The paper begins with a defence of a new definition of privacy as the absence of undocumented personal knowledge. In the middle section, I criticise alternative accounts of privacy. Finally, I show how my definition can be worked into contemporary American Law.

The project of studying children in order to understand them, which lies at the heart of contemporary thinking about children and their education, is misconceived. It rests, jrst of all, upon a false belief that we can only come to know something properly by deliberately and systematically pursuing knowledge of it. Secondly, it offers a paradigm of knowing children which justifies parents and teachers in not giving themselves to children. By re-interpreting the problems that adults experience with children as technical, (...) as arising from lack of information about them, it ignores the personal and moral dimension of adults’ relations with children and thus further alienates them from one another. (shrink)

The project of studying children in order to understand them, which lies at the heart of contemporary thinking about children and their education, is misconceived. It rests, jrst of all, upon a false belief that we can only come to know something properly by deliberately and systematically pursuing knowledge of it. Secondly, it offers a paradigm of knowing children which justifies parents and teachers in not giving themselves to children. By re-interpreting the problems that adults experience with children as technical, (...) as arising from lack of information about them, it ignores the personal and moral dimension of adults’ relations with children and thus further alienates them from one another. (shrink)

As public research organisations are increasingly driven by their national and regional governments to engage in knowledge transfer, they have started to support the creation of companies. These research based spin-off companies (RBSOs) often keep contacts with the research institutes they originate from. In this paper we present the results of a study of four research institutes within two universities and two non-university public research organisations (PROs) in the Netherlands. We show that research organisations have distinct motivations to support the (...) creation of spin-off companies. In terms of resources RBSOs contribute, mostly in a modest way, to research activities by providing information, equipment and monetary resources. In particular, RBSOs are helpful for researchers competing for research grants that demand participation of industry. Furthermore, RBSOs may be seen as a proactive response by Dutch public research organisations to demands of economic relevance from their institutional environment. RBSOs enhance the prestige of their parent organisations and create legitimacy for public funds invested in PROs. At the same time, most RBSOs do not have a significant impact on the direction of the research conducted at the PROs. (shrink)

Some children may face some developmental problems in one ormore areas of their developmental milestones. One of them is speech delay. Todate, a screening tool for speech delay early detection among children is stilllacking, especially in Malaysia. Parents do not know where to refer and whichorganisation can help them especially for first-time parents. The objective ofthis paper is twofold. First, this paper analyses existing screening system orapplication for speech delay in children. Second, this paper proposes a mobileapplication designed for Malaysian (...) parents to help them detect speech delayin their children. A qualitative expert review was used to design and build theapplication. The screening application proposed is for early detection and tourge parents to seek for early intervention through appropriate assessments. Inconclusion, early detection in speech delay is critically important to increasethe chances for improving speech and communication skills. Thus, a speechdelay screening tool is needed for parents to seek proper treatment for theirchildren. (shrink)

Background Genuine uncertainty on superiority of one intervention over the other is called equipoise. Physician-investigators in randomized controlled trials need equipoise at least in studies with more than minimal risks. Ideally, this equipoise is also present in patient-participants. In pediatrics, data on equipoise are lacking. We hypothesize that 1) lack of equipoise at enrolment among parents may reduce recruitment; 2) lack of equipoise during participation may reduce retention in patients assigned to a less favoured treatment-strategy. Methods We compared preferences of (...) parents/patients at enrolment, documented by a questionnaire, with preferences developed during follow-up by an interview-study to investigate equipoise of child-participants and parents in the BeSt-for-Kids-study. This trial in new-onset Juvenile Idiopathic Arthritis-patients consists of three strategies. One strategy comprises initial treatment with a biological disease-modifying-antirheumatic-drug, currently not standard-of-care. Semi-structured interviews were conducted with 23 parents and 7 patients, median 11 months after enrolment. Results Initially most parents and children were not in equipoise. Parents/patients who refused participation, regularly declined due to specific preferences. Many participating families preferred the biological-first-strategy. They participated to have a chance for this initial treatment, and would even consider stopping trial-participation when not randomized for it. Their conviction of superiority of the biological-first strategy was based on knowledge from internet and close relations. According to four parents, the physician-investigator preferred the biological-first-strategy, but the majority stated that she had no preferred strategy. In phase 2, preferences tended to change to the treatment actually received. Conclusions Lack of equipoise during enrolment did not reduce study recruitment, mainly due to the fact that preferred treatment was only available within the study. Still, when developing a trial it is important to evaluate whether the physicians’ research question is in line with preferences of the patient-group. By exploring so-called ‘informed patient-group’-equipoise, successful recruitment may be enhanced and bias avoided. In our study, lack of equipoise during trial-participation did not reduce retention in those assigned to a less favoured option. We observed a change for preference towards treatment actually received, possibly explained by comparable outcomes in all three arms. (shrink)

