Laspro et al. (2024) contemplate the first whole eye transplant (WET) procedure in humans. They discuss the implications of such a procedure on the physical, social, and psychological well-being of...

Pandemics first and foremost hit those who are most vulnerable, and the COVID-19 pandemic is not different. Although the infection rate in the nation’s poorest neighborhoods is twice as it is in th...

The United States’ ambitious Precision Medicine Initiative proposes to accelerate exponentially the adoption of precision medicine, an approach to health care that tailors disease diagnosis, treatment, and prevention to individual variability in genes, environment, and lifestyle. It aims to achieve this by creating a cohort of volunteers for precision medicine research, accelerating biomedical research innovation, and adopting policies geared toward patients’ empowerment. As strategies to implement the PMI are formulated, critical consideration of the initiative's ethical and sociopolitical dimensions is needed. (...) Drawing on scholarship of nationalism and democracy, we discuss the PMI's construction of what we term “genomic citizenship”; the possible normative obligations arising therefrom; and the ethical, legal, and social challenges that will ensue. Although the PMI is a work in progress, discussion of the existing and emerging issues can facilitate the development of policies, structures, and procedures that can maximize the initiative's ability to produce equitable and socially sensitive outcomes. Our analysis can also be applied to other population-based, precision medicine research programs. (shrink)

Since the inception of large‐scale human genome research, there has been much caution about the risks of exacerbating a number of socially dangerous attitudes linked to human genetics. These attitudes are usually labeled with one of a family of genetic or genomic “isms” or “ations” such as “genetic essentialism,” “genetic determinism,” “genetic reductionism,” “geneticization,” “genetic stigmatization,” and “genetic discrimination.” The psychosocial processes these terms refer to are taken to exacerbate several ills that are similarly labeled, from medical racism and psychological (...) fatalism to economic exploitation and social exclusion. But as genomic information becomes more familiar in clinical and research settings as well as other life activities, do we need to continue to worry so much about this family of attitudes and their impact on existing problems?In genomics, the underlying anxiety has been that disclosure of genomic information will trigger a series of (seemingly unavoidable) negative responses that will affect individuals, their families, and their communities at large. The fundamental social challenges that hyperbolic genomic messaging, low genomic literacy, and “folk biology” help sustain remain to be addressed. If we hope to break the cycle of genomic isms and ations, we will have to get better at resisting overinterpretations of the relevance that genomics has for people’s future potentials, ancestral vulnerabilities, community memberships, and ethnic affiliations. (shrink)

Meier et al. describe a pilot study that developed METHAD, an AI-based Medical Ethics Advisor tool that draws on the principlism approach and was tested using text-book cases and clinical et...

Whole genome and exome sequencing techniques raise hope for a new scale of diagnosis, prevention, and prediction of genetic conditions, and improved care for children. For these hopes to materialize, extensive genomic research with children will be needed. However, the use of WGS/WES in pediatric research settings raises considerable challenges for families, researchers, and policy development. In particular, the possibility that these techniques will generate genetic findings unrelated to the primary goal of sequencing has stirred intense debate about whether, which, (...) how, and when these secondary or incidental findings should be returned to parents and minors. The debate is even more pronounced when the subjects are adolescents, for whom decisions about return of SFs may have particular implications. In this paper, we consider the rise of “genomic citizenship” and the main challenges that arise for these stakeholders: adolescents' involvement in decisions relating to return of genomic SFs, the types of SFs that should be offered, privacy protections, and communication between researchers and adolescents about SFs. We argue that adolescents' involvement in genomic SF-related decisions acknowledges their status as valuable stakeholders without detracting from broader familial interests, and promotes more informed genomic citizens. (shrink)

Galasso (2024) shares findings from narrative analyses of relevant constituting material of and interviews with leaders in two national precision medicine research (PMR) programs: 100KGP of Genomic...

