Background: Direct–to–consumer genetic testing (DTCGT) offers risk estimates for a variety of complex diseases and conditions, yet little is known about its impact on actual users, including their decisions about sharing the information gleaned from testing. Ethical considerations include the impact of unsolicited genetic information with variable validity and clinical utility on relatives, and the possible burden to the health care system if revealed to physicians. Aims: The qualitative study explored primary care patients’ views, attitudes, and decision making considerations regarding (...) DTCGT. This article focuses on the disclosure decisions participants made regarding participation, testing, and results of DTCGT, a topic which arose as a secondary aim of the study. Methods: Through four longitudinal interviews (pre–test, results, 3 and 12 months post–test) we examined twenty primary care patients’ decisions, expressed intentions, and actions regarding disclosure to immediate and extended family, friends and coworkers, and physicians about participation in and results of DTCGT. Individual interviews were analyzed using qualitative content analysis and a summative approach to describe the global themes. Results: Most participants disclosed to some immediate family; less than half disclosed to extended family; approximately half talked to friends. Most participants stated they would or might disclose to physicians about DTCGT and a few did. Conceptual themes that emerged from the data analysis include ambivalence about disclosure, consistency between intention and actual disclosure behavior and decisions, and conditional information sharing. Conclusions: Participants’ intentional and actual disclosure patterns offer insight into how they view DTCGT, weigh results, and the potential impact of DTCGT. (shrink)

Eric Voegelin's _Israel and Revelation_ is the opening volume of his monumental _Order and History,_ which traces the history of order in human society. This volume examines the ancient near eastern civilizations as a backdrop to a discussion of the historical locus of order in Israel. The drama of Israel mirrors the problems associated with the tension of existence as Israel attempted to reconcile the claims of transcendent order with those of pragmatic existence and so becomes paradigmatic. According to Voegelin, (...) what happened in Israel was a decisive step, not only in the history of Israel, but also in the human attempt to achieve order in society. The uniqueness of Israel is the fact that it was the first to create history as a form of existence, that is, the recognition by human beings of their existence under a world-transcendent God, and the evaluation of their actions as conforming to or defecting from the divine will. In the course of its history, Israel learned that redemption comes from a source beyond itself. Voegelin develops rich insights into the Old Testament by reading the text as part of the universal drama of being. His philosophy of symbolic forms has immense implications for the treatment of the biblical narrative as a symbolism that articulates the experiences of a people's order. The author initiates us into attunement with _all_ the partners in the community of being: God and humans, world and society. This may well be his most significant contribution to political thought: "the experience of divine being as world transcendent is inseparable from an understanding of man as human.". (shrink)

James Bohman’s Democracy across borders: from demos to demoi is a rich and deep text. It is also deceptively short in length in comparison to those authors he engages and compactly reconstructs. Bohman puts forward strong normative arguments for a ‘reconstructed’ ideal of transnational democracy and provides models for realizing these ideals that also aim to meet standards of practicability. Bohman articulates the minimum necessary conditions for any democratic ideal in terms of freedom from domination and freedom to initiate and (...) engage in efficacious democratic deliberation across the borders of currently existing political communities. The argument charts a novel democratic ideal in terms of the global deliberative situation that is fundamentally different from the authors he discusses in light of existing facts about globalization, institutions, and the pluralism of demoi. In these comments I will focus on two main areas. (shrink)

Margaret Monahan Hogan; Catholic Health Care Institutions: Dinosaurs Awaiting Extinction or Safe Refuge in a Culture of Death, Christian bioethics: Non-Ecumenic.

Targeting injustices that cut across borders, they are making the scale of justice an object of explicit struggle.Inspired by these efforts, Nancy Fraser asks: ...