Research involving recently deceased humans that are physiologically maintained following declaration of death by neurologic criteria—or ‘research involving the recently deceased’—can fill a translational research gap while reducing harm to animals and living human subjects. It also creates new challenges for honouring the donor’s legacy, respecting the rights of donor loved ones, resource allocation and public health. As this research model gains traction, new empirical ethics questions must be answered to preserve public trust in all forms of tissue donation and (...) in the practice of medicine while respecting the legacy of the deceased and the rights of donor loved ones. This article suggests several topics for immediate investigation to understand the attitudes and experiences of researchers, clinical collaborators, donor loved ones and the public to ensure research involving the recently deceased advances ethically. (shrink)

Abstract:Facial transplantation is emerging as a therapeutic option for self-inflicted gunshot wounds. The self-inflicted nature of this injury raises questions about the appropriate role of self-harm in determining patient eligibility. Potential candidates for facial transplantation undergo extensive psychosocial screening. The presence of a self-inflicted gunshot wound warrants special attention to ensure that a patient is prepared to undergo a demanding procedure that poses significant risk, as well as stringent lifelong management. Herein, we explore the ethics of considering mechanism of injury (...) in the patient selection process, referring to the precedent set forth in solid organ transplantation. We also consider the available evidence regarding outcomes of individuals transplanted for self-inflicted mechanisms of injury in both solid organ and facial transplantation. We conclude that while the presence of a self-inflicted gunshot wound is significant in the overall evaluation of the candidate, it does not on its own warrant exclusion from consideration for a facial transplantation. (shrink)

Objective To assess parental permission for a neonate's research participation using the MacArthur competence assessment tool for clinical research (MacCAT-CR), specifically testing the components of understanding, appreciation, reasoning and choice. Study Design Quantitative interviews using study-specific MacCAT-CR tools. Hypothesis Parents of critically ill newborns would produce comparable MacCAT-CR scores to healthy adult controls despite the emotional stress of an infant with critical heart disease or the urgency of surgery. Parents of infants diagnosed prenatally would have higher MacCAT-CR scores than parents (...) of infants diagnosed postnatally. There would be no difference in MacCAT-CR scores between parents with respect to gender or whether they did or did not permit research participation. Participants Parents of neonates undergoing cardiac surgery who had made decisions about research participation before their neonate's surgery. Methods The MacCAT-CR. Results 35 parents (18 mothers; 17 fathers) of 24 neonates completed 55 interviews for one or more of three studies. Total scores: magnetic resonance imaging (mean 36.6, SD 7.71), genetics (mean 38.8, SD 3.44), heart rate variability (mean 37.7, SD 3.30). Parents generally scored higher than published subject populations and were comparable to published control populations with some exceptions. Conclusions The MacCAT-CR can be used to assess parental permission for neonatal research participation. Despite the stress of a critically ill neonate requiring surgery, parents were able to understand study-specific information and make informed decisions to permit their neonate's participation. (shrink)

In debates about genetic testing of children, as well as about disclosing unsolicited findings (UFs) of pediatric exome sequencing, respect for future autonomy should be regarded as a prima facie consideration for not taking steps that would entail denying the future adult the opportunity to decide for herself about what to know about her own genome. While the argument can be overridden when other, morally more weighty considerations are at stake, whether this is the case can only be determined in (...) concrete cases. Importantly, when children grow into adolescents, respect for future autonomy will have to give way to respecting their emerging autonomy. When pediatric exome sequencing is done for complex conditions not involving developmental delay, respect for the child’s future or emerging autonomy should be a primary consideration for those charged with deciding on behalf of the child. Building on what Emanuel and Emanuel have termed the ‘deliberative model’ of shared decision making, we argue that if parents fail to give these considerations their due, professionals should actively invite them to do so. Taking a directive stance may be needed in order to make sure that the future or emerging autonomy of the child are duly considered in the decision-making process, but also to help the parents and themselves to shape their respective roles as responsible care-givers. (shrink)

