The Perfect Baby is the most popular introduction to ethical issues in genetics. This new edition has been updated to discuss and debate advances in high tech reproduction, genetic testing, gene therapy, human cloning, and stem cell research. It includes a new epilogue by cloning pioneer Ian Wilmut and GlennMcGee.
Authors frequently refer to gene-based selection in biological evolution, the reaction of the immune system to antigens, and operant learning as exemplifying selection processes in the same sense of this term. However, as obvious as this claim may seem on the surface, setting out an account of “selection” that is general enough to incorporate all three of these processes without becoming so general as to be vacuous is far from easy. In this target article, we set out such a general (...) account of selection to see how well it accommodates these very different sorts of selection. The three fundamental elements of this account are replication, variation, and environmental interaction. For selection to occur, these three processes must be related in a very specific way. In particular, replication must alternate with environmental interaction so that any changes that occur in replication are passed on differentially because of environmental interaction. One of the main differences among the three sorts of selection that we investigate concerns the role of organisms. In traditional biological evolution, organisms play a central role with respect to environmental interaction. Although environmental interaction can occur at other levels of the organizational hierarchy, organisms are the primary focus of environmental interaction. In the functioning of the immune system, organisms function as containers. The interactions that result in selection of antibodies during a lifetime are between entities (antibodies and antigens) contained within the organism. Resulting changes in the immune system of one organism are not passed on to later organisms. Nor are changes in operant behavior resulting from behavioral selection passed on to later organisms. But operant behavior is not contained in the organism because most of the interactions that lead to differential replication include parts of the world outside the organism. Changes in the organism's nervous system are the effects of those interactions. The role of genes also varies in these three systems. Biological evolution is gene-based (i.e., genes are the primary replicators). Genes play very different roles in operant behavior and the immune system. However, in all three systems, iteration is central. All three selection processes are also incredibly wasteful and inefficient. They can generate complexity and novelty primarily because they are so wasteful and inefficient. Key Words: evolution; immunology; interaction; operant behavior; operant learning; replication; selection; variation. (shrink)
Long-standing theoretical education frameworks and methodologies have failed to provide space for the role mental health can play in mediating educational consequences. To illustrate the need for such space, Ebony McGee and David Stovall highlight the voices of black undergraduates they have served in the capacities of teacher, researcher, and mentor. Building from the theoretical contributions of intellectual giants like Frantz Fanon and W. E. B. Du Bois, the authors attempt to connect oppressive social systems to the psyche of (...) the oppressed in a way that is relevant to black students. McGee and Stovall pose a challenge to the current research trend of attributing the survival of black students at traditionally white institutions primarily to grit, perseverance, and mental toughness, noting that research on the aforementioned qualities often fails to properly acknowledge multiple forms of suffering. Utilizing the lens of Critical Race Theory, the authors also challenge the construct of grit to consider the extent to which the mental health concerns of black students go undetected. Although critical race theorists have unmasked and attacked the racial trauma experienced at all levels of the educational system, the connection of CRT to mental health and wellness research is in its embryonic stages. For these reasons, McGee and Stovall argue that CRT scholars need to incorporate praxis to address mental health and wellness in order to address a fuller spectrum of black students' racialized worlds. Ultimately, they seek interdisciplinary perspectives that can help identify and foster strategies to support black students in the project and process of healing from multiple forms of racialized trauma they experience within and beyond their educational encounters. (shrink)
Locke & Bogin (L&B) propose that humans are unique in possessing stages of childhood and adolescence. Arguments to the contrary include evidence for a similar and adaptive juvenile period in simians of slow growth, intense play and learning, and provisioning with solid food by adults. Likewise, simians as well as humans undergo a compensatory growth spurt during puberty.