One of the strongest strands in Nancy's philosophy is an attempt to rethink community and the very idea of the social in a way that does not ground these ideas in some individual subject or subjectivity. The fundamental argument of this book is that being is always 'being with', that 'I' is not prior to 'we', that existence is essentially co-existence. He thinks this being together, not as a comfortable enclosure in a pre-existing group, but as a mutual abandonment and (...) exposure to each other, one that would preserve the 'I' and its freedom in a mode of imagining community as neither a 'society of spectacle' nor via some form of 'authenticity'. (shrink)

That Claudian imitates Virgil's Georgics in the De raptu Proserpinae is well known. Most of his allusions are restricted to Golden Age or Underworld imagery, largely from Books 1, 2, and 4. However, one imitation of the third Georgic that appears not to have been noted previously occurs at De raptu Proserpinae 1.82. The context is Claudian's famous description of Pluto enthroned: ipse rudi fultus solio nigraque uerendusmaiestate sedet: squalent inmania foedosceptra situ; sublime caput maestissima nubesasperat et dirae riget inclementia (...) formae;terrorem dolor augebat. I argue that this recalls the following passage in Virgil: optima quaeque dies miseris mortalibus aeuiprima fugit; subeunt morbi tristisque senectuset labor, et durae rapit inclementia mortis. Inclementia occurs some twenty times in extant classical and late antique Latin verse. Claudian himself uses it three other times. None the less, the construction of Claudian's line makes it clear that the line from the Georgics is being imitated here: the lines are metrically equivalent, and the sound-pattern and identical grammatical structure make the imitation unmistakable. (shrink)

How the new conspiracists are undermining democracy—and what can be done about it Conspiracy theories are as old as politics. But conspiracists today have introduced something new—conspiracy without theory. And the new conspiracism has moved from the fringes to the heart of government with the election of Donald Trump. In A Lot of People Are Saying, Russell Muirhead and Nancy Rosenblum show how the new conspiracism differs from classic conspiracy theory, how it undermines democracy, and what needs to be done (...) to resist it. (shrink)

It is often supposed that the spectacular successes of our modern mathematical sciences support a lofty vision of a world completely ordered by one single elegant theory. In this book Nancy Cartwright argues to the contrary. When we draw our image of the world from the way modern science works - as empiricism teaches us we should - we end up with a world where some features are precisely ordered, others are given to rough regularity and still others behave in (...) their own diverse ways. This patchwork makes sense when we realise that laws are very special productions of nature, requiring very special arrangements for their generation. Combining classic and newly written essays on physics and economics, The Dappled World carries important philosophical consequences and offers serious lessons for both the natural and the social sciences. (shrink)

The last and most poignant of these essays is The Intruder, Nancys philosophical meditation on his heart transplant.

This paper critically analyses the concept of evidence in evidence-based-policy arguing that there is key problem: that there is no existing practicable theory of evidence, one which is philosophically grounded and yet applicable for evidencebased policy. The paper critically considers both philosophical accounts of evidence and practical treatments of evidence in evidence-based-policy. It argues that both fail in different ways to provide a theory of evidence that is adequate for evidence-basedpolicy. The paper is a valuable contribution to the part of (...) the research project that explores how evidence can and should be used to reduce contingency in science, and policy based on science. (shrink)

" Nancy Bauer begins her book by asking: "Then what kind of a problem does being a woman pose?

This paper argues that even when simple analogue models picture parallel worlds, they generally still serve as isolating tools. But there are serious obstacles that often stop them isolating in just the right way. These are obstacles that face any model that functions as a thought-experiment but they are especially pressing for economic models because of the paucity of economic principles. Because of the paucity of basic principles, economic models are rich in structural assumptions. Without these no interesting conclusions can (...) be drawn. This, however, makes trouble when it comes to exporting conclusions from the model to the world. One uncontroversial constraint on induction from special cases is to beware of extending conclusions to situations that we know are different in relevant respects. In the case of economic models it is clear by inspection that the unrealistic structural assumptions of the model are intensely relevant to the conclusion. Any inductive leap to a real situation seems a bad bet. (shrink)