Our objective is to understand how parents and children perceive their roles in decision making about research participation. Forty-five children (ages 4-15 years) with or without a chronic condition and 21 parents were the participants. A semistructured interview assessed perceptions of up to 4 hypothetical research scenarios with varying levels of risk, benefit, and complexity. Children were also administered the Peabody Picture Vocabulary Test, Third Edition, to assess verbal ability, as a proxy for the child's cognitive development. The audiotaped interviews (...) were transcribed and analyzed for themes related to parent and child decision-making roles. Both parents and children varied in their perceptions of decision-making roles. Child perceptions of parental influence on decision making as knowledge-based increased with cognitive development, whereas perceptions of parental influence as power-based decreased. Both children and parents commented that they would collaborate with each other when making decisions. Collaborative decision making appeared to increase with cognitive development. These findings suggest that approaches to child assent and parent permission should consider the parent-child relationship and how children and families typically make decisions. Future research is necessary to explain variation in the process of research decision making across children and families, explore the role of collaboration on children's decision-making skills, and understand developmental trajectories and mechanisms related to research decision making. (shrink)

Background: When adolescent boys experience close, secure relationships with their parents and peers, the implications are potentially far reaching, including lower levels of mental health problems in adolescence and young adulthood. Here we use rare prospective intergenerational data to extend our understanding of the impact of adolescent attachments on subsequent postpartum mental health problems in early fatherhood.Methods: At age 17–18 years, we used an abbreviated Inventory of Parent and Peer Attachment to assess trust, communication, and alienation reported by 270 (...) male participants in their relationships with mothers, fathers, and peers. More than a decade later, we assessed the adult males, now fathers, at 12 months postpartum for symptoms of depression, anxiety, and stress. Logistic regression was used to examine the extent to which attachment dimensions predicted paternal postpartum mental health, adjusting for potential confounding, and with assessment for interactions between parent and peer attachments.Results: Trust in mothers and peers, and good communication with fathers during adolescence, were associated with 5 to 7 percentage point reductions in postpartum mental health symptoms in early fatherhood. Weak evidence of parent-peer interactions suggested secure attachments with either parent or peer may compensate for an insecure attachment with the other.Conclusions: Our results suggest that fostering trust and communication in relationships that adolescent boys have with parents and peers may have substantial effects on rates of paternal postpartum mental health problems. The protective benefits may be preventative in intergenerational cycles of risk for mental health problems. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Could Understanding Harm?Iskra Fileva, PhD (bio) and Linda A.W. Brakel, MD (bio)We would like to thank the editors for organizing this symposium and our commentators—Marga Reimer and James Phillips—for the thought-provoking feedback. Although we had thought about the ideas we discuss from many different angles, our commentators raised several interesting issues we had not considered. We are grateful for the opportunity to continue the conversation.Reply to ReimerAs Professor Reimer (...) notes, we advocate an approach to self-constitution that we dub “understanding first.” On this approach, non-moral and non-normative understanding of the origin of maladaptive traits must precede moral evaluation and attempts to free oneself—or as we say “prune”—undesirable traits. Professor Reimer presents several interesting cases meant both to extend and test the limits of our proposal. We appreciate this approach and respond to each case in turn.Genes and AlcoholismSuppose Alejandro, an adult raised by adoptive parents, struggles with alcohol addiction. He learns that his biological parents died of alcoholic liver disease and comes to believe that his alcohol problem is caused by a genetic propensity toward alcohol abuse. One can ask: “Does an understanding first approach have the potential to undermine the sense of agency that is necessary for the effective treatment of maladaptive traits?”Answer: It can be explained to Alejandro that genetic proclivities are just that—proclivities—that can be overridden. In fact, behavior can alter our very genes—although not at the sequence level— changes known as “epigenetic.” And the liver disease of the biological parents can serve as a cautionary tale. If even in light of these considerations, Alejandro’s tendency to see genetic propensities as deterministic persists, it is worth asking why. There is no evidence that “genes are destiny,” so the disposition to see them that way must have a psychological explanation. What is the explanation? A self-destructive desire? Fear of freedom? This exploration can itself be empowering. [End Page 211]Adaptive ForgettingSuppose Beata, who has an eating disorder, was molested by her own father when she was a child. Subsequently, her father shot himself and now she has no recollection of the molestation. However, Beata’s eating disorder is largely a result of those experiences. It is quite possible that if Beata were to recall being molested, that would do more harm than good. In this connection, one can ask together with Reimer: “Does an understanding first approach have the potential to undermine an adaptive ‘forgetting’ of root causes of maladaptive traits?”Answer: Here, understanding the history, instead of forgetting it, might allow Beata to gain insight into and empathize with possible motives that may have led to becoming obese. For example, she might have the phantasy that if she had been obese and unattractive, she could have prevented the molestation—hence, become that way now to prevent it from happening again, and more wishfully reverse it. (In unconscious goings-on time is thought to be in the “unexamined present” (Brakel 2009, p. 63; 2015, p. 131; 2022, p. 4; 2023, p. 404.) One benefit of this is that in gaining this type of recognition, Beata might find it easier to change her behavior that she otherwise would not have; it was never her responsibility to prevent her own molestation, and there is no reason whatsoever for her to now make herself unattractive to her deceased father, and very little reason to remain obese in an attempt to deter current day men.Ego-Syntonic Maladaptive TraitsClaire is a concert pianist and alcoholic. Importantly, Claire does not see her own desire for alcohol as destructive but rather, as something constitutive of her own identity. “I wouldn’t be myself without alcohol,” she says. Reimer asks whether our approach would “work for cases where the agent sees a maladaptive trait as constitutive of their identity?”Answer: Although no approach can guarantee success, our claim is that our approach has a better chance than the main alternative known as the pruning view. Since Claire, by stipulation, is not inclined to see her own drinking as a problem, a... (shrink)

