The article by Dupras and Bunnik. makes a fundamental contribution in the context of the current boom in personalized medicine. We propose an additional crit...

Most human societies have undergone much greater change over the last few decades, or even years, than in the preceding millennia. This is partly due to the emergence of various phenomena in medici...

BackgroundSince 2006, the genetic testing company 23andMe has collected biological samples, self-reported information, and consent documents for biobanking and research from more than 1,000,000 individuals, through a direct-to-consumer online genetic-testing service providing a genetic ancestry report and a genetic health report. However, on November 22, 2013, the Food and Drug Administration halted the sale of genetic health testing, on the grounds that 23andMe was not acting in accordance with federal law, by selling tests of undemonstrated reliability as predictive tests for (...) medical risk factors. Consumers could still obtain the genetic ancestry report, but they no longer had access to the genetic health report in the United States. However, this did not prevent the company from continuing its health research, with previously obtained and future samples, provided that consent had been obtained from the consumers concerned, or with health reports for individuals from other countries. Furthermore, 23andMe was granted FDA authorization on February 19, 2015, first to provide reports about Bloom syndrome carrier status, and, more recently, to provide consumers with “carrier status” information for 35 genes known to cause disease.DiscussionIn this Debate, we highlight the likelihood that the primary objective of the company was probably two-fold: promoting itself within the market for predictive testing for human genetic diseases and ancestry at a low cost to consumers, and establishing a high-value database/biobank for research and personal information).SummaryBy dint of this marketing approach, a two-sided market has been established between the consumer and the research laboratories, involving the establishment of a database/DNA biobank for scientific and financial gain. We describe here the profound ethical issues raised by this setup. (shrink)

Networks for the exchange and/or sharing of genetic data are developing in many countries. We focus here on the situations in the US and France. We highlight some recent and remarkable differences between these two countries concerning the mode of access to, and the storage and use of genetic data, particularly as concerns two-sided markets and dynamic consent or dynamic electronic informed consent. This brief overview suggests that, even though the organization and function of these two-sided markets remain open to (...) criticism, dynamic e-IC should be more widely used, especially in France, if only to determine its real effectiveness. (shrink)

The practice and development of modern medicine requires large amounts of data, particularly in the domain of cancer. The future of personalized medicine lies neither with “genomic medicine” nor with “precision medicine”, but with “data medicine”. The establishment of this DM has required far-reaching changes, to establish four essential elements connecting patients and doctors: biobanks, databases, bioinformatic platforms and genomic platforms. The “transformation” of scientific research areas, such as genetics, bioinformatics and biostatistics, into clinical specialties has generated a new vision (...) of care. Molecular tumor boards are one response to these changes and are now providing better access to next-generation sequencing and new cancer treatments to patients with inoperable or metastatic cancers, and those for whom the usual treatment has failed. However, MTB face a crucial ethical challenge: maintaining and improving the trust of patients, clinicians, researchers and industry in academic medical centers supported by private or public funding rather than providing genetic data directly to private companies. We believe that, in this era of DM, appropriate modern digital communication networks will be required to maintain this trust and to improve the organization and effectiveness of the system. There is, therefore, a need to reconsider the form and content of informed consent documents at all academic medical centers and to introduce dynamic and electronic informed consent. (shrink)

Volume 20, Issue 7, July 2020, Page W1-W1.

Organoids, in general, have become an established theme in bioethics. However, brain organoids are almost unique due to the vital and symbolic nature of the organ they reproduce, albeit partially,...

The General Data Protection Regulation imposes, at European level, a need to seek express or explicit consent for the processing of health data. In the framework of biomedical research, some favor the use of express ‘broad’ consent, whereas other maintain, or wish to maintain the use of presumed or implicit consent, often referred to as ‘non-opposition’ in conditions in which such consent is still authorized. In our view, broad consent and presumed consent are likely to prove to be easy solutions (...) in the short term but much less relevant in the long term, for both hospital and patients, if the bioethical objective remains the improvement of patient quality of life and/or survival, regardless of the disease considered. Dynamic consent could be the best way to achieve this objective because only this type of consent could improve hospital transparency and increase patient confidence by allaying certain fears. (shrink)

