Suppose that you have deeply personal information that you do not want to share. Further suppose that this information could help others, perhaps even saving their lives. Should you reveal the information or keep it secret? With the increasing prevalence of genetic testing, more and more people are finding themselves in this situation. Although a patient's genetic results are potentially relevant to all her biological family members, her first‐degree relatives—parents, children, and full siblings—are most likely to be affected. This is (...) especially true for genetic mutations—like those in the BRCA1 and BRCA2 genes—that are associated with a dramatically increased risk of disease. Fortunately, people are usually willing to share results with their at‐risk relatives. Occasionally, however, a patient refuses to disclose her findings to anyone outside her clinical team. Ethicists have written little on patients’ moral duties to their at‐risk relatives. Moreover, the few accounts that have been advanced are problematic. Some unnecessarily expose patients’ genetic information to relatives who are unlikely to benefit from it, and others fail to ensure that patients’ most vulnerable relatives are informed of their genetic risks. Patients’ duty to warn can be defended in a way that avoids these problems. I argue that the duty to share one's genetic results is grounded in the principle of rescue—the idea that one ought to prevent, reduce, or mitigate the risk of harm to another person when the expected harm is serious and the cost or risk to oneself is sufficiently moderate. When these two criteria are satisfied, a patient will most likely have a duty to warn. (shrink)

Technological advances in genetic testing have enabled prospective parents to learn about their risk of passing a genetic condition to their future children. One option for those who want to ensure that their biological children do not inherit a genetic condition is to create embryos through in vitro fertilisation and use a technique called preimplantation genetic testing to screen embryos for genetic abnormalities before implantation. Unfortunately, due to its high cost, IVF-with-PGT is out of reach for the vast majority of (...) Americans. This article addresses an issue that has been underexplored in the medical ethics literature: the lack of insurance coverage for IVF-with-PGT.Within the US system, a key concept in insurance is that of medically necessary care, which broadly consists of diagnostic services and treatment services. In this article, I argue that IVF-with-PGT could be classified as either a diagnostic service or as a treatment service. To make this case, I show that IVF-with-PGT is similar to other types of services that are often covered by US insurance providers. In light of these similarities, I argue that the current system is inconsistent with respect to what is—and is not—covered by insurance. To promote consistency and fairness in coverage, like cases should be treated alike—starting with greater coverage for IVF-with-PGT. (shrink)

When new drugs are approved by the Food and Drug Administration, the default assumption is that they will be available by prescription only, safe for use exclusively under clinical supervision. The paternalism underlying this default must be interrogated in order to ensure appropriate respect for patient autonomy. Upon closer inspection, prescription requirements are justified when nonprescription status would risk harm to third parties and when a large segment of the population would struggle to exercise their autonomy in using a drug (...) safely and effectively on their own. Although these justifications can support prescription status for many drugs, we propose that reversing the FDA's current default to instead begin with a presumption in favor of over‐the‐counter status is the best way to avoid interference with valid claims of patient autonomy. Under this approach, a range of drug products could be considered for an OTC switch, including oral contraceptives, statins, and HIV‐prevention drugs. (shrink)

There is a strong need to connect agricultural research to social movements and community-based food system reform efforts. Participatory research methods are a powerful tool, increasingly used to give voice to communities overlooked by academia or marginalized in the broader food system. Plant breeding, as a field of research and practice, is uniquely well-suited to participatory project designs, since the basic process of observing and selecting plants for desirable traits is accessible to participants without formal plant breeding training. The challenge (...) for plant breeders engaged in participatory research is to consider not only how their work incorporates farmer input in developing new varieties, but also how it interacts with broader questions of food sovereignty, food justice, diversity and democratization in the food system. This article examines these issues in the context of the Seed to Kitchen Collaborative, a participatory variety evaluation and breeding project at the University of Wisconsin-Madison. (shrink)

David Wootton has written an engaging book about the emergence of the theory that all human action is self-interested and that believes societies should be structured in ways that satisfy our “insa...