Stress is one of the most powerful experiences to influence health and disease. Through epigenetic mechanisms, stress may generate a footprint that propagates to subsequent generations. Programming by prenatal stress or adverse experience in parents, grandparents, or earlier generations may thus be a critical determinant of lifetime health trajectories. Changes in regulation of microRNAs (miRNAs) by stress may enhance the vulnerability to certain pathogenic factors. This review explores the hypothesis that miRNAs represent stress‐responsive elements in epigenetic regulation that are potentially (...) heritable. Recent findings suggest that miRNAs are key players linking adverse early environments or ancestral stress with disease risk, thus they represent useful predictive disease biomarkers. Since miRNA signatures of disease are potentially heritable, big data management platforms will be vital to harness multi‐generational information and capture succinct yet potent biomarkers capable of directing preventative treatments. This feature would offer a unique window of opportunity to advance personalized medicine. (shrink)

The primary aim of this study was to investigate the relation between self-perceived executive functions and the school achievement of young adolescents, while controlling for parental education and sex. We specifically focused on executive aspects of daily life behavior and the higher-order EFs, as measured with self-report, rather than on the more basic EFs which have been the primary focus of prior investigations. In two independent samples of sixth graders, students evaluated their EFs on a self-report questionnaire, the Amsterdam Executive (...) Functioning Inventory. School achievement in the domains of mathematics and reading comprehension were evaluated with nationally used, norm-based achievement tests. Results revealed that the self-perceived EFs of young adolescents were significantly correlated with their school achievement in both study samples. School achievement was also correlated with the level of parental education, but the factor sex did not have such influence. In study 1, self-perceived EFs explained additional variance in school achievement, while controlling for parental education and sex. In study 2, this was only the case for the most robust measure of school achievement, i.e., the end-of-primary-school final achievement test. Furthermore, besides the relation with achievement tests, we also found a relation between self-perceived EFs and teacher ratings behavioral problems in the classroom. Together, our findings imply that young students can properly reflect on the effectiveness and appropriateness of their EFs in a way that is relevant to their academic achievement and classroom behavior. The findings underscore the importance of considering the development of EFs and parental education in the evaluation of academic achievements in early adolescence. (shrink)

From Dr. Littlejohn's guide: "You'd never know Athens was locked in a life-or-death struggle from the tranquil and leisurely philosophical discussion that unfolds through the pages of the Republic...Plato's masterpiece continues to inform our questions and our thinking when it comes to being, truth, beauty, goodness, justice, community, the soul, and more." The Worldview Guides from the Canon Classics Literature Series provide an aesthetic and thematic Christian perspective on the most definitive and daunting works of Western Literature. Each Worldview Guide (...) presents the big picture (both the good and the bad) without neglecting the details. Each Worldview Guide is a friendly literary coach -- and a treasure map, and a compass, and a key -- to help teachers, parents, and students appreciate, critique, and begin to master the classics. The bite-size WGs are divided into these ten sections (with some variation due to genre): Introduction, The World Around, About the Author, What Other Notables Said, Setting, Characters, & Argument, Worldview Analysis, Quotables, 21 Significant Questions & Answers, Further Discussion & Review, and instructions for how to take the Classics Quiz. (shrink)