The exponential growth of genetic knowledge and precision medicine research raises hopes for improved prevention, diagnosis, and treatment options for children with behavioral and psychiatric conditions. Although well-intended, this prospect also raise the possibility — and concern — that behavioral, including psychiatric genetic data would be increasingly used — or misused — outside the clinical context, such as educational settings. Indeed, there are ongoing calls to endorse a “personalized education” model that would tailor educational interventions to children's behavioral and psychiatric (...) genetic makeup. This article explores the justifications for, and prospects and pitfalls of such endeavors. It considers the scientific challenges and highlights the ethical, legal, and social issues that will likely arise should behavioral genetic data become available and are routinely incorporated in student education records. These include: when to disclose students' behavioral and psychiatric genetic profile; whose genomic privacy is protected and by whom; and how students' genetic data may affect education-related decisions. I argue that the introduction of behavioral genetics in schools may overshadow the need to address underlying structural and environmental factors that increase the risk for psychiatric conditions of all students, and that the unregulated use of student behavioral genetic profiles may lead to unintended consequences that are detrimental for individuals, families and communities. Relevant stakeholders — from parents and students to health professionals, educators, and policy-makers — ought to consider these issues before we forge ahead with a genomically informed education system. (shrink)

In our target article (Sabatello et al. 2021), we proposed the use of community engagement and the establishment of a Truth and Reconciliation Commission (TRC) as pathways for promoting social just...

Not a single day goes by without some news about personalized medicine, especially in its genomic context (precision medicine). In tandem with the scientific excitement, however, come the cautionary notes. These include worries about Big Brother surveillance, concerns about the impact of genomic results on the psychosocial well‐being of patients and research subjects, and attention to issues of social and distributive justice. Personalised Medicine, Individual Choice and the Common Good, coedited by Britta van Beers, Sigrid Sterckx, and Donna Dickenson, falls (...) squarely into this discourse with an aim to “fuel and stimulate the debate about personalised medicine and enable its participants to come to a more balanced understanding of the interests and values at stake.” At its core, the book laments the shift from “We Medicine” to “Me Medicine,” with ostensibly all authors highlighting that, on balance, the costs associated with “Me Medicine” far outweigh the benefits. This is both a strength and a weakness of the book. (shrink)

Volume 20, Issue 7, July 2020, Page 187-190.

Many countries currently invest in technologies and data infrastructures to foster precision medicine (PM), which is hoped to better tailor disease treatment and prevention to individual patients. But who can expect to benefit from PM? The answer depends not only on scientific developments but also on the willingness to address the problem of structural injustice. One important step is to confront the problem of underrepresentation of certain populations in PM cohorts via improved research inclusivity. Yet, we argue that the perspective (...) needs to be broadened because the (in)equitable effects of PM are also strongly contingent on wider structural factors and prioritization of healthcare strategies and resources. When (and before) implementing PM, it is crucial to attend to how the organisation of healthcare systems influences who will benefit, as well as whether PM may present challenges for a solidaristic sharing of costs and risks. We discuss these issues through a comparative lens of healthcare models and PM-initiatives in the United States, Austria, and Denmark. The analysis draws attention to how PM hinges on—and simultaneously affects—access to healthcare services, public trust in data handling, and prioritization of healthcare resources. Finally, we provide suggestions for how to mitigate foreseeable negative effects. (shrink)

In the article, “Precision Medicine for Whom? Public Health Outputs from “Genomics England” and “All of Us” to Make Up for Upstream and Downstream Exclusion,” Galasso focuses on how marginalized pe...

The usefulness of machine learning algorithms has led to their widespread adoption prior to the development of a conceptual framework for making sense of them. One common response to this situation is to say that machine learning suffers from a “black box problem.” That is, machine learning algorithms are “opaque” to human users, failing to be “interpretable” or “explicable” in terms that would render categorization procedures “understandable.” The purpose of this paper is to challenge the widespread agreement about the existence (...) and importance of a black box problem. The first section argues that “interpretability” and cognates lack precise meanings when applied to algorithms. This makes the concepts difficult to use when trying to solve the problems that have motivated the call for interpretability. Furthermore, since there is no adequate account of the concepts themselves, it is not possible to assess whether particular technical features supply formal definitions of those concepts. The second section argues that there are ways of being a responsible user of these algorithms that do not require interpretability. In many cases in which a black box problem is cited, interpretability is a means to a further end such as justification or non-discrimination. Since addressing these problems need not involve something that looks like an “interpretation” of an algorithm, the focus on interpretability artificially constrains the solution space by characterizing one possible solution as the problem itself. Where possible, discussion should be reformulated in terms of the ends of interpretability. (shrink)

The standard counterexamples to David Lewis’s account of intrinsicality involve two sorts of properties: identity properties and necessary properties. Proponents of the account have attempted to deflect these counterexamples in a number of ways. This paper argues that none of these moves are legitimate. Furthermore, this paper argues that no account along the lines of Lewis’s can succeed, for an adequate account of intrinsicality must be sensitive to hyperintensional distinctions among properties.