Conceived as a solution to clinical dilemmas, and now required by organizations for hospital accreditation, ethics committees have been subject only to small-scale studies. The wide use of ethics committees and the diverse roles they play compel study. In 1999 the University of Pennsylvania Ethics Committee Research Group (ECRG) completed the first national survey of the presence, composition, and activities of U.S. healthcare ethics committees (HECs). Ethics committees are relatively young, on average seven years in operation. Eighty-six percent of ethics (...) committees report that they play a role in ongoing clinical decision making through clinical ethics consultation. All are engaged in developing institutional clinical policy. Although 4.5% of HECs write policy on managed care, 50% of HEC chairs feel inadequately prepared to address managed care. The power and activity of ethics committees parallels the composition of those committees and the relationship of members to their institutions. The role of ethics committees across the nation in making policies about clinical care is greater than was known, and ethics committees will likely continue to play an important role in the debate and resolution of clinical cases and clinical policies. (shrink)
In 1992, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) passed a mandate that all its approved hospitals put in place a means for addressing ethical concerns.Although the particular process the hospital uses to address such concernsmay vary, the hospital or healthcare ethics committee (HEC) is used most often. In a companion study to that reported here, we found that in 1998 over 90% of U.S. hospitals had ethics committees, compared to just 1% in 1983, and that many (...) have some and a few have sweeping clinical powers in hospitals. (shrink)
Clinical bioethics is big business. There are now hundreds of people who bioethics in community and university hospitals, nursing homes, rehabilitation and home care settings, and some who play the role of clinical ethics consultant to transplant teams, managed care companies, and genetic testing firms. Still, there is as much speculation about what clinically active bioethicists actually do as there was ten years ago. Various commentators have pondered the need for training standards, credentials, exams, and malpractice insurance for ethicists engaged (...) in clinical consultation. Much of the discussion seems to accept an implicit presumption that all clinical ethics consultation practices look pretty much alike. But is this accurate? What do clinical ethicists do, how and where do they do it, and what kind of clinical ethics is useful in the hospital and in other settings? (shrink)
For a long time, several natural phenomena have been considered unproblematically selection processes in the same sense of “selection.” In our target article we dealt with three of these phenomena: gene-based selection in biological evolution, the reaction of the immune system to antigens, and operant learning. We characterize selection in terms of three processes (variation, replication, and environmental interaction) resulting in the evolution of lineages via differential replication. Our commentators were largely supportive with respect to variation and environmental interaction but (...) critical with respect to replication, in particular its appeal to information. With some reservations, our commentators think that our general analysis of selection may fit gene-based selection in biological evolution and the reaction of the immune system but not operant learning. If nothing else, this article shows that the notion of selection is not as straightforward as it may seem. (shrink)
Modern scientific and medical advances bring new complexity and urgency to ethical issues in health care and biomedical research. This book applies the American philosophical theory of pragmatism to such bioethics. Critics of pragmatism argue that it lacks a universal moral foundation. Yet it is this very lack of a metaphysical dividing line between facts and values that makes pragmatism such a rigorous and appropriate method for solving problems in bioethics. For pragmatism, ethics is a way of satisfying the complex (...) demands of multiple individuals and groups in a contingent and changing world. Pragmatism also demands careful attention to the ways in which scientific advances change our values and ethics.The essays in this book present different approaches to pragmatism and different ways of applying pragmatism to scientific and medical matters. They use pragmatism to guide thinking about such timely topics as stem cell research, human cloning, genetic testing, human enhancement, and care for the poor and aging. This new edition contains three new chapters, on difficulties with applying pragmatism to law and bioethics, on helping people to die, and on embryonic stem cell research. (shrink)
This essay argues that while we have examined clinical ethics quite extensively in the literature, too little attention has been paid to the complex question of how clinical ethics is learned. Competing approaches to ethics pedagogy have relied on outmoded understandings of the way moral learning takes place in ethics. It is argued that the better approach, framed in the work of Aristotle, is the idea of phronesis, which depends on a long-term mentorship in clinical medicine for either medical students (...) or clinical ethics students. Such an approach is articulated and defended. (shrink)
: Pluripotent human stem cell research may offer new treatments for hundreds of diseases, but opponents of this research argue that such therapy comes attached to a Faustian bargain: cures at the cost of the destruction of many frozen embryos. The National Bioethics Advisory Commission (NBAC), government officials, and many scholars of bioethics, including, in these pages, John Robertson, have not offered an adequate response to ethical objections to stem cell research. Instead of examining the ethical issues involved in sacrificing (...) human embryos for the goal of curing fatal and disabling diseases, they seek to either dismiss the moral concerns of those with objections or to find an "accommodation" with those opposed to stem cell research. An ethical argument can be made that it is justifiable to modify or destroy certain human embryos in the pursuit of cures for dread and lethal diseases. Until this argument is made, the case for stem cell research will rest on political foundations rather than on the ethical foundations that the funding of stem cell research requires. (shrink)
Many analogies exist between the process of evolution by natural selection and of learning by reinforcement and punishment. A full extension of the evolutionary analogy to learning to include analogues of the fitness, genotype, development, environmental influences, and phenotype concepts makes possible a single theory of the learning process able to encompass all of the elementary procedures known to yield learning.