National education is a conscious and planned effort to help children develop their potential be spiritually strong, religious, intelligent, a strong personality and noble character and noble skills. For this reason, education not only focuses on the aspect of children’s knowledge but also on religion and morals aspects. This education begins in the family through communication patterns that are created between parents and children in the form of interpersonal communication that can increase the religiosity of adolescents. Therefore, this article aims (...) to measure the interpersonal communication within the family. The author uses quantitative methods with technical correlation to determine the relationship between two variables, namely interpersonal communication in the family and youth religiosity, and includes 303 adolescents as a sample. The data were collected using a Likert scale and processed using Excel and SPSS 16 programs in order to obtain the results that the application of good interpersonal communication in families will increase adolescent religiosity. This leads to the conclusion ‘there is a mutually influential relationship between interpersonal communication in the family and adolescent religiosity’.Contribution: This article contributes to Christian families in increasing interpersonal communication as a pattern of youth formation, because it can increase their religiosity. (shrink)

National education is a conscious and planned effort to help children develop their potential be spiritually strong, religious, intelligent, a strong personality and noble character and noble skills. For this reason, education not only focuses on the aspect of children's knowledge but also on religion and morals aspects. This education begins in the family through communication patterns that are created between parents and children in the form of interpersonal communication that can increase the religiosity of adolescents. Therefore, this article aims (...) to measure the interpersonal communication within the family. The author uses quantitative methods with technical correlation to determine the relationship between two variables, namely interpersonal communication in the family and youth religiosity, and includes 303 adolescents as a sample. The data were collected using a Likert scale and processed using Excel and SPSS 16 programs in order to obtain the results that the application of good interpersonal communication in families will increase adolescent religiosity. This leads to the conclusion 'there is a mutually influential relationship between interpersonal communication in the family and adolescent religiosity'.CONTRIBUTION: This article contributes to Christian families in increasing interpersonal communication as a pattern of youth formation, because it can increase their religiosity. (shrink)

_Psychoanalysis and Women_, Volume 32 of _The Annual of Psychoanalysis_, is a stunning reprise on theoretical, developmental, and clinical issues that have engaged analysts from Freud on. It begins with clinical contributions by Joyce McDougall and Lynne Layton, two theorists at the forefront of clinical work with women; Jessica Benjamin, Julia Kristeva, and Ethel Spector Person, from their respective vantage points, all engage the issue of passivity, which Freud tended to equate with femininity. Employing a self-psychological framework, Christine Kieffer returns (...) to the Oedipus complex and sheds new light on the typically Pyrrhic oedipal victory of little girls. Section III broadens the historical context of contemporary theorizing about women by offering the personal reminiscences of Nancy Chodorow, Carol Gilligan, Brenda Solomon, and Malkah Notman. A final section, dedicated to "women who shared psychoanalysis," features historical essays on Ida Bauer, Anna Freud, Dorothy Burlingham, Edith Jacobson, and Therese Benedek, along with Linda Hopkins's revealing interview of Marion Milner. Of special note is Marian Tolpin's examination of three women - Bauer, Helene Deutch, and Anna Freud - who helped shape Freud's notion of the "femail castration complex," and Elisabeth Young-Bruehl's exploration of how two women - Anna Freud and Dorothy Burlingham - developed parent-infant observation. _Psychoanalysis and Women_ is an extraordinary chronicle of the distance traveled since Freud characterized women's sexual life as "the dark continent." The contributors vitalize a half century of theory with the lessons of biography, and they broaden clinical sensibilities by drawing on recent developmental, gender-related, and socio-psychological research. In doing so, they attest to the ongoing reconfiguration of Freud's dark continent and show the psychoanalytic psychology of women to be very much a revolution in progress. (shrink)

That holobionts are units of selection squares poorly with the observation that microbes are often recruited from the environment, not passed down vertically from parent to offspring, as required for collective reproduction. The taxonomic makeup of a holobiont’s microbial community may vary over its lifetime and differ from that of conspecifics. In contrast, biochemical functions of the microbiota and contributions to host biology are more conserved, with taxonomically variable but functionally similar microbes recurring across generations and hosts. To save (...) what is of interest in holobiont thinking, we propose casting metabolic and developmental interaction patterns, rather than the taxa responsible for them, as units of selection. Such units need not directly reproduce or form parent-offspring lineages: their prior existence has created the conditions under which taxa with the genes necessary to carry out their steps have evolved in large numbers. These taxa or genes will reconstruct the original interaction patterns when favorable conditions occur. Interaction patterns will vary in ways that affect the likelihood of and circumstances under which such reconstruction occurs. Thus, they vary in fitness, and evolution by natural selection will occur at this level. It is on the persistence, reconstruction, and spread of such interaction patterns that students of holobiosis should concentrate, we suggest. This model also addresses other multi-species collectively beneficial interactions, such as biofilms or biogeochemical cycles maintaining all life. (shrink)