Public engagement in ethically laden pandemic planning decisions may be important for transparency, creating public trust, improving compliance with public health orders, and ultimately, contributing to just outcomes. We conducted focus groups with members of the public to characterize public perceptions about social distancing measures likely to be implemented during a pandemic. Participants expressed concerns about job security and economic strain on families if businesses or school closures are prolonged. They shared opposition to closure of religious organizations, citing the need (...) for shared support and worship during times of crises. Group discussions elicited evidence of community-mindedness, while some also acknowledged strong self-interest. Participants conveyed desire for opportunities for public input and education, and articulated distrust of government. Social distancing measures may be challenging to implement and sustain due to strains on family resources and lack of trust in government. (shrink)

Randomized controlled trials (RCTs) are widely taken as the gold standard for establishing causal conclusions. Ideally conducted they ensure that the treatment ‘causes’ the outcome—in the experiment. But where else? This is the venerable question of external validity. I point out that the question comes in two importantly different forms: Is the specific causal conclusion warranted by the experiment true in a target situation? What will be the result of implementing the treatment there? This paper explains how the probabilistic theory (...) of causality implies that RCTs can establish causal conclusions and thereby provides an account of what exactly that causal conclusion is. Clarifying the exact form of the conclusion shows just what is necessary for it to hold in a new setting and also how much more is needed to see what the actual outcome would be there were the treatment implemented. (shrink)

By any metric, the twentieth century university was a successful institution. However, in the twenty-first century, ongoing neoliberal educational reform has been accompanied by a growing epistemological crisis in the meaning and value of the humanities and social sciences (HaSS). Concerns have been expressed in two main forms. The governors of tertiary education systems—governments, private investors, university managers and consultancy firms—have focused on how HaSS can adapt to the perceived research needs of the 21st century. At the same time, a (...) competing set of discourses has been generated by scholars and researchers employed within the critical HaSS themselves. This article considers what these differing perspectives mean for reconceptualising HaSS for the twenty-first century. After surveying the contemporary climate, this article examines the findings of key reports on the future of the humanities from the United States, the United Kingdom and Australia. Alongside those of Western Europe, these university systems are arguably the key drivers for the global university system. It is argued that these reports provide an opportunity for emerging universities to reflect on their research priorities and developmental strategies. The article concludes with some reflections on the wider consequences of the globalising of the university system, the increase of China's influence in Asia, and ponders the prospect of post-human/ist futures of the humanities. (shrink)

Hunting Causes and Using Them argues that causation is not one thing, as commonly assumed, but many. There is a huge variety of causal relations, each with different characterizing features, different methods for discovery and different uses to which it can be put. In this collection of new and previously published essays, Nancy Cartwright provides a critical survey of philosophical and economic literature on causality, with a special focus on the currently fashionable Bayes-nets and invariance methods - and it exposes (...) a huge gap in that literature. Almost every account treats either exclusively how to hunt causes or how to use them. But where is the bridge between? It's no good knowing how to warrant a causal claim if we don't know what we can do with that claim once we have it. This book will interest philosophers, economists and social scientists. (shrink)

What kinds of evidence reliably support predictions of effectiveness for health and social care interventions? There is increasing reliance, not only for health care policy and practice but also for more general social and economic policy deliberation, on evidence that comes from studies whose basic logic is that of JS Mill's method of difference. These include randomized controlled trials, case–control studies, cohort studies, and some uses of causal Bayes nets and counterfactual-licensing models like ones commonly developed in econometrics. The topic (...) of this paper is the 'external validity' of causal conclusions from these kinds of studies. We shall argue two claims. Claim, negative: external validity is the wrong idea; claim, positive: 'capacities' are almost always the right idea, if there is a right idea to be had. If we are right about these claims, it makes big problems for policy decisions. Many advice guides for grading policy predictions give top grades to a proposed policy if it has two good Mill's-method-of difference studies that support it. But if capacities are to serve as the conduit for support from a method-of-difference study to an effectiveness prediction, much more evidence, and much different in kind, is required. We will illustrate the complexities involved with the case of multisystemic therapy, an internationally adopted intervention to try to diminish antisocial behaviour in young people. (shrink)