The Continuous Parameter Estimation Model is applied to develop individual genomic-level heritabilities for the latent hierarchical structure and developmental dynamics of Life History (LH) strategy LH strategies relate to the allocations of bioenergetic resources into different domains of fitness. LH has moderate to high population-level heritability in humans, both at the level of the high-order Super-K Factor and the lower-order factors, the K-Factor, Covitality Factor, and General Factor of Personality (GFP). Several important questions remain unexplored. We developed measures of genome-level (...) heritabilities employing an American sample of 316 monozygotic (MZ) and 274 dizygotic (DZ) twin dyads and a Swedish sample of 863 MZ and 475 DZ twin dyads. This novel heritability index measures individual genetic transmissibility, therefore opening new avenues for analyzing complex interactions among heritable traits inaccessible to standard structural equations methods. For these samples: (1) moderate to high heritability of factor loadings of Super-K on its lower-order factors is demonstrated, evidencing biological preparedness, genetic accommodation, and the gene-culture coevolution of biased epigenetic rules of development; (2) moderate to high heritability of the magnitudes of the effect of the higher-order factors upon their loadings on their constituent factors, evidencing genetic constraints upon phenotypic plasticity; and (3) that heritability of the LH factors, of factor loadings, and of the magnitudes of the correlations among factors are weaker among those with slower LH speeds, demonstrating that inter-individual variation in transmissibility is a function of individual socioecological selection pressures. (shrink)

There is a strong need to connect agricultural research to social movements and community-based food system reform efforts. Participatory research methods are a powerful tool, increasingly used to give voice to communities overlooked by academia or marginalized in the broader food system. Plant breeding, as a field of research and practice, is uniquely well-suited to participatory project designs, since the basic process of observing and selecting plants for desirable traits is accessible to participants without formal plant breeding training. The challenge (...) for plant breeders engaged in participatory research is to consider not only how their work incorporates farmer input in developing new varieties, but also how it interacts with broader questions of food sovereignty, food justice, diversity and democratization in the food system. This article examines these issues in the context of the Seed to Kitchen Collaborative, a participatory variety evaluation and breeding project at the University of Wisconsin-Madison. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Studies 21.1 (2001) vi-vii [Access article in PDF] In Memoriam: Winston L. King Winston L. King was ninety-three when he died on February 15, 2000, at his home in Madison, Wisconsin. Diagnosed with cancer over a year ago, he continued many of his usual activities--reading widely, maintaining a voluminous correspondence, visiting with friends, and walking daily. Winston was one of those remarkable scholar-teachers of an older generation (...) who never ceased to develop new intellectual and research interests. With degrees from Asbury College (A.B., 1929), Andover Newton Theological Seminary (1936), and Harvard (S.T.M., 1938; Ph.D., 1940), his career included pastorates in New England (1930-1943, 1945-1949), Dean of the Chapel and professor of Grinnell College (1949-1963), professor of the history of religions atVanderbilt University (1964-1973), and after his retirement fromVanderbilt, an appointment as professor of philosophy at Colorado State University.Winston's two-year appointment with the Ford Foundation as the advisor to the International Institute for Buddhistic Studies in Rangoon (Yangon), Burma (Myanmar), from 1958 to 1960 proved to be a major turning point in his life and established his reputation as a significant interpreter of Theravada Buddhism in Southeast [End Page vi] Asia. Three important monographs resulted from Winston's stay in Burma: Buddhism and Christianity: Some Bridges of Understanding (1963), In the Hope of Nibbana: An Essay on Theravada Buddhist Ethics(1964), andAThousand Lives Away(1964). The last volume was the most widely regarded of the three, but each was at the forefront of later developments in the fields of Buddhist-Christian studies, Buddhist ethics, and modern studies in Southeast Buddhism.Winston was already well grounded in a broad comparative study of religion, as demonstrated by his Introduction to Religion(Harper,1954), before his sojourn in Burma. In the first chapter of that textbook, he set forth an understanding of religion as "unity-in-diversity and diversity-in-unity" that informed his sensibilities as a historian of religions--especially Buddhism--throughout his life. He saw being a person of faith as an advantage rather than a disadvantage in the study of religion, anticipating his subsequent work in Buddhist-Christian studies.Winston believed that the adherent of a particular faith is better able "to penetrate to the centrally important features of another religion" that might be opaque to the "nonreligionist." His analogical observation, "Being in love he will know how to understand something of another's being in the same situation" grew out of the deep mutual devotion between Winston and Jocelyn, his beloved wife of more than sixty-six years.Winston's special interest in Japanese Buddhism began to take shape in the latter part of his career with a Fulbright Lecturership in Kyoto in 1965-1966. Subsequently, he was to return to Japan to continue his study of Buddhism and Japanese language at sixty years of age. Several articles and two major monographs followed: Death Was His Koan: The Samurai-Zen of Suzuki Shosan(1986) and Zen and the Way of the Sword (1993).Throughout his career, Winston maintained a strong interest in the practice of faith, giving both personal and scholarly attention to Buddhist meditation in particular. While he was in Burma, he spent ten days at the International Meditation Center founded by U Ba Khin. An account of his experience appeared in the Journal of Religion (1961). In Buddhism and Christianity, he compared Christian prayer and Buddhist meditation; later he was to compare Theravada and Zen meditational methods and goals (History of Religions, 1970) and explore the yogic methodological background to Buddhist insight meditation (Theravada Meditation: The Buddhist Transformation ofYoga, 1980).Winston's empathetic approach to religious understanding, his scholarly breadth and productivity, and his humane, personal integrity set a standard to be emulated by those who follow him. We celebrate his life and his scholarship.Donald K. Swearer Swarthmore College... (shrink)