Although law is established on a strong presumption that persons younger than a certain age are not competent to consent, statutory age limits for asking children’s consent to clinical research differ widely internationally. From a clinical perspective, competence is assumed to involve many factors including the developmental stage, the influence of parents and peers, and life experience. We examined potential determining factors for children’s competence to consent to clinical research and to what extent they explain the variation in competence judgments.

On her seventy-fifth birthday, the author’s mother confessed to an affair more than three decades past. His father’s response was unforgiving. Her need to confess met his limitless rage. She acted out of love; he sought revenge. Their battle consumed everything and everyone around them. In the middle of this struggle, she was diagnosed with cancer. Two years later, she died. Testimony is a son’s memoir of this struggle. Paul Kahn finds here a story of the twentieth century, beginning with (...) poverty in the Depression and immigration from Hitler’s Germany. He follows his father’s experience of the war and his return with PTSD. He traces his parents’ movement through the turbulent 60s. More than a study of twentieth-century culture, Testimony is a philosophical inquiry into the possibility of faith in a secular age. History, philosophy, and theology flow together as Kahn finds in his parents’ lives the resources for a series of essays on the nature of truth, memory, death, and faith. Testimony is most of all a meditation on love in a time in which the very possibility of faith is constantly put to the test. (shrink)

The distinction between moral values and others is not an easy one. There are easy extremes: the value that one places on his neighbor's welfare is moral, and the value of peanut brittle is not. The value of decency in speech and dress is moral or ethical in the etymological sense, resting as it does on social custom; and similarly for observance of the Jewish dietary laws. On the other hand the eschewing of unrefrigerated oysters in the summer, though it (...) is likewise a renunciation of immediate fleshly pleasure, is a case rather of prudence than morality. But presumably the Jewish taboos themselves began prudentially. Again a Christian fundamentalist who observes the proprieties and helps his neighbor only from fear of hellfire is manifesting prudence rather than moral values.1 Similarly for the man with felony in his heart who behaves himself for fear of the law. Similarly for the child who behaves himself in the course of moral training; his behavior counts as moral only after these means get transmuted into ends. On the other hand the value that the child attaches to the parent's approval is a moral value. It had been a mere harbinger of a sensually gratifying caress, if my recent suggestion is right, but has been transmuted into an end in itself. · 1. Bernard Williams, Morality , pp. 75-78, questions the disjointedness of these alternatives. I am construing them disjointedly. W.V. Quine, Edgar Pierce professor emeritus of philosophy at Harvard University, is the author of many influential works, including The Roots of Reference. "A Postscript on Metaphor," his previous contribution to Critical Inquiry, appeared in the Autumn 1978 issue. The present essay is being published in a festschrift, Values and Morals: Essays in Honor of William Frankenna, Charles Stevenson, and Richard Brandt. (shrink)

Background While prenatal surgery historically was performed exclusively for lethal conditions, today intrauterine surgery is also performed to decrease postnatal disabilities for non-lethal conditions. We sought to describe physicians' attitudes about prenatal surgery for lethal and non-lethal conditions and to elucidate characteristics associated with these attitudes. Methods Survey of 1200 paediatric surgeons, neonatologists and maternal–fetal medicine specialists. Results Of 1176 eligible physicians, 670 responded. In the setting of a lethal condition for which prenatal surgery would likely result in the child (...) surviving with a severe disability, most respondents either disagreed or strongly disagreed that they would recommend the surgery. Male physicians were twice as likely to recommend surgery for the lethal condition, as were physicians who believe that abortion is morally wrong. Older physicians were less likely to recommend surgery. For non-lethal conditions, most respondents agreed that they would recommend prenatal surgery, even if the surgery increases the risk of prematurity or fetal death. Compared with MFMs, surgeons were less likely to recommend such surgery, as were physicians not affiliated with a fetal centre, and physicians who were religious. Conclusion Physician’s attitudes about prenatal surgery relate to physicians’ beliefs about disability as well as demographic, cultural and religious characteristics. Given the variety of views, parents are likely to receive different recommendations from their doctors about the preferable treatment choice. (shrink)

