The scope of noninvasive prenatal testing (NIPT) could expand in the future to include detailed analysis of the fetal genome. This will allow for the testing for virtually any trait with a genetic contribution, including “non-medical” traits. Here we discuss the potential use of NIPT for these traits. We outline a scenario which highlights possible inconsistencies with ethical decision-making. We then discuss the case against permitting these uses. The objections include practical problems; increasing inequities; increasing the burden of choice; negative (...) impacts on the child, family, and society; and issues with implementation. We then outline the case for permitting the use of NIPT for these traits. These include arguments for reproductive liberty and autonomy; questioning the labeling of traits as “non-medical”; and the principle of procreative beneficence. This summary of the case for and against can serve as a basis for the development of a consistent and coherent ethical framework. (shrink)

The scope of noninvasive prenatal testing (NIPT) could expand in the future to include detailed analysis of the fetal genome. This will allow for the testing for virtually any trait with a genetic contribution, including “non-medical” traits. Here we discuss the potential use of NIPT for these traits. We outline a scenario which highlights possible inconsistencies with ethical decision-making. We then discuss the case against permitting these uses. The objections include practical problems; increasing inequities; increasing the burden of choice; negative (...) impacts on the child, family, and society; and issues with implementation. We then outline the case for permitting the use of NIPT for these traits. These include arguments for reproductive liberty and autonomy; questioning the labeling of traits as “non-medical”; and the principle of procreative beneficence. This summary of the case for and against can serve as a basis for the development of a consistent and coherent ethical framework. (shrink)

Non-invasive prenatal testing is at the forefront of prenatal screening. Current uses for NIPT include fetal sex determination and screening for chromosomal disorders such as trisomy 21. However, NIPT may be expanded to many different future applications. There are a potential host of ethical concerns around the expanding use of NIPT, as examined by the recent Nuffield Council report on the topic. It is important to examine what NIPT might be used for before these possibilities become consumer reality. There is (...) limited research exploring views of women on possible future uses of NIPT, particularly those of women who have undergone NIPT. In this study, we examined the views of women who undertook NIPT previously on the acceptability of and interest levels in using NIPT for a number of current and possible future applications. These included several medical conditions encompassing psychiatric, neurodevelopmental and adult-onset conditions as well as non-medical traits such as intelligence. One thousand women were invited to participate and 235 eligible surveys were received. Women generally reported an interest in using NIPT for medical conditions that severely impacted quality of life and with an onset earlier in life and stressed the importance of the accuracy of the test. Concerns were raised about the use of NIPT for non-medical traits. Respondents indicated that termination of pregnancy was not their only reason for testing, particularly in the case of sex. These results can further inform the ethical debate around the increasing integration of NIPT into healthcare systems. (shrink)