La médecine personnalisée devrait être renommée "médecine des données". Les finalités de cette médecine sont, à partir d'une quantité importante de données, de déduire ou d'induire différentes informations valorisables à la fois au niveau du soin, de la recherche et de l'industrie. Pour cela, un réseau d'échange ou de partage d'échantillons biologiques, de données génétiques et d'informations entre patients, cliniciens, chercheurs et industriels est développé, grâce à des voies de communication dématérialisées. Ce réseau permet de centraliser le stockage, et une (...) partie du traitement et de l'analyse, au niveau de centres de soin et de recherche académiques et/ou de "plateformes bifaces". Les enjeux éthiques majeurs de cette médecine résident alors dans les moyens et les modalités d'accès, de stockage et d'usage des données génétiques et requièrent des solutions. L'intérêt de cette thèse de doctorat est donc de proposer à la fois une nouvelle méthode de recherche en bioéthique permettant de mieux étudier de tels phénomènes sociaux complexes et une solution possible aux enjeux éthiques identifiés grâce à cette méthode. Il s'agit, respectivement, de la modélisation théorique systémique inductive qualitative et du consentement éclairé exprès dynamique électronique. (shrink)

In the face of the pandemic, bioethics, once again, proved its scientific utility. In France, in particular, the academic approach should be given priority over the institutional approach, in hospitals, research institutes, universities, and companies, with the professionalization that this would imply.

BackgroundAt the start of 2021, oncologists lacked the necessary scientific knowledge to adapt their clinical practices optimally when faced with cancer patients refusing or reluctant to be vaccinated against COVID-19, despite the marked vulnerability of these patients to severe, and even fatal forms of this new viral infectious disease. Oncologists at Foch Hospital were confronted with this phenomenon, which was observed worldwide, in both the general population and the population of cancer patients.MethodsBetween April and November 2021, the Ethics and Oncology (...) Departments of Foch Hospital decided to investigate this subject, through an empirical and interdisciplinary study in bioethics. Our scientific objective was to try to identify and resolve the principal bio-ethical issues, with a view to improving clinical practices in oncology during future major pandemics of this kind, from a highly specific bio-ethical standpoint. We used a mainly qualitative methodological approach based on questionnaires and interviews.ResultsIn April 2021, 29 cancer patients refused or were reluctant to be vaccinated. Seventeen of these patients said that making vaccination mandatory would have helped them to accept vaccination. In October 2021, only 10 cancer patients continued to maintain their refusal. One of the main reasons for the decrease in refusals was probably the introduction of the “pass sanitaire” in July 2021, which rendered vaccination indispensable for many activities. However, even this was not sufficient to convince these 10 cancer patients.ConclusionWe identified a key bio-ethical issue, which we then tried to resolve: vaccination policy. We characterized a major tension between “the recommendation of anti-COVID-19 vaccination” and “free will”, and the duty to “protect each other”. Mandatory vaccination, at least in France, could resolve this tension, with positive effects on quality of life, or survival, in cancer patients initially refusing or reluctant to be vaccinated, but only if collective and individual scales are clearly distinguished. (shrink)

The practice and development of modern medicine requires large amounts of data, particularly in the domain of cancer. The future of personalized medicine lies neither with “genomic medicine” nor with “precision medicine”, but with “data medicine”. The establishment of this DM has required far-reaching changes, to establish four essential elements connecting patients and doctors: biobanks, databases, bioinformatic platforms and genomic platforms. The “transformation” of scientific research areas, such as genetics, bioinformatics and biostatistics, into clinical specialties has generated a new vision (...) of care. Molecular tumor boards are one response to these changes and are now providing better access to next-generation sequencing and new cancer treatments to patients with inoperable or metastatic cancers, and those for whom the usual treatment has failed. However, MTB face a crucial ethical challenge: maintaining and improving the trust of patients, clinicians, researchers and industry in academic medical centers supported by private or public funding rather than providing genetic data directly to private companies. We believe that, in this era of DM, appropriate modern digital communication networks will be required to maintain this trust and to improve the organization and effectiveness of the system. There is, therefore, a need to reconsider the form and content of informed consent documents at all academic medical centers and to introduce dynamic and electronic informed consent. (shrink)

Henry Morris (1889-1961), the great educational philosopher, and initiator of the integrated community educational centre - embodied in the Cambridgeshire village college system - was county education officer and had his first 'memorandum' on the concept of community education printed by the Cambridge University Press. 1984 is both the 60th anniversary of his first memorandum and the 400th anniversary of the Press and this commemorative book will be published to coincide with a number of events to celebrate that. The book (...) is a collection of his papers, mainly about community education, edited by Professor Harry Re;e, who is closely associated with the Community Education Development Centre in Coventry. (shrink)