Resemblances obtain not only between objects but between properties. Resemblances of the latter sort - in particular resemblances between quantitative properties - prove to be the downfall of a well-known theory of universals, namely the one presented by David Armstrong. This paper examines Armstrong's efforts to account for such resemblances within the framework of his theory and also explores several extensions of that theory. All of them fail.

Corporeality: Emergent consciousness within its spatial dimensions develops our understanding of what we can experience through our bodies in relation to the space around us. Rather than considering architecture as being about manifestation and mediation of fixed meanings, the book focuses instead on architectural space as a field that envelopes us incessantly, intimately, and affectively. We are in immediate contact with that space, and the way we relate to it determines how we are able to grasp the realities of the (...) social and material worlds around us. This enquiry considers architectural space and its impact on and relation to us from a range of disciplines and perspectives, leading from space to sense and to sensibility. The theatre becomes a central point of reference on this journey, allowing us to understand how space “works” by linking concrete spatial conditions to corresponding “forms of experience”. It allows showing how the ways we feel, think, and act emerge from within the rich texture of the pre-conscious and non-contemplative. That texture is induced and nourished by our bodily encounters with space. Offering a view of how immediate experience is generated in the body, this book enhances empirical research into the links between space, body, experience and consciousness. Maya Nanitchkova Öztürk is Associate Professor in Theory and Criticism of Architecture. Her academic interests and publications focus on space-body relationships and experience of space/place, as grounds for developing analytical methodologies and interdisciplinary links in discourse, and teaching. She works at Bilkent University (Ankara), Faculty of Art, Design and Architecture, Department of Interior Architecture and Environmental Design. She is on the editorial boards of ISI journal Space and Culture, and the web-journal Consciousness, Literature and the Arts. (shrink)

This paper offers a theoretical discussion on why the nursing profession has had a delayed response to the issue of climate change. We suggest this delay may have been influenced by the early days of nursing's professionalization. Specifically, we examine nursing's professional mandate, the generally accepted metaparadigm, and the grand theorists’ conceptualizations of both the environment and the nurse–environment relationship. We conclude that these works may have encouraged nurses to conceptualize the environment, as well as their relationship with it, mainly (...) in terms of the individual patient, and as such, nurses have not been encouraged to understand these concepts from a broader perspective. By not having the philosophical and theoretical foundations to understand the environment in relation to society, it is not surprising that nurses have had a delayed response to climate change and may not have viewed it as a professional concern. A planetary health perspective is suggested as a theoretical basis for nursing education, research and practice. Taking on a planetary health perspective could help nurses progress the profession and move healthcare systems towards supporting a climate‐resilient future. (shrink)

Intelligible speakers achieve specific vocal tract constrictions in rapid sequence. These constrictions are associated in theory with speech motor goals. Adult-focused models of speech production assume that discrete phonological representations, sequenced into word-length plans for output, define these goals. This assumption introduces a serial order problem for speech. It is also at odds with children's speech. In particular, child phonology and timing control suggest holistic speech plans, and so the hypothesis of whole word production. This hypothesis solves the serial order (...) problem by avoiding it. When the same solution is applied to adult speech the problem becomes how to explain the development of highly intelligible speech. This is the problem addressed here. A modeling approach is used to demonstrate how perceptual-motor units of production emerge over developmental time with the perceptual-motor integration of holistic speech plans that are also phonological representations; the specific argument is that perceptual-motor units are a product of trajectories (nearly) crossing in motor space. The model, which focuses on the integration process, defines the perceptual-motor map as a set of linked pairs of experienced perceptual and motor trajectories. The trajectories are time-based excursions through speaker-defined perceptual and motor spaces. By hypothesis, junctures appear where motor trajectories near or overlap one another in motor space when the shared (or extremely similar) articulatory configurations in these regions are exploited to combine perceptually-linked motor paths along different trajectories. Junctures form in clusters in motor space. These clusters, along with their corresponding (linked) perceptual points, represent perceptual-motor units of production, albeit at the level of speech motor control only. The units serve as pivots in motor space during speaking; they are points of transition from one motor trajectory to another along perceptually-linked paths that are selected to produce best approximations of whole word targets. (shrink)