Joining the ongoing academic debates around medical students’ alternative career choices, this research examines the role of family in medical school attendees’ entrepreneurial intention. Specifically, this study decomposes the multidimensionality of family embeddedness and highlights the mediated nature of the family–EI relationship. The empirical analysis relied on data from graduation year medical students from diverse geographical locations and from different institution types in China. These data were collected from a total of 687 questionnaires covering the basic information of individual, parents, (...) and family composition, as well as the measuring scale of EI. Examining medical students’ EI and its antecedents provide a dual-missing-link in the extant knowledge, i.e., it adds the medical school piece to the overall picture of university students’ EI, and equally important, it de-trivializes entrepreneurship from the extant theorizations of medical students’ career choices. This study also bears implications for educators, practitioners, and policymakers interested in better understanding EI of medical school attendees and family embeddedness. (shrink)

For many years the evolution of language has been seen as a disreputable topic, mired in fanciful “just so stories” about language origins. However, in the last decade a new synthesis of modern linguistics, cognitive neuroscience and neo-Darwinian evolutionary theory has begun to make important contributions to our understanding of the biology and evolution of language. I review some of this recent progress, focusing on the value of the comparative method, which uses data from animal species to draw inferences about (...) language evolution. Discussing speech first, I show how data concerning a wide variety of species, from monkeys to birds, can increase our understanding of the anatomical and neural mechanisms underlying human spoken language, and how bird and whale song provide insights into the ultimate evolutionary function of language. I discuss the “descended larynx” of humans, a peculiar adaptation for speech that has received much attention in the past, which despite earlier claims is not uniquely human. Then I will turn to the neural mechanisms underlying spoken language, pointing out the difficulties animals apparently experience in perceiving hierarchical structure in sounds, and stressing the importance of vocal imitation in the evolution of a spoken language. Turning to ultimate function, I suggest that communication among kin (especially between parents and offspring) played a crucial but neglected role in driving language evolution. Finally, I briefly discuss phylogeny, discussing hypotheses that offer plausible routes to human language from a non-linguistic chimp-like ancestor. I conclude that comparative data from living animals will be key to developing a richer, more interdisciplinary understanding of our most distinctively human trait: language. (shrink)

While across the animal kingdom offspring are born smaller than their parents, notable exceptions exist. Several dipteran species belonging to the Hippoboscoidea superfamily can produce offspring larger than themselves. In this essay, the blood‐feeding tsetse is focused on. It is suggested that the extreme reproductive strategy of this fly is enabled by feeding solely on highly nutritious blood, and producing larval offspring that are soft and malleable. This immense reproductive expenditure may have evolved to avoid competition with other biting flies. (...) Tsetse also transmit blood‐borne parasites that cause the fatal diseases called African trypanosomiases. It is discussed how tsetse life history and reproductive strategy profoundly influence the type of vector control interventions used to reduce fly populations. In closing, it is argued that the unusual life history of tsetse warrants their preservation in the areas where human and animal health is not threatened. (shrink)

Lactation constitutes a major focus for research in international health because of its dramatic impact on child survival; evolutionary biology has investigated lactation as an important aspect of parenting strategy, with implications for understanding parent-offspring conflict. These perspectives are brought together in an attempt to develop integrated models for an issue of key international health concern: the duration of exclusive breast-feeding and the timing of weaning. This analysis highlights the relevance of evolutionary theory for practical problems in public health, (...) and it suggests the utility of public health outcomes for addressing evolutionary questions. (shrink)

This book, written by four internationally renowned bioethicists and first published in 2000, was the first systematic treatment of the fundamental ethical issues underlying the application of genetic technologies to human beings. Probing the implications of the remarkable advances in genetics, the authors ask how should these affect our understanding of distributive justice, equality of opportunity, the rights and obligations as parents, the meaning of disability, and the role of the concept of human nature in ethical theory and practice. The (...) book offers a historical context to contemporary debate over the use of these technologies by examining the eugenics movement of the late nineteenth and early twentieth centuries. The questions raised in this book will be of interest to any reflective reader concerned about science and society and the rapid development of biotechnology, as well as to professionals in such areas as philosophy, bioethics, medical ethics, health management, law, and political science. (shrink)