Activity anorexia illustrates selection of behavior at the biological, behavioral, and neural levels. Based on evolutionary history, food depletion increases the reinforcement value of physical activity that, in turn, decreases the reinforcement effectiveness of eating – resulting in activity anorexia. Neural opiates participate in the selection of physical activity during periods of food depletion.
When one examines the emerging debate about genetic patenting, it becomes clear that those who oppose so-called misunderstand genetics or apply inappropriate moral and jurisprudential theory. In this brief essay I examine some arguments against gene patents of the variety, and conclude that patents on methods for detecting the presence of a genetic correlation with disease-related (and other) phenotypes can be appropriate, and that with several precautions the U.S. Patent and Trademark Office should continue granting patent protection to investigators who (...) generate genetic disease diagnostic innovations. (shrink)
Genetic counselors are on the front lines of the genetic revolution, presented with tests of varying predictive values and reliability, unfair testing distribution mechanisms, tests for conditions where no treatment exists, and companies that oversell the usefulness of their tests to physicians and nurses. Many scholars, both genetic testing task forces as well as the newly formed National Bioethics Advisory Commission, have all noted that genetic counseling programs and services are critical for adequate genetic testing. At the same time, in (...) our own work at the University of Pennsylvania we have encountered many requests for new materials for training genetic counselors in ethics and providing ethics resources for genetic counseling. One of us has noted elsewhere that it is crucial that resources from the Human Genome Project, the Centers for Disease Control, and other public agencies be devoted to providing better resources for genetic counselors facing difficult ethical issues. Although the American Board of Genetic Counseling requires that training programs include some formal coursework in ethics, many wonder whether enough is being done to prepare genetic counselors for an ever-tougher job, and in particular there has been much concern expressed about whether is an outmoded ideal that hampers this profession as it attempts to grow and identify the value of its practice. On the basis of many comments to us by genetic counselors and on the basis of our review of the current literature, we hypothesized that accredited genetic counseling training programs are poised at the turn of the century to begin planning a new approach toteaching the philosophy of genetic counseling, one that integrates philosophical, theoretical, and ethical training throughout thecurriculum in genetic counseling. (shrink)
This article examines the difficulties encountered in teaching professionalism to medical students in the current social and political climate where economic considerations take top priority in health care decision making. The conflict between the commitment to advocate at all times the interests of one’s patients over one’s own interests is discussed. With personal, institutional, tech industry, pharmaceutical industry, and third-party payer financial imperatives that stand between patients and the delivery of health care, this article investigates how medical ethics instructors are (...) to teach professionalism in a responsible way that does not avoid dealing with the principle of justice. (shrink)
Although he devotes little explicit analysis to ethics, Whitehead’s understanding of the human moral life immerses both human moral agency and environmental ethics in the natural world, judging good actions in the context of complex and interdependent histories of value present in societies of what he calls actual occasions. In this sense, Whiteheadian environmental ethics draws on the most interesting features of Michel Foucault’s genealogies of values that suffuse institutions. Nevertheless, a Whiteheadian notion of environmental ethics exceeds Foucault’s work in (...) that Whitehead acknowledges the possibility of responsible human values and actions with regard to the environment. (shrink)
Richard Rorty places William James in the same category of thinkers as Hegel. These thinkers, he claims, do not believe that philosophical discussion involves any reference to a reality external to their dialogue. Rorty’s claim initially seems justified, for Jamesdoes after all speak of the malleability of reality and insists that reality is part of experience. However, the fact that reality is part of experience does not necessarily mean that it is created by experience. Indeed, James insists that the reality (...) that limits truth is “found, not manufactured,” and the flexibility of truth cannot be attributed to the lack of an external reality but rather results from the interplay of thought and reality in determining truth. (shrink)
Seeking parallels among disciplines can have both risks and benefits. Finding parallels may be a vacuous exercise in categorization, generating no new insights. And pointing to analogous functions may cause us to treat them as homologous. Hull et al. have provided a basis for the generation of insights in different selectionist areas, without confusing analogy with homology.
The interaction of the organism with the environment requires not only reactive, but also active behavior which helps subject to meet the challenge of the uncertainty of the environment. A positive feedback between active behavior and immune system makes the selection process effective.