Henri Meschonnic was a linguist, poet, translator of the Bible and one of the most original French thinkers of his generation. He strove throughout his career to reform the understanding of language and all that depends on it. His work has had a shaping influence on a generation of scholars and here, for the first time, a selection of these are made available in English for a new generation of linguists and philosophers of language. This Reader, featuring fourteen texts (...) covering the core concepts and topics of Meschonnic's theory, will enrich, enhance and challenge your understanding of language. It explores his key ideas on poetics, the poem, rhythm, discourse and his critique of the sign. Meschonnic's vast oeuvre was continuously preoccupied with the question of a poetics of society; he constantly connected the theory of language to its practice in various fields and interrogated what that means for society. In exploring this fundamental question, this book is central to the study and philosophy of language, with rich repercussions in fields such as translation studies, poetics and literary studies, and in redefining notions such as rhythm, modernity, the poem and the subject. (shrink)

The requirements of education at Lagos. 15 Apr. 1892.--Primary, elementary, secondary, and supplementary education. 22 Jan. 1902.--Christian marriage. 26 May 1909.--Religious instruction in church schools. 28 May 1909.--Education of women. 18 May 1911.--The Rt. Rev. Bishop James Johnson, M.A., D.D. 1918.--The problems of education in Southern Nigeria. 9 Nov. 1920.--Our religion and our social life. 2 Oct. 1923.--Moral character. 5 July 1924.--The truth about my background and my career. 1924.--Religion as the basis of education. 1934.--Overseas scholarships for deserving Nigerian youths. (...) 3 Dec. 1935. (shrink)

I am going to be discussing a mode of moral responsibility that anglophone philosophers have largely neglected. It is a type of responsibility that looks to the future rather than the past. Because this forward-looking moral responsibility is relatively unfamiliar in the lexicon of analytic philosophy, many of my locutions will initially strike many readers as odd. As a matter of everyday speech, however, the notion of forward-looking moral responsibility is perfectly familiar. Today, for instance, I said I would be (...) responsible for watching my nieces while they swam. Neglecting this responsibility would have been a moral fault. When people marry, they undertake responsibilities, of moral import, of fidelity and mutual support. When people have children, they accrue moral responsibilities to feed, rear, and educate them. Not all forward-looking responsibilities are moral. While finishing this essay, I have had to keep an eye on a number of my administrative responsibilities, and, while reading it, you may well be occasionally distracted by some of your own. The notion of a responsibility that we accrue or take on, to look out for some range of concerns over some range of the future, is, then, perfectly familiar. Because this common notion of forward-looking responsibility has not been integrated into recent moral theory, however, my philosophical discussion of it will initially seem strange. (shrink)

In this paper we study local induction w.r.t. Σ1‐formulas over the weak arithmetic. The local induction scheme, which was introduced in, says roughly this: for any virtual class that is progressive, i.e., is closed under zero and successor, and for any non‐empty virtual class that is definable by a Σ1‐formula without parameters, the intersection of and is non‐empty. In other words, we have, for all Σ1‐sentences S, that S implies, whenever is progressive. Since, in the weak context, we have (at (...) least) two definitions of Σ1, we obtain two minimal theories of local induction w.r.t. Σ1‐formulas, which we call Peano Corto and Peano Basso.In the paper we give careful definitions of Peano Corto and Peano Basso. We establish their naturalness both by giving a model theoretic characterization and by providing an equivalent formulation in terms of a sentential reflection scheme.The theories Peano Corto and Peano Basso occupy a salient place among the sequential theories on the boundary between weak and strong theories. They bring together a powerful collection of principles that is locally interpretable in. Moreover, they have an important role as examples of various phenomena in the metamathematics of arithmetical (and, more generally, sequential) theories. We illustrate this by studying their behavior w.r.t. interpretability, model interpretability and local interpretability. In many ways the theories are more like Peano arithmetic or Zermelo Fraenkel set theory, than like finitely axiomatized theories as Elementary Arithmetic, and. On the one hand, Peano Corto and Peano Basso are very weak: they are locally cut‐interpretable in. On the other hand, they behave as if they were strong: they are not contained in any consistent finitely axiomatized arithmetical theory, however strong. Moreover, they extend, the theory of parameter‐free Π1‐induction. (shrink)