The public rejection of scientific claims is widely recognized by scientific and governmental institutions to be threatening to modern democratic societies. Intense conflict between science and the public over diverse health and environmental issues have invited speculation by concerned officials regarding both the source of and the solution to the problem of public resistance towards scientific and policy positions on such hot-button issues as global warming, genetically modified crops, environmental toxins, and nuclear waste disposal. The London Royal Society’s influential report (...) “Public Understanding of Science”, which spearheaded the now-thriving area of science... (shrink)

In this article I argue that the Critical Kant endorses the claim that God creates the best possible world, and that this claim is best understood as committing him to the view that God creates an infinitely valuable world. Kant’s understudied Critical theory of the best possible world differs significantly from his better-known quasi-Leibnizian pre-Critical account insofar as it uses an axiological rather than ontological metric for the goodness of worlds. The axiological metric introduces unique challenges for a Kantian account (...) of the best possible world. These challenges are in turn resolved via an infinite value interpretation. (shrink)

In recent years, new forms of high-tech controlled environment agriculture (CEA) have received increased attention and investment. These systems integrate a suite of technologies – including automation, LED lighting, vertical plant stacking, and hydroponic fertilization – to allow for greater control of temperature, humidity, carbon dioxide, oxygen, and light in an enclosed growing environment. Proponents insist that CEA can produce sustainable, nutritious, and tasty local food, particularly for the cities of the future. At the same time, a variety of critics (...) raise concerns about its environmental impacts and energy use, high startup costs, and consumer accessibility challenges, among other issues. At this stage, however, relatively little research has explored actual consumer knowledge and attitudes related to CEA processes and products. Guided by theories of sense-making, this article draws from structured interviews with local food consumers in New York City to examine what people know and think about high-tech CEA. From there, it explores the extent to which CEA fits into consumer conceptualizations of what makes for “good food.” Key findings emphasize that significant gaps in public understanding of CEA remain, that CEA products’ success will depend on the ability of the industry to deliver on its environmental promises, and that concerns about “unnatural” aspects of CEA will need to be allayed. Given the price premium at which high-tech CEA products are currently sold, the industry’s expansion will depend in large part on its ability to convince value-oriented food consumers that the products meet the triple-bottom-line of economic, social, and environmental sustainability goals. (shrink)

The evidence-based medicine (EBM) movement is touted as a new paradigm in medical education and practice, a description that carries with it an enthusiasm for science that has not been seen since logical positivism flourished (circa 1920–1950). At the same time, the term ‘‘evidence-based medicine’’ has a ring of obviousness to it, as few physicians, one suspects, would claim that they do not attempt to base their clinical decision-making on available evidence. However, the apparent obviousness of EBM can and should (...) be challenged on the grounds of how ‘evidence’ has been problematised in the philosophy of science. EBM enthusiasm, it follows, ought to be tempered. The post-positivist, feminist, and phenomenological philosophies of science that are examined in this paper contest the seemingly unproblematic nature of evidence that underlies EBM by emphasizing different features of the social nature of science. The appeal to the authority of evidence that characterizes evidence-based practices does not increase objectivity but rather obscures the subjective elements that inescapably enter all forms of human inquiry. The seeming common sense of EBM only occurs because of its assumed removal from the social context of medical practice. In the current age where the institutional power of medicine is suspect, a model that represents biomedicine as politically disinterested or merely scientific should give pause. (shrink)

We live in an era characterized by technology as an integral part of the overall experiences. Non-hierarchic access to communication and virtual contacts in the metaverse, experienced as no less real than those in the brick-and-mortar world. The global health crisis has further highlighted the understanding that the integration of technology into our lives is inevitable, and when it comes to teaching and learning, the right use of technology can take teachers and learners to new, exciting places. The social distancing (...) regulations imposed worldwide provided educators with an opportunity to try out a variety of technological tools that enable surprising collaborations and access to information that encourages cognitive flexibility and a reexamination of our assumptions on knowledge, learning, teaching, human interaction, and space-time’s limitations. However, one great challenge within this ongoing transition concerns underprepared educators, feeling the pressure to make a successful shift while sustaining their educational inner compass regarding what constitutes adequate education. In this teacher’s self-study, I examined my teaching experience while teaching online. Informed by existing research, critical reflections, dialogue with a critical friend, a community of colleagues, and students’ artifacts, I inquire whether—and how—I can practice dialogical pedagogy while teaching online. (shrink)