OBJECTIVE: To describe the issues faced, and how they were addressed, by the University of Toronto Critical Care Medicine Program/Joint Centre for Bioethics Task Force on Appropriate Use of Life-Sustaining Treatment. The clinical problem addressed by the Task Force was dealing with requests by patients or substitute decision makers for life-sustaining treatment that their healthcare providers believe is inappropriate. DESIGN: Case study. SETTING: The University of Toronto Joint Centre for Bioethics/Critical Care Medicine Program Task Force on Appropriate Use of Life-Sustaining (...) Treatment. PARTICIPANTS: The 24-member Task Force included physician and nursing leaders from five critical care units, bioethicists, a legal scholar, a health administration expert, a social worker, and a hospital public relations professional. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Our specific lessons learned include a) a policy focus on process; b) use of a negotiation and mediation model, rather than a hospital ethics committee model, for this process; and c) the policy development process is itself a negotiation, so we recommend equal involvement of interested groups including patients, families, and the public. CONCLUSIONS: This article describes the key issues faced by the Task Force while developing its policy. It will provide a useful starting point for other groups developing policy on appropriate use of life-sustaining treatment. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Christian’s Appreciation of the BuddhaBonnie ThurstonEs gibt, so glaube ich, in der Tat jenes Ding nicht, das wir >Lernen< nennen.—Hermann Hesse, SiddharthaI must warn you at the beginning that what follows is an embarrassingly personal reflection—a confession even—and not a scholarly essay. I cannot be dispassionate about the Buddha, to whom in a roundabout way I owe both my status as an ordained Christian minister and perhaps the (...) greatest joy of my life, the study and practice of the Christian scripture. How? In February 1970 I was given a copy of Hesse’s novel Siddhartha, a fictionalized account of the Buddha’s life. Already an active Christian, it was this gift, received my senior year in high school, that introduced me to Buddhism and to the reality of spiritual journey and the possibility of enlightenment. While I know the Buddhist meaning of that term, it serves for Christians as well, because our God could not leave us in darkness but made light the first creature (Gen. 1:1–5) and came among us as light (John 1:1–5). 1 When in the fall of 1970 my brother traveled to Japan, the memento I requested was a small statue of the Buddha. It is beside me as I write. In 1983 when we moved to Germany, the second book I bought in German was Siddhartha; the first was the New Testament.Over the years I have had the opportunity to continue to study the life of the Buddha and the spread and development of his teachings. By the Buddha, of course, I mean Sakyamuni (“sage of the Sakyas”) Buddha (“enlightened one”), son of Suddhodana and Maya, whom they called Siddhartha (“wish fulfilled” or “goal realized”) and whom we also know as Gotama or Gautama (literally “superior cow”), whose dates are given variously as 560–480 B.C. or 460–380 B.C. 2 I am appreciative of what I have learned—applying the root meaning of that word, appretiare: “to see” or “to appraise.” The Buddha has helped me to see and to appraise or evaluate many aspects of life. The appreciation that follows, then, is both a grateful recognition as of benefits received and a sensitive awareness or an estimate. I have tried both to view the Buddha clearly and to appraise what he has meant in my life. In essence, Buddhism and the Buddha have been for me the means of establishing a personal, internal religious clarity about what I do believe, passionately. In a deeply Buddhist sense, the Buddha has been my raft. But he has not been my Savior.There is, as Tillich noted in Christianity and the Encounter with World Religions, a point “in the depth of every living religion... at which the religion itself loses its importance, and that to which it points breaks through its particularity.” 3 It has [End Page 121] helped me to understand religions as fingers and the Divine Reality as the moon to which they point. And I am convinced that Tillich’s breakthrough point is usually reached by means of deep penetration into one religious tradition. Jacques-Albert Cuttat was exactly correct: “The more deeply a person probes into his own religious faith, the more he is able to understand the religious faith of others from the inside; conversely, the more a person explores religious connections other than his own, the more he deepens his understanding of his own religion.” 4 This has been my experience. Dialogue with the Buddha has given me great clarity about the Christ. And the study and practice of Christianity has afforded me my glimpses of the moon.What, then, do I appreciate about the Buddha? What have I learned from him? To help focus my answer, I read or reread a number of different accounts of his life 5 and noted six specific aspects of his life and teaching (his quest itself; his powers of analysis; his pragmatism; his moral vision; his compassion; and the outcome of living, his ‘way’) that have attracted and taught me.First, I am appreciative of the Buddha’s quest itself. To put it simply, according to the accounts... (shrink)

Background: There is limited research on brain lesions in children with cerebral visual impairment of heterogeneous etiologies and according to associated subtyping and vision dysfunctions. This study was part of a larger project establishing data-driven subtypes of childhood CVI according to visual dysfunctions. Currently there is no consensus in relation to assessment, diagnosis and classification of CVI and more information about brain lesions may be of potential diagnostic value.Aim: This study aimed to investigate overall patterns of brain lesions and associations (...) with level of visual dysfunction and to compare the patterns between the classification subgroups in children with CVI.Methods: School-aged children with CVI received ophthalmological and neuro-psychological/developmental assessments to establish CVI-related subtyping. Other pediatric information was collected from medical records. MRI scans were coded according to a semi-quantitative template including brain regions and summed for total scores. Non-parametric analyses were conducted.Results: 28 children had clinical brain MRI scans available [44% of total sample, Group A n = 16, Group B n = 12]. Total brain scores ranged between 0 and 18 and were widespread across regions. 71 per cent had post-geniculate visual pathway damage. The median total brain and hemisphere scores of Group B were higher than subgroup A but differences did not reach statistical significance. No statistically significant associations were found between brain scores and vision variables.Conclusion: This study found a spread of lesions across all regions on the brain scans in children with congenital CVI. The majority had damage in the postgeniculate visual pathways and visual cortex region suggesting this is an area of interest and potentially informative for diagnosis. However the subtyping classification did not show differences in number or region of lesions though the trend was higher toward Group B. This study confirms the complex diffuse and variable nature of brain lesions in children with congenital CVI, many of whom have other neurological impairments. (shrink)