This book, written by four internationally renowned bioethicists and first published in 2000, was the first systematic treatment of the fundamental ethical issues underlying the application of genetic technologies to human beings. Probing the implications of the remarkable advances in genetics, the authors ask how should these affect our understanding of distributive justice, equality of opportunity, the rights and obligations as parents, the meaning of disability, and the role of the concept of human nature in ethical theory and practice. The (...) book offers a historical context to contemporary debate over the use of these technologies by examining the eugenics movement of the late nineteenth and early twentieth centuries. The questions raised in this book will be of interest to any reflective reader concerned about science and society and the rapid development of biotechnology, as well as to professionals in such areas as philosophy, bioethics, medical ethics, health management, law, and political science. (shrink)

Le monde se révèle à l'homme, comme matière, temps et esprit. L'on sait à présent que considérés dans l'espace et le temps, la terre est d'une extrême petitesse et l'homme un être éphémère. Une conception du monde qui prendrait l'homme pour centre et partirait de lui ne donnerait donc aucune garantie de probabilité. Pourtant elle est assez générale, accoutumés comme nous sommes à juger d'après les perceptions grossières des sens, qui trop souvent nous induisent en erreur. Selon les physiciens, la (...) formule mathématique réunissant les coördonnées du temps et de l'espace, serait la plus conforme à la représentation du monde matériel. Nous avançons ici l'hypothèse que le monde matériel répond effectivement à cette conception, et qu'il est donc un monde plongé dans un repos éternel, dans lequel nous voyageons, pour ainsi dire, avec notre temps. Grâce à cette hypothèse, la causalité, le miracle, la prévoyance de l'avenir, s'expliquent plausiblement. Manifestement le troisième principe, l'esprit, est à la fois en interaction avec la matière et indépendante d'elle (p.e. la télépathie). Cette action réciproque suppose une parenté partielle entre l'esprit et la matière. C'est pourquoi nous proposons une seconde hypothèse: l'esprit est une "facies" de la matière qui reste en dehors de la rigidité du monde considéré comme espace et temps. On a toujours considéré ces éléments spirituels comme étant des êtres spirituels, mais leur aspect anthropomorphique nous empêche de croire à leur existence réelle. Si nous identifions la partie spirituelle du corps humain avec l'homme spirituel, le problème du libre arbitre s'explique avec clarté. Seul le procès spirituel du libre arbitre est vraiment libre, mais la volonté ne peut réaliser aucun changement dans la substance purement matérielle. La conception d'une àme se logeant dans le corps matériel comme dans une maison, et qui par ses actions détermine sa demeure future ne s'accorde pas avec l'hypothèse du monde matériel-et-temporel-en-repos. Suivant nos conceptions humaines, nous avons imaginé des êtres spirituels animés d'une volonté libre. Mais alors il faut supposer une unité spirituelle supérieure, qui considère et qui décide. Or, cette conception étant anthropomorphique il est admissible qu'elle soit la véritable figuration du monde. La solution de ce problème pourrait être trouvée par une troisième hypothèse" selon laquelle il existerait un monde supérieur, dans lequel le monde-du-temps-et-de-l'espace fusionne avec un temps supérieur, auquel le nom de "temps spirituel" serait approprié. Seul, ce monde supérieur plongé dans un repos éternel peut nous expliquer d'une façon convaincante l'univers. Un monde d'une essence et d'une invariabilité éternelles, dans lequel le temps, capable d'agir pas des voies infiniment variées, introduit des événements innombrables, les processus spirituels étant effectués par le temps spirituel, les événements matériels par ce que nous sommes habitués à appeler "le temps". (shrink)

Rights and Obligations of Parents Historically, philosophers have had relatively little to say about the family. This is somewhat surprising, given the pervasive presence and influence of the family upon both individuals and social life. Most philosophers who have addressed issues related to the parent-child relationship—Kant and Aristotle, for example—have done so in a fairly […].

The ethical guidelines for prenatal diagnosis proposed by the World Health Organisation , as well as by national regulations, only refer to paternity and gender of the fetus as unacceptable, disease-unrelated criteria for prenatal selection, as no other such parameters are at hand so far. This perspective is too narrow because research on complex genetic systems such as cognition and ageing is about to provide clinically applicable tests for genetic constituents of potentially desirable properties such as intelligence or longevity which (...) could be misused as parameters for prenatal diagnosis. Moreover, there is an increasing number of prenatally testable genetic traits, such as heritable deafness, which are generally regarded as pathological but desired by some prospective parents and taken into account as parameters for pro-disability selection. To protect prenatal diagnosis from ethically unacceptable genetic consumerism, guidelines must be clarified as soon as possible and updated towards a worldwide restriction of prenatal genetic testing to immediately disease-determining traits. (shrink)