Being excerpts from pages 187, 203, 204, 207, 208, 209, 210 and 211 of Uncle Tungsten , extracted by Michael Laing with the consent of the author, Professor Oliver Sacks, and Picador Publishers.

There are strong indications that many consumers are switching towards more socially and environmentally responsible products and services, reflecting a shift in consumer values indicated in several countries. However, little is known about the motives that drive some toward, or deter others from, higher levels of ethical concern and action in their purchasing decisions. Following a qualitative investigation using ZMET and focus group discussions, a questionnaire was developed and administered to a representative sample of consumers; nearly 1,000 usable questionnaires were (...) collected. The degree of awareness, concern and action regarding 16 ethical issues was quantified, using a measure developed from the Stages of Change concept within the Transtheoretical model. Motivations for ethical behaviour, in relation to each individual’s most salient ethical issue, were investigated using initially 22 motive statements within the framework of the Decisional Balance Scale (DBS). The findings suggest that the DBS and Stages model have an explanatory value within the ethical decision-making context, and that the motives identified do reflect the Decisional Balance Constructs. Indeed the study suggests that respondents’ motivational attitudes are a function of their stage of ethical awareness, concern and action. Therefore, the Decisional Balance Scale may well prove useful for designing appropriate interventions and communications to facilitate movement towards more ethical decision-making. These findings yield strategic insight for communicating messages to ethical consumers and for better understanding their purchasing decisions. (shrink)

Understanding the clinical significance of variants associated with hereditary cancer risk requires access to a pooled data resource or network of resources—a “cancer gene variant commons”—incorporating representative, well-characterized genetic data, metadata, and, for some purposes, pathways to case-level data. Several initiatives have invested significant resources into collecting and sharing cancer gene variant data, but further progress hinges on identifying and addressing unresolved policy issues. This commentary provides insights from a modified policy Delphi process involving experts from a range of stakeholder (...) groups involved in the data-sharing ecosystem. In particular, we describe policy issues and options generated by Delphi participants in five domains critical to the development of an effective cancer gene variant commons: incentives, financial sustainability, privacy and security, equity, and data quality. Our intention is to stimulate wider discussion and lay a foundation for further work evaluating policy options more in-depth and mapping them to those who have the power to bring about change. Addressing issues in these five domains will contribute to a cancer gene variant commons that supports better care for at-risk and affected patients, empowers patient communities, and advances research on hereditary cancers. (shrink)

The use of platelet rich plasma as a novel treatment is discussed in the context of a qualitative research study comprising 38 interviews with sports medicine practitioners and other stakeholders working within the English Premier League during the 2013–16 seasons. Analysis of the data produced several overarching themes: conservatism versus experimentalism in medical attitudes; therapy perspectives divergence; conflicting versions of appropriate evidence; subcultures; community beliefs/practices; and negotiation of medical decision-making. The contested evidence base for the efficacy of PRP is presented (...) in the context of a broader professional shift towards evidence based medicine within sports medicine. Many of the participants while accepting this shift are still committed to casuistic practices where clinical judgment is flexible and does not recognize a context-free hierarchy of evidentiary standards to ethically justifiable practice. We also discuss a tendency in the data collected to consider the use of deceptive, placebo-like, practices among the clinician participants that challenge dominant understandings of informed consent in medical ethics. We conclude that the complex relation between evidence and ethics requires greater critical scrutiny for this emerging specialism within the medical community. (shrink)

According to the positive duties objection, it is not possible to derive positive duties from Kant’s Formula of Universal Law (FUL). However, in his recent “Deriving Positive Duties from Kant’s Formula of Universal Law”, Guus Duindam tries to answer this objection. More specifically, Duindam tries to show how both a duty of benevolence and a duty of self-perfection can be derived from the FUL. I critically examine Duindam’s arguments. I maintain that Duindam’s argument for the positive duty of benevolence is (...) ambiguous and that this ambiguity exposes him to a fatal dilemma: on one horn, Duindam faces the same objection that he concedes to be effective against other attempts to answer the positive duties objection; on the other horn, the procedure he recommends cannot be based on the FUL (because it does not evaluate actions on the basis of their corresponding maxims). In addition, I maintain that Duindam’s benevolence argument rests on a procedure that is, in general, intractable and, in this particular case, foredoomed (because it can be shown that there are no positive duties of the kind he tries to derive). From there, I turn to Duindam’s argument for the positive duty of self-perfection. I explain that Duindam’s derivation of the duty of self-perfection, even if successful, does not answer the positive duties objection. This is because Duindam never appeals to the FUL in his derivation of the duty of self-perfection (the derivation is based, rather, on instrumental reasoning from the second-order end to accomplish our first-order ends). I elaborate on this by comparing and contrasting Duindam’s argument with Oliver Sensen’s interpretation of how to apply the FUL in the latter’s recent “Universal Law and Poverty Relief”. (shrink)

Guide to conditional Relations. Part 1. PTS series IV. 3. By U Narada. with 8 charts.