This volume contains thirty-one papers grouped under the following headings: "The Nature of Philosophy," "Man and Knowledge," "God and Religious Knowledge," "Ethics," "Law," and "Texts." A few of the papers discuss the Augustinian tradition. Munoz-Alonso, Blondel, and Sciacca are mentioned as men who have renewed for our time the thought of Augustine. The papers on St. Bonaventure include an analysis by John O. Riedl of some of Bonaventure’s texts on Dionysius the Areopagite, a comparison and contrast by Bernardino Bonansea of (...) the position of Bonaventure and Thomas on the question of creation from eternity, a study by Ewert Cousins of Bonaventure’s dynamic self-diffusive God, and a discussion of his symbolic theology by Leonard Bowman. Scholars will be interested in the report of Ignatius Brady on the Quaracchi edition of Bonaventure’s writings, as well as in the report of James P. Reilly, Jr. on the Leonine Commission’s work on the texts of Thomas Aquinas. (shrink)

This work contributes to recent transdisciplinary efforts to view the Haitian slave revolt (1791–1804) as the historical inspiration for Hegel’s master-slave dialectic. Reconstructions offered by contemporary postcolonial scholars argue that the Haitian revolt was chronicled in Minerva as Hegel raced to finish his Phenomenology. Benhabib recently recognized the Hegel-Haiti thesis as entailing the sort of inclusive dialogical learning process necessary to validate subaltern experiences. The thesis has also drawn its share of sceptical scrutiny as Badiou claims that it risks forcing (...) an unnecessary moral dissymmetry, neglects objectionable features of enslavement and imposes a mismatch between apolitical subject and revolutionary. In reply, we appeal to the pioneering work of Tavares to show that the asymmetrical construction of classification schemes for persons of mixed-racial statuses accords with decades of documented literary exchanges between Hegel and Gregoire. We then turn to the work of James on the role of mixed-race merchants in the testimonial accounts of late 18th century French historians to show that European literate publics were well aware of the extremely coercive forms of commodified labour found in Saint-Domingue. We then invoke the archival work of Du Bois on French, British and American parliamentary proceedings that show the provisional colonial identities ascribed to Caribbean subjects did not hinder their self-conscious exercise of political agency. Viewing Hegel in terms of the historiographic records of the racial ontologies of early modern transatlantic literary exchanges helps explain how he adapted these tropes concerning mixed-race subjects in a manner that better explains many of the anomalous features of the dialectic. However, conferring the Haitian revolution its proper world-historical warrant as inspiration for his infamous master-slave dialectic need not lead us to overlook Hegel’s complicity with many of the epistemic and ontological flaws of colonial tropes held in early modern transatlantic print. (shrink)

Popular culture can play a significant role in shaping the acceptance of evolving technologies, with nanotechnology likely to be a case in point. The most popular fiction work to date in this arena has been Michael Crichton's techno-thriller Prey, which fuses together nanotechnology science with science fiction. Within the context of Prey, this article examines the role that scientists and popular culture play in educating society, and one another, about emerging technologies. In di ferentiating fact from fiction, the article reflects (...) on how such distinctions may be important in proactive public dialogue projects. The article concludes that popular culture will be a key factor in informing citizen beliefs about the coming nano-age. Accordingly, governments, in conjunction with the scientific community, will need to be proactive in distinguishing science fact from science fiction for the benefit of their citizens. (shrink)

Proposed educational outcomes for the health humanities in medical education range from empathy to visual thinking skills to social accountability. This lack of widely agreed-upon high-level curricular goals limits humanities educators’ ability to design purposeful curricula toward clear, common ends and threatens justifications for scarce curricular time. We propose a novel approach to the hoped-for outcomes of health humanities training in medical schools, which has the potential to encompass traditional health humanities knowledge, skills, and behaviors while also being concrete and (...) measurable: humanistic practice. Humanistic practice, adapted from the concept of ethical sensitivity, is an intentional process of applying humanities knowledge and skills to a clinical scenario by 1) noticing that the scenario requires humanities knowledge or skills, 2) informing one’s clinical and interpersonal strategy and behavior with humanities knowledge or skills, 3) reflecting on the effectiveness of the strategy and behavior, and 4) reorienting to develop new approaches for future practice. The construct of humanistic practice may help address some of the foundational problems in health humanities outcomes research since it transcends the traditional diverse content domains in the health humanities, can link patient and provider experiences, and may bridge the divide among the additive, curative, and intrinsic epistemic positions of humanities to medical education. (shrink)