WE AIM HERE to outline a theory of evidence for use. More specifically we lay foundations for a guide for the use of evidence in predicting policy effectiveness in situ, a more comprehensive guide than current standard offerings, such as the Maryland rules in criminology, the weight of evidence scheme of the International Agency for Research on Cancer (IARC), or the US ‘What Works Clearinghouse’. The guide itself is meant to be well-grounded but at the same time to give practicable (...) advice, that is, advice that can be used by policy-makers not expert in the natural and social sciences, assuming they are well-intentioned and have a reasonable but limited amount of time and resources available for searching out evidence and deliberating. (shrink)

This book is a rich collection of philosophical essays radically interrogating key notions and preoccupations of the phenomenological tradition. While using Heidegger’s Being and Time as its permanent point of reference and dispute, this collection also confronts other important philosophers, such as Kant, Nietzsche, and Derrida. The projects of these pivotal thinkers of finitude are relentlessly pushed to their extreme, with respect both to their unexpected horizons and to their as yet unexplored analytical potential. A Finite Thinking shows that, paradoxically, (...) where the thought of finitude comes into its own it frees itself, not only to reaffirm a certain transformed and transformative presence, but also for a non-religious reconsideration and reaffirmation of certain theologemes, as well as of the body, heart, and love. This book shows the literary dimension of philosophical discourse, providing important enabling ideas for scholars of literature, cultural theory, and philosophy. (shrink)

A study of visual culture in the teaching of the life sciences.

Many people profess to believe that acting morally, or as we ought to act, involves the self-conscious acceptance of some (quite specific) constraints or rules that place limits both on the pursuit of our own interests and on our pursuit of the general good. Though these people do not regard the furtherance of our own interests or the pursuit of the general good as ignoble ends, or ones that we are morally required to eschew, they believe that neither can be (...) regarded as providing us with morally sufficient reason to take action. Those who hold such a view believe that there are certain sorts of acts that are wrong in themselves, and thus morally unacceptable means to the pursuit of any ends, even ends that are morally admirable, or morally obligatory. (How strong the prohibition is against performing such acts is a matter that will be taken up later.) Philosophers call such ethical views ‘deontological’ (from the Greek deon , ‘duty’), and contrast them to views that are ‘teleological’ in structure (from telos , Greek for ‘goal’). Those who hold teleological views reject the view that there are special kinds of acts that are right or wrong in themselves. For teleologists, the rightness or wrongness of our acts is determined by a comparative assessment of their consequences. [...] The focus of this essay is on deontological theories. (shrink)

Cognition in work teams has been predominantly understood and explained in terms of shared cognition with a focus on the similarity of static knowledge structures across individual team members. Inspired by the current zeitgeist in cognitive science, as well as by empirical data and pragmatic concerns, we offer an alternative theory of team cognition. Interactive Team Cognition (ITC) theory posits that (1) team cognition is an activity, not a property or a product; (2) team cognition should be measured and studied (...) at the team level; and (3) team cognition is inextricably tied to context. There are implications of ITC for theory building, modeling, measurement, and applications that make teams more effective performers. (shrink)

This article agrees with Philip Kitcher that we should aim for a well-ordered science, one that answers the right questions in the right ways. Crucial to this is to address questions of use: Which scientific account is right for which system in which circumstances? This is a difficult question: evidence that may support a scientific claim in one context may not support it in another. Drawing on examples in physics and other sciences, this article argues that work on the warrant (...) of theories in philosophy of science needs to change. Emphasis should move from the warrant of theories in the abstract to questions of evidence for use. (shrink)