Dialog is a joint action at different levels. At the highest level, the goal of interlocutors is to align their mental representations. This emerges from joint activity at lower levels, both concerned with linguistic decisions (e.g., choice of words) and nonlinguistic processes (e.g., alignment of posture or speech rate). Because of the high‐level goal, the interlocutors are particularly concerned with close coupling at these lower levels. As we illustrate with examples, this means that imitation and entrainment are particularly pronounced during (...) interactive communication. We then argue that the mechanisms underlying such processes involve covert imitation of interlocutors’ communicative behavior, leading to emulation of their expected behavior. In other words, communication provides a very good example of predictive emulation, in a way that leads to successful joint activity. (shrink)

Misattributed paternity or ‘false’ paternity is when a man is wrongly thought, by himself and possibly by others, to be the biological father of a child. Nowadays, because of the progression of genetics and genomics the possibility of finding misattributed paternity during familial genetic testing has increased. In contrast to other medical information, which pertains primarily to individuals, information obtained by genetic testing and/or pedigree analysis necessarily has implications for other biologically related members in the family. Disclosing or not a (...) misattributed paternity has a number of different biological and social consequences for the people involved. Such an issue presents important ethical and deontological challenges. The debate centres on whether or not to inform the family and, particularly, whom in the family, about the possibility that misattributed paternity might be discovered incidentally, and whether or not it is the duty of the healthcare professional to disclose the results and to whom. In this paper, we consider the different perspectives and reported problems, and analyse their cultural, ethical and legal dimensions. We compare the position of HCPs from an Italian and British point of view, particularly their role in genetic counselling. We discuss whether the Oviedo Convention of the Council of Europe can be seen as a basis for enriching the debate. (shrink)

Liturgy and ritual -- Structure -- Curriculum.

Traditional welfare states were based on passive solidarity. Able bodied, healthy minded citizens paid taxes and social premiums, usually according to a progressive taxation logic following the ability to pay principle. Elderly, fragile, weak, unhealthy and disabled citizens were taken care of in institutions, usually in quiet parts of the country. During the nineteen eighties and nineties of the twentieth century, ideas changed. Professionals, patients and policy makers felt that it would be better for the weak and fragile to live (...) in mainstream society, rather than be taken care of in institutions outside society. This might be cheaper too. Hence policy measures were taken to accomplish deinstitutionalization. This article discusses the implications of deinstitutionalization for distributive justice. It is argued that the weakest among the weak and fragile stand to lose from this operation. For able bodied citizens deinstitutionalization entails a move from passive to active solidarity. Rather than just pay taxes they have to actively care for and help the needy themselves. The move from passive to active solidarity tends to take advantage of benevolent citizens and burden the socioeconomically disadvantaged. This may be a reason to reconsider the policy move toward deinstitutionalization. (shrink)

The Geological Society of London was the first learned society to be devoted solely to geology, and its members were responsible for much of the spectacular progress of the science in the nineteenth century. Its distinctive character as a centre of geological discussion and research was established within the first five years from its foundation in 1807. During this period its activities were directed, and its policies largely shaped, by its President, George Bellas Greenough, on whose unpublished papers this account (...) is chiefly based.The Society began as a small scientific dining club in London, but it developed rapidly into a learned society with a nation-wide membership. It became so independent in outlook and so active in research that it was felt to threaten the esteem of the Royal Society; and little more than a year after its foundation it clashed with the Royal Society so violently that its continued existence was for a time uncertain.Its development into a large independent society was the outcome of its ‘Baconian’ view of the importance of collecting geological facts as a surer basis for geological theories. For this purpose it initiated an ambitious scheme for co-operative research, which would unite the efforts of ‘philosophers’ with those of ‘practical men’. Only personal reasons seem to have kept the most prominent of the practical men—William Smith—from co-operating with the Society. (shrink)