The focus on translational research in clinical trials has the potential to generate clinically relevant genetic data that could have importance to patients. This raises challenging questions about communicating relevant genetic research results to individual patients. An exploratory pharmacogenetic analysis was conducted in the international ovarian cancer phase III trial, AGO-OVAR 16, which found that patients with clinically important germ-line BRCA1/2 mutations had improved progression-free survival prognosis. Mechanisms to communicate BRCA results were evaluated, because these findings may be beneficial to (...) patients and their families. Communicating individual BRCA results was not anticipated during clinical trial design. Consequently, options were not available for patients to indicate their preference for receiving their individual results when they signed pharmacogenetic informed consent. Differences in local requirements, clinical practice, and opinion regarding the ethical aspects of how to convey genetic results to patients are all potential barriers to returning individual BRCA results to patients. Communicating the aggregate BRCA result from this study provided clinical investigators with a mechanism to disseminate the overall study finding to patients while taking individual circumstances, local guidelines and clinical practice into account. This study illustrates the importance of increasing the clarity and scope of informed consent and the need for patient engagement to ensure clinical trial participants can indicate their preference regarding receipt of potentially important individual pharmacogenetic results. This study was registered in the NCT Clinical Trial Registry under NCT00866697 on March 19, 2009, following approval from participating ethics committees. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Freedom, Truth, and Human Dignity: The Second Vatican Council’s Declaration on Religious Freedom: A New Translation, Redaction History, and Interpretation of “Dignitatis humanae.” by David L. Schindler and Jr. Nicholas J. HealyBarrett H. TurnerFreedom, Truth, and Human Dignity: The Second Vatican Council’s Declaration on Religious Freedom: A New Translation, Redaction History, and Interpretation of “Dignitatis humanae.” By David L. Schindler and Nicholas J. Healy, Jr. Grand Rapids, Mich.: (...) Eerdmans, 2015. Pp. xiv + 477. $45.00 (paper). ISBN: 978-0-8028-7155-8.“I fear that you are going to give the inaccurate impression that this document was exclusively the work of the Americans at the Council, or nearly so,” wrote Ernest Primeau, an American bishop who helped revise Dignitatis humanae (DH) at Vatican II, to a priest-journalist. “The truth is... that many others from other nations played an important role in the writing and passage of the declaration.” Despite Primeau’s warning, popular and scholarly interpretations of DH have often hewed closely to John Courtney Murray’s juridical approach, usually in contrast to the integralism of Cardinal Alfredo [End Page 309] Ottaviani and the Spanish episcopate. Yet “many others” did not fit into those two groups, for a large contingent of bishops favorable to religious liberty nonetheless sought to undergird the juridical reasoning for the right with an ontological foundation.David L. Schindler and Nicholas Healy promote these other voices in Freedom, Truth, and Human Dignity. Indeed, they argue that the other voices—the “French” or “ontological” school comprised of bishops such as Alfred Ancel and Karol Wojtyła—provide the true key to DH’s meaning and significance. The book thus responds from the perspective of Communio theology to Murray-ite political theologies that are critical of John Paul II’s emphasis on truth as the basis for freedom. Accompanying Schindler’s and Healy’s essays are conciliar texts charting the origin and influence of this ontological school: the six conciliar drafts, the oral and written interventions of Wojtyła, and an oral intervention of Ancel. These texts, transcribed from the Acta Synodalia Sacrosancti Concilii Oecumenici Vaticani II (AS), have been translated by Patrick T. Brannon, S.J., and Michael Camacho. Also included is a side-by-side comparison of the third and sixth drafts that displays the changes made to the juridical position in response to the ontological school.Schindler’s 170-page essay, “Freedom, Truth, and Human Dignity: An Interpretation of Dignitatis Humanae on the Right to Religious Freedom,” is the heart of the work. Schindler recapitulates in a fresh way themes from his prior analyses of liberalism and Murray. In section 1, he summarizes how Wojtyła’s interventions influenced the evolution of DH such that Murray’s juridical approach became subordinated to an emphasis on truth as the foundation and telos of freedom. He conveys Wojtyła’s concern that DH not divide reason and revelation, but that reason be presented as capable of knowing that religion is “nature’s crown and summit” (50). Section 2 outlines Murray’s postconciliar objections to DH’s final version, namely, that it assumes that the American juridical approach leads to relativism and that its insistence on truth as religious liberty’s foundation undermines the universality of the