Immediately after the publication of Darwin's book on the origin of species, Engels, having familiarized himself with it, wrote to Marx on December 12, 1859: "All in all, Darwin, whom I am reading right now, is superb. Teleology had hitherto not yet been destroyed in one of its aspects, and now this has been done. Moreover, hitherto there has never been so sweeping an attempt to prove historical development in nature, especially with such success." Soon Marx enlarged upon the evaluation (...) of Darwinism. In his letter of December 19, 1860, he commented that this theory "provides a foundation in natural history for our views." It is therefore no accident that Engels, in developing the principles of dialectical materialism and problems of the dialectics of nature, interested himself so deeply and comprehensively in the theory of evolution. (shrink)

Concentrating on the thought of Canada's major scientists, philosophers, and clerics - men such as William Dawson and Daniel Wilson, John Watson and W.D. LeSeur, G.M. Grant and Salem Bland - A Disciplined Intelligence begins by reconstructing the central strands of intellectual and moral orthodoxy prevalent in Anglo-Canadian colleges on the eve of the Darwinian revolution. These include Scottish common sense philosophy and the natural theology of William Paley. The destructive impact of evolutionary ideas on that orthodoxy and the major (...) exponents of the new forms of social evolution - Spencerian and Hegelian alike - are examined in detail. By the twentieth century the centre of Anglo-Canadian thought had been transformed by what had become a new, evolutionary orthodoxy. The legacy of this triumphant intellectual movement, British idealism, was immense. It helped to destroy Protestant denominationalism, provide the philosophical core of the social gospel movement, and constitute a major force behind the creation of the United Church of Canada. Throughout the nineteenth century and continuing into the twentieth, however, the moral imperative in Anglo-Canadian thought remained a constant presence. (shrink)

This book is a study of the second-edition version of the 'Transcendental Deduction', which is one of the most important and obscure sections of Kant's Critique of Pure Reason. By way of a close analysis of the B-Deduction, Adam Dickerson makes the distinctive claim that the Deduction is crucially concerned with the problem of making intelligible the unity possessed by complex representations - a problem that is the representationalist parallel of the semantic problem of the unity of the proposition. Along (...) the way he discusses most of the key themes in Kant's theory of knowledge, including the nature of thought and representation, the notion of objectivity, and the way in which the mind structures our experience of the world. (shrink)

There are many theories surrounding infant imitation; however, there is no research to our knowledge evaluating the reliability of listener perception of vocal imitation in prelinguistic infants. This paper evaluates intra- and inter-rater judgments on the degree of “imitativeness” in utterances of infants below 12 months of age. 18 listeners were presented audio segments selected from naturalistic recordings to represent in each case a parent vocal model followed by an infant utterance ranging from low to high degrees of imitativeness. The (...) naturalistic data suggested vocal imitation occurred rarely across the first year, but strong intra- and inter-rater correlations were found for judgments of imitativeness. Our results suggest salience of the infant’s vocal imitation despite its rare occurrence as well as active perception by listeners of the imitative signal. We discuss infant vocal imitation as a potential signal of well-being and as an indicator of language learning and vocal communication skills as perceived by caregivers. (shrink)

Following lesions to the primary visual cortex, some patients maintain visual capacities within areas of the visual field in which they are defined as clinically blind by static field perimetry. Blindsight describes the ability to discriminate visual stimuli in the absence of awareness of the stimuli in such patients. Some patients exhibit blindsight, but others are aware of the stimuli with which they are presented, a response mode that has been referred to as residual vision. The two response modes are (...) of great interest as they are capable of providing us with information concerning the conscious and unconscious processing of visual signals in humans. However, determining consciousness in these patients is a difficult task and relies on the patient assessing and then reporting on his awareness. In this paper, an experiment is described which is capable of demonstrating conscious visual processing of motion under conditions where the observer is not required to assess his level of awareness. In applying this technique to a human hemianope, GY, it is demonstrated that GY has veridical and conscious perception of visual motion presented to his blind hemifield. Although previously reported, this result can be derived without any reference to GY's commentary on his blind field perception. (shrink)