Substantial medical evidence shows that about half of ovarian cancers originate in the fallopian tube. Some medical organizations and clinical articles have suggested opportunistic salpingectomy to reduce the risk of ovarian cancer in patients at average risk of developing it. This entails removing the fallopian tubes at the same time as another procedure that would occur anyway. The authors argue that the principles of totality and double effect can justify such salpingectomies, even though there is a low incidence of ovarian (...) cancer. Since screening tools for ovarian cancer are ineffective and treatment options are poor, the good effect of reducing the risk of death from this type of ovarian cancer can be proportionate to the bad effects of the minor increase in surgical risk over the other procedure, the unintended side effect of infertility, and the removal of normally functioning tissue. The authors conclude that it is within the purview of a patient and physician to determine whether the benefits are proportionate to the risks in a particular case. (shrink)

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

John Rawls’s political liberalism and its ideal of public reason are tremendously influential in contemporary political philosophy and in constitutional law as well. Many, perhaps even most, liberals are Rawlsians of one stripe or another. This is problematic, because most liberals also support the redefinition of civil marriage to include same-sex unions, and as I show, Rawls’s political liberalism actually prohibits same- sex marriage. Recently in Perry v. Schwarzenegger, however, California’s northern federal district court reinterpreted the traditional rational basis (...) review in terms of liberal neutrality akin to Rawls’s “public reason,” and overturned Proposition 8 and established same-sex marriage. (This reinterpretation was amplified in the 9th Circuit Court’s decision upholding the district court on appeal in Perry v. Brown.) But on its own grounds Perry should have drawn the opposite conclusion. This is because all the available arguments for recognizing same-sex unions as civil marriages stem from controversial comprehensive doctrines about the good, and this violates the ideal of public reason; yet there remains a publicly reasonable argument for traditional marriage, which I sketch here. In the course of my argument I develop Rawls’s politically liberal account of the family by drawing upon work by J. David Velleman and H. L. A. Hart, and discuss the implications of this account for political theory and constitutional law. (shrink)

This paper reports on-going work in the eSCAPE Project (Esprit Long Term Research Project 25377) directed to the research and development of electronic landscapes for public use. Our concern here is to elucidate a sociologically informed approach towards the design of electronic landscapes or virtual worlds. We suggest — and demonstrate through ethnographic studies of virtual technologies at a multimedia art museum and information technology trade show — that members sense of space is produced through social practices tied to the (...) accomplishment of activities occurring within the locations their actions are situated. Space, in other words, is socially constructed and shaped through members’ practices for accomplishing situated activities. We explicate, by practical examples, an approach to discovering social practices in and through which a sense of space is constructed and outline how such understandings may be used to formulate requirements for the design of electronic landscapes. In explicating our ethnographically informed approach, we outline how future technologies may bedeveloped through the situated evaluation of experimental prototypes in public use. (shrink)

National Action Plans on business and human rights are a growing phenomenon. Since 2011, 42 such plans have been adopted or are in-development worldwide. By comparison, only 39 general human rights action plans were published between 1993 and 2021. In parallel, NAPs have attracted growing scholarly interest. While some studies highlight their potential to advance national compliance with international norms, others criticise NAPs as cosmetic devices that states use to deflect attention from persisting abuses and needed regulation. In response to (...) wider critiques of international human rights norms, and their failure to exact universal state compliance, experimentalist governance theory highlights the dynamic, dialogic and iterative character of human rights implementation as well as the role of stakeholders. In this article, we apply experimentalist governance theory to evaluate the role and character of business and human rights NAPs. Rather than attempting to evaluate NAPs’ ultimate consequences for rights-holders, which appears premature, we focus on NAPs processes. Specifically, we analyse NAPs processes in twenty-five states against five experimentalist governance criteria relating to stakeholder participation; agreement on a broad problem definition; local contextualisation; monitoring and peer review and periodic revision and learning. According to our findings, NAPs on business and human rights in most states demonstrate resemblance to the traits of experimentalist governance. In particular, our analysis points to the emergence of relatively sophisticated and demanding institutional governance mechanisms within NAPs — including the institutionalisation of complex deliberative processes. Nevertheless, our paper also identifies some significant shortcomings in NAPs, related to the lack of inclusion of vulnerable groups and the lack of explicit indicators and targets. (shrink)

While new generations of implantable brain computer interface devices are being developed, evidence in the literature about their impact on the patient experience is lagging. In this article, we address this knowledge gap by analysing data from the first-in-human clinical trial to study patients with implanted BCI advisory devices. We explored perceptions of self-change across six patients who volunteered to be implanted with artificially intelligent BCI devices. We used qualitative methodological tools grounded in phenomenology to conduct in-depth, semi-structured interviews. Results (...) show that, on the one hand, BCIs can positively increase a sense of the self and control; on the other hand, they can induce radical distress, feelings of loss of control, and a rupture of patient identity. We conclude by offering suggestions for the proactive creation of preparedness protocols specific to intelligent—predictive and advisory—BCI technologies essential to prevent potential iatrogenic harms. (shrink)

Platonic love is a concept that has profoundly shaped Western literature, philosophy and intellectual history for centuries. First developed in the Symposium and the Phaedrus, it was taken up by subsequent thinkers in antiquity, entered the theological debates of the Middle Ages, and played a key role in the reception of Neoplatonism and the etiquette of romantic relationships during the Italian Renaissance. In this wide-ranging reference work, a leading team of international specialists examines the Platonic distinction between higher and lower (...) forms of eros, the role of the higher form in the ascent of the soul and the concept of Beauty. They also treat the possibilities for friendship and interpersonal love in a Platonic framework, as well as the relationship between love, rhetoric and wisdom. Subsequent developments are explored in Plutarch, Plotinus, Augustine, Pseudo-Dionysius, Eriugena, Aquinas, Ficino, della Mirandola, Castiglione and the contra amorem tradition. (shrink)

Doctors have an ethical and legal duty to respect patient confidentiality. We consider the basis for this duty, looking particularly at the meaning and value of autonomy in health care. Enabling patients to decide how information about them is disclosed is an important element in autonomy and helps patients engage as active partners in their care.Good quality data is, however, essential for research, education, public health monitoring, and for many other activities essential to provision of health care. We discuss whether (...) it is necessary to choose between individual rights and the wider public interest and conclude that this should only rarely be necessary. The paper makes some recommendations on practical steps which could help ensure that good quality information is available for work which benefits society and the public health, while still enabling patients’ autonomy to be respected. (shrink)

This book is an in-depth treatment of Darwinian evolutionism and its applicability to the investigation of the archaeological record. The authors explain the unique position that this kind of evolutionism holds in science and how it bears on any attempt to explain change over time in the organic world, demonstrate commonalities between archaeology and paleobiology, and explain the principles, methods, and techniques - the systematics - inherent in the approach.

We agree that the emergence of cumulative technological culture was tied to nonsocial cognitive skills, namely, technical-reasoning skills, which allowed humans to constantly acquire and improve information. Our concern is with a reading of the history of cumulative technological culture that is based largely on modern experiments in simulated settings and less on phenomena crucial to the long-term dynamics of cultural evolution.