality. Interaction analyses were conducted to examine the effect of offspring sex composition with regard to historical period, (...) residential location, socioeconomic status, and childhood survival. No other interactions were found to be statistically significant. Having mostly boys remained detrimental to maternal mortality regardless of childhood survival. (shrink)
We agree that language adapts to the brain, but we note that language also has to adapt to brain-external constraints, such as those arising from properties of the cultural transmission medium. The hypothesis that Christiansen & Chater (C&C) raise in the target article not only has profound consequences for our understanding of language, but also for our understanding of the biological evolution of the language faculty.
In The Frontiers of Justice, Martha Nussbaum argues that social contract theory cannot accommodate political duties to animals because it requires the parties to the contract to enjoy rough physical and mental equality. Her interpretation of the social contract tradition is unpersuasive; social contract theory requires only that the parties be equally free and deserving of moral consideration. Moreover, social contract theory is superior to her capabilities approach in that it allows us to limit the scope of the community of (...) justice to animals we are capable of recognizing as subjects of justice and with whom we have a political relationship. (shrink)
The concept of wilderness found in the black American intellectual tradition poses a provocative alternative to the preservationist concept. For black writers, the wilderness is not radically separate from human society but has an important historical and social dimension. Nor is it merely a feature of the external landscape; there is also a wilderness within, a vital energy that derives from and connects one to the external wilderness. Wilderness is the origin and foundation of culture; preserving it means preserving not (...) merely the physical landscape but our collective memory of it. But black writers also highlight the racial essentialism that infuses both their own and traditional American concepts of the wild, giving us greater insight into why the wilderness celebrated by preservationists can be a problematic value for racial minorities. (shrink)
In this article we contend that attempts to foster democratic education in the United States' public schools rarely include mathematics class in meaningful ways. We begin with Dewey's conception of democracy and then argue that current ways of thinking about mathematics do not provide adequate foundations for democratic mathematics education. Our reconceptualization of mathematics draws on Dewey's uniquely humanistic philosophy of mathematics. We conclude with some implications of democratic mathematics education for school and society. Thus, this project seeks to (...) blur the theory-practice dualism, developing a theoretical argument which draws sustenance from and seeks to contribute back to educational practice. (shrink)
This study examines cheating behaviors among 422 business students at two public Association to Advance Collegiate Schools of Business-accredited business schools. Specifically, we examined the simultaneous influence of attitudinal characteristics and motivational factors on (a) reported prior cheating behavior, (b) the tendency to neutralize cheating behaviors, and (c) likelihood of future cheating. In addition, we examined the impact of in-class deterrents on neutralization of cheating behaviors and the likelihood of future cheating. We also directly tested potential mediating effects of neutralization (...) on cheating behavior. Using structural equations modeling procedures, we conducted an assessment of the validity of a modified version of the K. J. Smith, Davy, Rosenberg, and Haight (2002) model of cheating behavior and its antecedents. The modified model included motivation as a potential predictor of cheating behavior. Results supported the differentiation of the theoretical constructs within the specified process model. Furthermore, tests of the aforementioned theoretical model indicated a significant positive relation between extrinsic motivation and prior cheating and a significant negative relation between both intrinsic motivation and academic performance, and prior cheating. Finally, prior cheating had a significant positive relation, whereas deterrents had a significant negative relation to likelihood of future cheating. (shrink)