This article presents evidence supporting the claim that ethical reasoning is a skill that can be taught and assessed. We propose a working definition of ethical reasoning as 1) the ability to identify, analyze, and weigh moral aspects of a particular situation, and 2) to make decisions that are informed and warranted by the moral investigation. The evidence consists of a description of an ethical reasoning education program—Ethical Reasoning in Action —designed to increase ethical reasoning skills in a variety of (...) situations and areas of life. ERiA is housed at a public, major comprehensive U.S. university—James Madison University—and assessment of the program focuses on interventions delivered prior to and during orientation for incoming first-year students. Findings indicate that the interventions measurably enhance the ability of undergraduate students to reason ethically. ERiA’s competency-targeted program and positive student learning outcomes offers a promising model for higher education ethics programs seeking to connect classroom learning in ethics to decision-making in everyday life. (shrink)

This chapter first surveys general issues in the epistemic internalism / externalism debate: what is the distinction, what motivates it, and what arguments can be given on both sides. -/- The second part of the chapter will examine the internalism / externalism debate as regards to the specific case of the epistemology of memory belief.

There are indications that simple reaction time might have slowed in Western countries, based on both cohort- and multi-study comparisons. A possible limitation of the latter method in particular is measurement error stemming from methods variance, which results from the fact that instruments and experimental conditions change over time and between studies. We therefore set out to measure the simple auditory reaction time (SRT) of 7,081 individuals (2,997 males and 4,084 females) born in Sweden 1959-1985 (subjects were aged between 27 (...) and 54 years at time of measurement). Depending on cut-offs and adjustment for ageing related slowing on SRT, the data suggest that SRT has increased between 3 and 16 ms in the 27 birth years covered in the present sample. The slowing is unlikely to be explained by attrition, as evaluated by comparing the general intelligence × birth-year interactions and standard deviations for both male participants and dropouts, utilizing military conscript cognitive ability data. The present result is consistent with previous studies employing alternative methods, and may result from several synergistic factors, such as possible recent micro-evolutionary trends favouring lower g in Sweden and the effects of industrially produced neurotoxic substances on peripheral nerve conduction velocity. (shrink)

To read Working through Derrida is to plunge into the midst of a lively debate on the place of Jacques Derrida and the thought associated with him in today's literary and philosophical consciousness. With essays by major philosophers such as Richard Rorty, John R. Searle, and John D. Caputo, the volume focuses on the ethical, legal, and political dimensions of Derrida's production and on his more recent concerns. It addresses the key themes of law and justice, the law of exemplarity, (...) phenomenological critique, semiology, ethics and the other, Rorty on Derrida, and Habermas vs. Derrida. Gary B. Madison's critical introduction caps this major appraisal of Derrida and deconstruction. (shrink)

In bioethics, discussions of justice have tended to focus on questions of fairness in access to health care: is there a right to medical treatment, and how should priorities be set when medical resources are scarce. But health care is only one of many factors that determine the extent to which people live healthy lives, and fairness is not the only consideration in determining whether a health policy is just. In this pathbreaking book, senior bioethicists Powers and Faden confront foundational (...) issues about health and justice. How much inequality in health can a just society tolerate. The audience for the book is scholars and students of bioethics and moral and political philosophy, as well as anyone interested in public health and health policy. (shrink)

Structural Injustice advances a theory of what structural injustice is and how it works. Powers and Faden present both a philosophically powerful, integrated theory about human rights violations and structural unfairness, alongside practical insights into how to improve them.