Palliative care seeks to improve the quality of life for patients suffering from the impact of life‐limiting illnesses. Palliative care encompasses but is more than end‐of‐life care, which is defined as care during the final hours/days/weeks of life. Although palliative care policies increasingly require all healthcare professionals to have at least basic or non‐specialist skills in palliative care, international evidence suggests there are difficulties in realising such policies. This study reports on an action research project aimed at developing respiratory nursing (...) practice to address the palliative care needs of patients with advanced chronic obstructive pulmonary disease (COPD). The findings suggest that interlevel dynamics at individual, team, interdepartmental and organisational levels are an important factor in the capacity of respiratory nurses to embed non‐specialist palliative care in their practice. At best, current efforts to embed palliative care in everyday practice may improve end‐of‐life care in the final hours/days/weeks of life. However, embedding palliative care in everyday practice requires a more fundamental shift in the organisation of care. (shrink)

Epistemic trustworthiness is defined as a complex character state that supervenes on a relation between first- and second-order beliefs, including beliefs about others as epistemic agents. In contexts shaped by unjust power relations, its second-order components create a mutually supporting link between a deficiency in epistemic character and unjust epistemic exclusion on the basis of group membership. In this way, a deficiency in the virtue of epistemic trustworthiness plays into social/epistemic interactions that perpetuate social injustice. Overcoming that deficiency and, along (...) with it, normalized practices of epistemic exclusion, requires developing a self-critical perspective on the partial, socially-located character of one's perspective and the consequent epistemic value of inclusiveness. (shrink)

This paper is one of the four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention and multi-disciplinary partners. Each of the action agenda papers deals with one of the four core elements of public health legal preparedness: laws and legal authorities; competency in using those laws; coordination of law-based public health actions; and information. Options presented in this paper are for consideration by (...) policy makers and practitioners — in all jurisdictions and all relevant sectors and disciplines — with responsibilities for all-hazards emergency preparedness.Advancing and protecting the public's health depends upon the coordination of actions by many, diverse partners. For effective public health preparedness, there must be effective coordination of legal tools and law-based strategies across local, state, tribal, and federal jurisdictions, and also across sectors such as public health, health care, emergency management, education, law enforcement, community design, and academia. (shrink)

Mechanisms are now taken widely in philosophy of science to provide one of modern science’s basic explanatory devices. This has raised lively debate concerning the relationship between mechanisms, laws and explanation. This paper focuses on cases where a mechanism gives rise to a ceteris paribus law, addressing two inter-related questions: What kind of explanation is involved? and What is going on in the world when mechanism M affords behavior B described in a ceteris paribus law? We explore various answers offered (...) by ‘new mechanists’ and others before setting out and explaining our own answers: mechanistic explanations are a species of oldfashioned covering-law explanation and this often accounts in part for their explanatory power; and B is what it takes for some set of principles that govern the features of M’s parts in their arrangement in M all to be instanced together. (shrink)

The ethical tensions inherent in all Baby Doe treatment decisions are compounded by medical uncertainty. Physicians both here and abroad have adopted various strategies. Swedish doctors tend to withhold treatment from the beginning from infants for whom statistical data suggest a grim prognosis. The British are more likely to initiate treatment but withdraw it if the infant appears likely to die or suffer severe brain damage. The trend in the U.S. is to start treating any baby who is potentially viable (...) and continue until it is virtually certain that the infant will die. The “least worst” strategy is an individualized one: starting treatment gathering data, and then reassessing the decision. (shrink)

This collection of writings by Jean-Luc Nancy, the renowned French critic and poet, delves into the history of philosophy to locate a fundamentally poetic modus operandi there. The book represents a daring mixture of Nancy’s philosophical essays, writings about artworks, and artwork of his own. With theoretical rigor, Nancy elaborates on the intrinsic multiplicity of art as a concept of “making,” and outlines the tensions inherent in the faire, the “making” that characterizes the very process of production and thereby the (...) structure of poetry in all its forms. Nancy shows that this multiplication that belongs to the notion of art makes every single work communicate with every other, all material in the artwork appeal to some other material, and art the singular plural of a praxis of the finite imparting of an infinity which is actually there in every utterance. In the collection, Nancy engages with the work of, among others, François Martin, Maurice Blanchot, and On Kawara. (shrink)