right by degrading the liberty of those in error. To the first, Schindler replies (in section 3) that Murray’s juridical approach necessarily entails what Servais Pinckaers, O.P., called the “freedom of indifference,” Murray’s denials of relativism notwithstanding. The juridical approach leads to the conception of civil space as something neutral to truth-claims about God, but finally results in a state-enforced indifferentism that limits the religious liberty of those who hold that all of existence, prior to human freedom, is intrinsically ordered to God. “The human act, considered from the perspective of the juridical order, is first empty; and truth thus becomes, from that same juridical perspective, adventitious, something that, as such, cannot but logically burden the free-intelligent human act by arbitrarily limiting and closing what is considered by government, for legal purposes, to be simply open, or abstracted from all (metaphysical-religious) content... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 529 any agent qualitatively identical with S would do A in a situation qualitatively identical with S's" (257). (14) The " would " in the above statement is the " would " of Molina, and the author acknowledges that his theory resembles that of Molina (262). For a reader who cannot swallow Molina's "futurihles," a good deal of Leftow's argument falls apart. In the end, then, we (...) have here a hook that verges on the monumental hut that will he diversely judged-as is normally the caseaccording to the philosophic stance of the reader. Surely it is a hook that cannot he ignored. JAMES w. FELT, S.J. Santa Clara University Santa Clara, California Wittgenstein on Ethics and Religious Belief. By CYRIL BARRETT. Oxford : Basil Blackwell, 1991. Pp. xiv + 285. $44.95 (cloth). Since his editorship in 1974 of the volume Lectures and Conversa· tions: Aesthetics, Psychology, and Religious Belief, Cyril Barrett's name has been associated with the interpretation of Wittgenstein's views on ethics and religious belief. At last we have in hook form his comprehensive exposition of this important dimension of the philosopher's thought. Barrett ranges from the Notebooks 1914-1916 all the way to remarks in On Certainty that stem from only a few days before Wittgenstein 's death. In addition to placing pertinent remarks of early and late periods in the context of the relevant major works and their chief themes, Barrett also expounds and analyses such shorter, more explicit treatments of ethics and religious belief as the " Lecture on Ethics," the "Remarks on Frazer's Golden Bough," and the remarks collected in Vermischte Bemerkungen (Remarks on Culture and Value). The hook is sympathetic in tone-perhaps too much so. The reader quite often feels-as I will make plain in what follows-that Barrett interprets Wittgenstein in a way that obscures the strangeness of his thought, tending to assimilate it too readily to the mainstream of Western theological reflection. Barrett has a three-fold program: "to show that (a) what Wittgen· stein has to say on ethics and religious belief was for him of the ut· most importance, if not sole importance; (h) his views on these subjects did not radically alter throughout his life, appearances to the contrary notwithstanding; and (c) what Wittgenstein said about ethics was intimately interwoven with what he said about religious belief " (xiv). The elements of this program call for different sorts of evalua· 530 BOOK REVIEWS tion. Clearly Wittgenstein thought ethics and religious belief were im· portant. So the question is whether Barrett's claim, that for Wittgen· stein they are the most important elements of his work or even the only important elements of his work, is an exaggeration. Barrett takes as determinative such remarks as Wittgenstein's statement to Ludwig Ficker that the point of the Tractatus is ethical, and he must explain or discount the fact that the vast hulk of his work has little obvious hearing on ethics or religion. Or if the hulk of that work is ethical and religious, then these terms come to mean, in a Wittgensteinian context, something quite different from their senses in Barrett's somewhat domesticated reading. As for the third element in the program-the interweaving of ethics and religion-this, too, is a question of degree. And the question is whether Barrett's analysis, keeping as it does to relatively standard notions of what constitutes religious belief, really does justice to Wittgenstein's insistence that religion must he a way of life rather than a body of doctrine. But it is Barrett's second thesis which is most interesting, most difficult to understand, and most promising, if it is true, for helping us to understand Wittgenstein's thought on ethics and religion. Barrett writes: " Wittgenstein did not abandon his earlier views on ethics and religious belief with their attendant notions of the mystical, transcendental, inexpressible, viewing sub specie aetemitate.... (T) here is no compelling reason to assume such a radical change of view and... all the features of the earlier views can he fitted into the new conceptions of language-games and forms of life" (xiii). Can it he that what Wittgenstein has to... (shrink)