A historical investigation of the exclusion of Africa and Asia from modern histories of philosophy.

A growing body of literature argues that achieving radical change in the agri-food system requires a radical renegotiation of our relationship with the environment alongside a change in our thinking and approach to transformational food politics. This paper argues that relational approaches such as a more-than-human ethic of care (MTH EoC) can offer a different and constructive perspective to analyse agri-food system transformation because it emphasises social structures and relationships as the basis of environmental change. A MTH EoC has not (...) yet been applied to regenerative agriculture, yet other literature on regenerative agriculture suggests that care may be present in these spaces and calls for the need for social science analysis of the regenerative movement. This paper uses a MTH EoC lens to reveal a diverse array of ways in which power is and can be deployed for change in the regenerative agriculture movement in Aotearoa, New Zealand. Globally, regenerative agriculture tends to be analysed through positivist, scientific approaches that focus on biophysical markers of ecological improvement. Yet, a relational approach reveals how engagement in regenerative agriculture is creating significant shifts in mindset towards more holistic and relational understandings of biological and social ecosystems. A regenerative mindset framework is suggested as a method of understanding the connection between a regenerative form of thinking, being and doing for farmers. Interviews suggested that this shift in farmers’ socio-ecological relations is crucial to the transformational potential of regenerative agriculture. This paper argues that relational analyses such as the MTH EoC approach used to analyse regenerative agriculture in this research, refresh the way we analyse agri-food system change. They also are critical to guiding and supporting on-the-ground socio-ecological shifts that are necessary to see agricultural transformation. (shrink)

This paper investigates the adequacy of evidential relevance relations proposed by Glymour and others. These accounts incorporate, as a necessary condition, what I call the Positive Instance Condition (PIC): the evidence statement and auxiliary assumptions entail a "positive instance" of the hypothesis. I argue that any account which incorporates PIC as a necessary condition while allowing "bootstrap testing" is doomed to fail. A nonbootstrapping evidential relevance relation of similar form is proposed, and it is argued that, in addition to avoiding (...) published counter examples, this new relation meets two general requirements which, if not met, would undermine the ability of any account that incorporates PIC to accord with our intuitions of evidential relevance. (shrink)

BackgroundEthical and regulatory guidance on the collection and use of human biospecimens for research forms an essential component of national health systems in Sub-Saharan Africa, where rapid advances in genetic- and genomic-based technologies are fueling clinical trials involving HBS and the establishment of large-scale biobanks.MethodsAn extensive multi-level search for publicly available ethics regulatory guidance was conducted for each SSA country. A second review documented active trials listed in the WHO International Clinical Trials Registry Platform as of January 2015 in which (...) HBS collection was specified in the protocol. Findings were combined to determine the extent to which countries that are study sites for HBS-related research are supported by regulatory guidance language on the collection, use, ownership and storage of biospecimens.ResultsOf the 49 SSA countries, 29 had some form of national ethics guidance, yet only 17 provided language relating to HBS-related research, with specific guidance on consent, ownership, reuse, storage, and export/import/transfer. Ten countries accounted for 84 % of the active clinical trials involving the collection of HBS in SSA. All except one of these countries were found to have some national guidance in the form of regulations, codes of ethics, and/or standard operating procedures; however, only seven of the ten offered any language specific to HBS.ConclusionsDespite the fact that the bulk of registered clinical trials in SSA involving HBS, as well as existing and proposed sites for biorepositories under the H3Africa Initiative, are currently situated in countries with the most complete ethics and regulatory guidance, variability in the regulations themselves may create challenges for planned and future pan-African collaborations and may require legislative action at the national level to revise. Countries in SSA that still lack regulatory guidance on HBS will require extensive health system strengthening in ethics governance before they can be full participants in the modern research enterprise. (shrink)

I Deliberation, Practical Syllogisms , and Intuition. Introduction Aristotle's views on moral reasoning are a difficult and much disputed subject. ...