Few books have so firmly established their place in American literature as The Education of Henry Adams. When it was first published in 1918, it became an instant bestseller and went on to win the Pulitzer Prize. More than eighty years later, in an age of self-reflection and exhaustive memoirs, The Education still stands as perhaps the greatest American autobiography. The son of a diplomat, the grandson and great-grandson of two American presidents, a man of extraordinary gifts and learning in (...) his own right, Henry Adams recounts his life from his birth in 1838 and upbringing as a Boston Brahmin, through the Civil War, the nation's industrial expansion, and its emergence as a world power. In the process, he gives us a brilliant history of a changing country as well as a thoughtful, humane, often tender exploration of himself. From the original publisher, this edition of The Education of Henry Adams, newly introduced by Donald Hall, celebrates and honors this classic work on what it means to be an American. (shrink)

pt. 1. Chapters 1-10 and 27-28 -- pt. 2. Chapters 11-26.

Quantum theory is essentially a rationally coherent theory of the interaction of mind and matter, and it allows our conscious thoughts to play a causally efficacious and necessary role in brain dynamics. It therefore provides a natural basis, created by scientists, for the science of consciousness. As an illustration it is explained how the interaction of brain and consciousness can speed up brain processing, and thereby enhance the survival prospects of conscious organisms, as compared to similar organisms that lack consciousness. (...) As a second illustration it is explained how, within the quantum framework, the consciously experienced ``I'' directs the actions of a human being. It is concluded that contemporary science already has an adequate framework for incorporating causally efficacious experiential events into the physical universe in a manner that: 1) puts the neural correlates of consciousness into the theory in a well defined way, 2) explains in principle how the effects of consciousness, per se, can enhance the survival prospects of organisms that possess it, 3) allows this survival effect to feed into phylogenetic development, and 4) explains how the consciously experienced ``I'' can direct human behaviour. (shrink)

George Herbert Mead, one of America’s most important and influential philosophers, a founder of pragmatism, social psychology, and symbolic interactionism, was also a keen observer of American culture and early modernism. In the period from the 1870s to 1895, Henry Northrup Castle maintained a correspondence with family members and with Mead—his best friend at Oberlin College and brother-in-law—that reveals many of the intellectual, economic, and cultural forces that shaped American thought in that complex era. Close friends of John Dewey, Jane (...) Addams, and other leading Chicago Progressives, the author of these often intimate letters comments frankly on pivotal events affecting higher education, developments at Oberlin College, Hawaii, progressivism, and the general angst that many young intellectuals were experiencing in early modern America. The letters, drawn from the Mead-Castle collection at the University of Chicago, were collected and edited by Mead after the tragic death of Henry Castle in a shipping accident in the North Sea. Working with his wife Helen Castle, he privately published fifty copies of the letters to record an important relationship and as an intellectual history of two progressive thinkers at the end of the nineteenth century. American historians, such as Robert Crunden and Gary Cook, have noted the importance of the letters to historians of the late nineteenth century. The letters are made available here using the basic Mead text of 1902. Additional insights into the connection between Mead, John Dewey, Henry and Harriet Castle, and Hawaii’s progressive kindergarten system are provided by the foundation’s executive director Alfred L. Castle. Marvin Krislov, president of Oberlin College, has added additional comments on the importance of the letters to understanding the intellectual relationship that flourished at Oberlin College. Published with the support of the Samuel N. and Mary Castle Foundation. (shrink)

Nearly all the extracts presented here are new translations and most have never appeared in English before.

Le biographe tourne autour d'une realite a deux inconnues. Il y a l'homme et il y a l'image de l'homme dans l'homme. Je dois retrouver Auguste Comte tel qu'il s'est vu; il m'est interdit de renoncer a savoir s'il s'est vu tel qu'il fut. La vie de Comte romancee par Comte est un fragment de son histoire: c'est un fait que le biographe rencontre lorsqu'il regarde l'interieur de son personnage; mais il simplifierait trop sa tache s'il n'essayait point de saisir (...) d'autres faits, au dela de la vision qui les deforme. (shrink)

With the help of American friends, he revised the book and published it anew six years later. The present volume is the third version of the biography, completed in 1908 but never published in Salt's lifetime.

Selections from the philosophical writings of More: The antidote against atheism.--The immortality of the soul.--Enchiridion metaphysicum.