Can we have objective knowledge of the world? Can we understand what is morally right or wrong? Yes, to some extent. This is the answer given by Adam Smith and Edmund Husserl. Both rejected David Hume’s skeptical account of what we can hope to understand. But they held his empirical method in high regard, inquiring into the way we perceive and emotionally experience the world, into the nature and function of human empathy and sympathy and the role of the imagination (...) in processes of intersubjective understanding. The challenge is to overcome the natural constraints of perceptual and emotional experience and reach an agreement that is informed by the facts in the world and the nature of morality. This collection of philosophical essays addresses an audience of Smith- and Husserl scholars as well as everybody interested in theories of objective knowledge and proper morality which are informed by the way we perceive and think and communicate. (shrink)

This paper attempts to clarify how one might understand philosophy as necessarily involving both third-person and first-person perspectives. It argues, first, that philosophy must incorporate the first-person perspective in order to provide an adequate account of consciousness and the prereflective awareness of the self and, second, in opposition to Dennett’s hetero-phenomenology that this incorporation is possible only within a transcendental perspective. The paper also attempts to meet the challenge of those who claim that the notion of the self—and along with (...) it, the idea of first-person perspective—is dependent upon a second-person perspecive. It argues that the second-person challenge depends upon a sense of “self ” different from that at stake in the first-person perspective operative in prereflective self-awareness. (shrink)

Over the last forty-five years, there have been three monumental stories on the national American crime scene: a run up in crime in the 1960s, a move towards a more punitive American justice system starting in the 1970s, and a strong decline in US crime rates beginning in the 1990s. At the center of understanding these three stories lies Gary Becker's pioneering work on the economics of crime . Becker offered a price theoretical model in which criminals are viewed as (...) rational actors seeking to maximize their benefits in choosing certain criminal actions while minimizing their costs. Becker's model has not only shaped academic debate on the topic of criminal behavior since the 70s, but it has also had a powerful impact on governmental policies regarding crime and justice. Most significantly, Becker's work_—with some of its nuance overlooked_—ended up providing intellectual backing to the increasingly punitive and harsh nature of the American justice system, as reflected in the massive increases in incarceration levels and the revival of the use of the death penalty.While Becker correctly predicted that massive increases in incarceration would have a dampening effect on crime, the supporters of this policy have not been attentive to the need to weigh costs as well as benefits in assessing the major prison build-up. Evidence that equal crime reductions could be achieved through targeted social spending merits consideration, since Becker noted that improving the legal opportunities available to potential criminals could be as potent a deterrent to crime as increasing the cost of criminal choices. Furthermore, I review current research in the death penalty debate and argue that—contrary to the positions defended by Becker and many ardent disciples of price-theory— the empirical evidence does not currently support the conclusion that the death penalty as administered in the United States has served as a deterrent to crime. (shrink)

Discussions of the Tylenol and Exxon Valdez cases found in textbooks, public relations scholarship, and news coverage are assessed to understand the meanings that practitioners, educators, critics, and journalists have attributed to those events. The essay objects to a central claim made by critics who say these cases set standards for ethical behavior in public relations. This claim, according to us, mistakes moral drama for ethical deliberation.

Although conditional stimulus (CS)/unconditional stimulus (US) contingency awareness appears to be necessary for human Pavlovian autonomie conditioning, only a selective review of the literature and the forgetting of certain basic, brute facts can allow the cognitive conclusion that awareness causes, or even is important for, conditioning. That conclusion is theoretically barren for explaining the phenomenon and is also of little potential practical use.

The popular mind is deep and means a thousand times more than it knows.It is fitting that the Royal Institute of Philosophy series on American philosophy include a session on the thought of Josiah Royce, for his most formidable philosophical work, The World and the Individual, was a result of his Gifford lectures in the not too distant city of Aberdeen in 1899 and 1900. The invitation to offer the Gifford lectures was somewhat happenstance, for it was extended originally to (...) William James, who pleaded, as he often did in his convenient neurasthenic way, to postpone for a year on behalf of his unsettled nerves. James repaired himself to the Swiss home of Theodore Flournoy, with its treasure of books in religion and psychology, so as to write his Gifford lectures, now famous as The Varieties of Religious Experience. In so doing, however, James was able to solicit an invitation for Royce to occupy the year of his postponement. Royce accepted with alacrity, although this generosity of James displeased his wife Alice, who ranted, ‘Royce!! He will not refuse, but over he will go with his Infinite under his arm, and he will not even do honour to William's recommendation.’ Alice was partially correct in that Royce, indeed, did carry the Infinite across the ocean to the home of his intellectual forebears, although on that occasion as on many others, he acknowledged the support of his personal and philosophical mentor, colleague and friend, William James. (shrink)

These remarks are offered as a celebration of Peter Hare as a philosopher. Stressed here is the astute character of Hare's philosophical commentary.