In "Does Four-Dimensionalism Explain Coincidence" Mark Moyer argues that there is no reason to prefer the four-dimensionalist (or perdurantist) explanation of coincidence to the three-dimensionalist (or endurantist) explanation. I argue that Moyer's formulations of perdurantism and endurantism lead him to overlook the perdurantist's advantage. A more satisfactory formulation of these views reveals a puzzle of coincidence that Moyer does not consider, and the perdurantist's treatment of this puzzle is clearly preferable.

Acts of intimate partner violence and abuse of nonhuman animals are common, harmful, and co-occurring phenomena. The aim of the present study was to identify perpetrator subtypes based on variable paths hypothesized to influence physical violence toward both partners and nonhuman animals: callousness and instrumental representations of aggression and rejection-sensitivity and expressive representations of aggression. Strong associations emerged between callousness and instrumental representations and between rejection-sensitivity and expressive representations. For males, callousness directly predicted both IPV and animal abuse. For females, (...) rejection-sensitivity predicted IPV. Instrumental representations mediated the relationship between callousness and animal abuse for females but not for males. Results suggest that IPV and animal abuse functionally interconnect, that perpetration of animal abuse may differ in function across gender, and that identifying distinct pathways to violence may facilitate violence prediction and prevention. (shrink)

A framework to support ?Arguing from Experience? using groups of collaborating agents (termed participant agents/players) is described. The framework is an extension of the PISA multi-party arguing from experience framework. The original version of PISA allowed n participants to promote n goals (one each) for a given example. The described extension of PISA allows individuals with the same goals to pool their resources by forming ?groups?. The framework is fully described and its effectiveness illustrated using a number of classification scenarios. (...) The main finding is that by using groups more accurate results can be obtained than when agents operate in isolation. (shrink)

One of the most fundamental and recurring issues in the social sciences--the relation between language and thought--is examined in this work from a broad and coherent interdisciplinary perspective. Many of the great historical issues are also addressed and newly examined such as: the multifunctionality of language, the role of natural logic in the structuring of linguistic rules, and the place of linguistic disambiguation and repair in particular cultures.

Questions regarding the formation of the Universe and ‘what was there’ before it came to existence have been of great interest to mankind at all times. Several suggestions have been presented during the ages – mostly assuming a preliminary state prior to creation. Nevertheless, theories that require initial conditions are not considered complete, since they lack an explanation of what created such conditions. We therefore propose the ‘Creatio Ex Nihilo’ (CEN) theory, aimed at describing the origin of the Universe from (...) ‘nothing’ in information terms. The suggested framework does not require amendments to the laws of physics: but rather provides a new scenario to the Universe initiation process, and from that point merges with state-of-the-art cosmological models. The paper is aimed at providing a first step towards a more complete model of the Universe creation – proving that creation Ex Nihilo is feasible. Further adjustments, elaborations, formalisms and experiments are required to formulate and support the theory. (shrink)

Because “evidence” is at issue in evidence-based medicine (EBM), the critical responses to the movement have taken up themes from post-positivist philosophy of science to demonstrate the untenability of the objectivist account of evidence. While these post-positivist critiques seem largely correct, I propose that when they focus their analyses on what counts as evidence, the critics miss important and desirable pragmatic features of the evidence-based approach. This article redirects critical attention toward EBM’s rigid hierarchy of evidence as the culprit of (...) its objectionable epistemic practices. It reframes the EBM discourse in light of a distinction between objectivist and pragmatic epistemology, which allows for a more nuanced analysis of EBM than previously offered: one that is not either/or in its evaluation of the decision-making technology as either iconoclastic or creedal. -/- . (shrink)

Wiggins and Wilbanks (2019) raise a number of interesting concerns vis-à-vis citizen science and research. However, one area of innovation in citizen science that has seen significant advancements...