In this article, we address the relevance of J.S. Mill’s political philosophy for a framework of public health ethics. In contrast to some readings of Mill, we reject the view that in the formulation of public policies liberties of all kinds enjoy an equal presumption in their favor. We argue that Mill also rejects this view and discuss the distinction that Mill makes between three kinds of liberty interests: interests that are immune from state interference; interests that enjoy a presumption (...) in favor of liberty; and interests that enjoy no such presumption. We argue that what is of focal importance for Mill in protecting liberty is captured by the essential role that the value of self-determination plays in human well-being. Finally, we make the case for the plausibility of a more complex and nuanced Millian framework for public health ethics that would modify how the balancing of some liberty and public health interests should proceed by taking the thumb off the liberty end of the scale. Mill’s arguments and the legacy of liberalism support certain forms of state interference with marketplace liberties for the sake of public health objectives without any presumption in favor of liberty. (shrink)

Political liberalism has increasingly come under fire from both the right and the left, in politics as well as in philosophy. In this new study, G.B. Madison offers a systematic rebuttal to these contemporary critics, attempting to demonstrate that the basic principles of classical liberal philosophy are not only internally valid and coherent but also directly relevant to the problems faced by society in the post-industrial age. Building on the theory of Frank H. Knight and other liberal tinkers, (...) class='Hi'>Madison outlines the postmodern theory of reason that is presupposed within classical liberal theory and makes the case that as a political philosophy liberalism can be justified entirely within its own terms, without reference to arbitrary or absolute values. (shrink)

In "Pursuits of Wisdom," John Cooper brings this crucial question back to life. This marvelous book will shape the way we think about and engage with ancient philosophical traditions.

Putative counterexamples to the Principle of Identity of Indiscernibles (PII) are notoriously inconclusive. I establish ground rules for debate in this area, offer a new response to such counterexamples for friends of the PII, but then argue that no response is entirely satisfactory. Finally, I undermine some positive arguments for PII.

: The increasing reliance upon, and perhaps the growing public and professional skepticism about, the special expertise of bioethicists suggests the need to consider the limits of moral expertise. For all the talk about method in bioethics, we, bioethicists, are still rather far off the mark in understanding what we are doing, even when we may be going about what we are doing fairly well. Quite often, what is most fundamentally at stake, but equally often insufficiently acknowledged, are inherently political, (...) essentially contested visions of the most compelling and attractive forms of life for individuals and social organization. The current situation in bioethics parallels similar debates in eighteenth-century jurisprudence, especially Jeremy Bentham's withering critique of the prevalent forms of judicial argument and his own, equally unsuccessful, attempt to develop a decision-making procedure in ethics that would operate on a plane above politics. The risk, both then and now, is that we will fail to appreciate the wide range of reasonable disagreement that will remain past the point of extended reflection and discussion. (shrink)

Physical activity is important for managing the side effects and long-term outcomes of cancer treatment, yet many adolescents and young adults diagnosed with cancer are not meeting PA guidelines. Body image and social support are two factors that can influence PA behavior and require further attention in this population. The purpose of this study was to examine the associations between body image, social support, and PA among AYAs. An online cross-sectional survey administered through the Research Electronic Data Capture platform was (...) used to assess self-reported body image, social support, and PA in AYAs. Based on findings from path analyses, body image and social support were directly associated with PA. Social support was also directly associated with body image. However, there were no indirect effects. These findings provide preliminary support for the influential role of appearance and fitness body-related emotions and cancer-specific social support on PA. The results have important implications for the development of targeted strategies aimed at improving body image and social support, with the overall goal of increasing AYAs’ PA. (shrink)

Many of the contemporary disagreements regarding privacy are conceptual in nature. They concern the meaning or definition of privacy and the analytic basis of distinguishing privacy rights from other kinds of rights recognized within moral, political, or legal theories. The two main alternatives within this debate include reductionist views, which seek a narrow account of the kinds of invasions or intrusions distinctly involving privacy losses, and anti-reductionist theories, which treat a much broader array of interferences with a person as separate (...) and irreducible kinds of privacy invasions. Other theorists have expressed doubts about the prospects for achieving greater analytical precision even within a fairly expansive anti-reductionist approach. However, a reductionist privacy definition is defended in this article, and its primary theoretical virtues are its ability to unify and explain the insights of several competing definitions and its role in developing an account of privacy rights that is both internally coherent and consistent with a plausible understanding of the theoretical basis for a number of related rights. (shrink)