There is a global shortage of organs for transplantation and despite many governments making significant changes to their organ donation systems, there are not enough kidneys available to meet the demand. This has led scientists and clinicians to explore alternative means of meeting this organ shortfall. One of the alternatives to human organ transplantation is xenotransplantation, which is the transplantation of organs, tissues, or cells between different species. The resurgence of interest in xenotransplantation and recent scientific breakthroughs suggest that genetically-engineered (...) pigs may soon present a realistic alternative as sources of kidneys for clinical transplantation. It is therefore important for nurses and allied health professionals to understand what is involved in xenotransplantation and its future implications for their clinical practices. First, we explore the insufficiency of different organ donation systems to meet the kidney shortage. Second, we provide a background and a summary of the progress made so far in xenotransplantation research. Third, we discuss some of the scientific, technological, ethical, and economic issues associated with xenotransplantation. Finally, we summarise the literature on the attitudes of healthcare professionals toward xenotransplantation. (shrink)

Formal clinical trials of pig-to-human organ transplant—known as xenotransplantation—may begin this decade, with the first trials likely to consist of either adult renal transplants or pediatric cardiac transplant patients. Xenotransplantation as a systematic scientific study only reaches back to the latter half of the 20th century, with episodic xenotransplantation events occurring prior to that. As the science of xenotransplantation has progressed in the 20th and 21st centuries, the public's knowledge of the potential therapy has also increased. With this, there have (...) been shifting ethical stances toward xenotransplantation in key areas, such as religious and public viewpoints towards xenotransplantation, animal rights, and public health concerns. This review provides a historical–ethical account of xenotransplantation and details if or how viewpoints have shifted over time. (shrink)

Florence Ashley has argued that requiring patients with gender dysphoria to undergo an assessment and referral from a mental health professional before undergoing hormone replacement therapy is unethical and may represent an unconscious hostility towards transgender people. We respond, first, by showing that Ashley has conflated the self-reporting of symptoms with self-diagnosis, and that this is not consistent with the standard model of informed consent to medical treatment. Second, we note that the model of informed consent involved in cosmetic surgery (...) resembles the model Ashley defends, and that psychological assessment and referral is recognised as an important aspect of such a model. Third, we suggest that the increased prevalence of psychiatric morbidity in the transgender population arguably supports the requirement of assessment and referral from a mental health professional prior to undergoing HRT. (shrink)

This paper applies models of the onset of adolescent sexual intercourse using national data from Denmark and the USA. The model gave excellent fits to data on Danish Whites and a good fit to American Whites, but the model-fits for American Blacks and Hispanics were not as good. The weakness of the latter model fits may reflect either real processes that the model does not capture or problems in the reliability of adolescent sexuality data.

Florence Ashley has responded to our response to ‘Gatekeeping hormone replacement therapy for transgender patients is dehumanising.’ Ashley criticises some of our objections to their view that patients seeking hormone replacement therapy (HRT) for gender dysphoria should not have to undergo a prior psychological assessment. Here we clarify our objections, most importantly that concerning the parity between cosmetic surgery and the sort of intervention Ashley has in mind. Firstly, we show Ashley’s criticism of our comparison is insubstantial. We then examine (...) their comments regarding the analogy between abortion and HRT, and the language of informed consent. We also scrutinize the data upon which Ashley relies to defend the claim that informed consent without assessment always yields positive outcomes, finding this conclusion to be overstated. Finally, even if Ashley’s arguments were vindicated, the claim that the gatekeeping of HRT is motivated by hostility towards transgender people remains unsupported. (shrink)

In a recent article in this journal, Abram Brummett argues that new and future assisted reproductive technologies will provide challenging ethical questions relating to lesbian, gay, bisexual and transgender (LGBT) persons. Brummett notes that it is likely that some clinicians may wish to conscientiously object to offering assisted reproductive technologies to LGBT couples on moral or religious grounds, and argues that such appeals to conscience should be constrained. We argue that Brummett's case is unsuccessful because he: does not adequately interact (...) with his opponents’ views; equivocates on the meaning of ‘natural’; fails to show that the practice he opposes is eugenic in any non‐trivial sense; and fails to justify and explicate the relevance of the naturalism he proposes. We do not argue that conscience protections should exist for those objecting to providing LGBT people with artificial reproductive technologies, but only show that Brummett's arguments are insufficient to prove that they should not. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

The Roman Senate in 144 B.C. instructed the urban praetor, Q. Marcius Rex, to repair the conduits of Rome's two existing aqueducts, the Appia and the Anio , and to put an end to illegal use of their water by private citizens. Urban growth now demanded a more copious water supply, and so the Senate further I instructed Marcius to secure additional water for the city. Money was appropriated for this work, and Marcius' praetorship was prorogued for 143. At this (...) point the decemviri objected to a plan for bringing water to the Capitol. The issue was debated in the Senate in 143, and again in 140; but on both occasions Marcius' gratia prevailed, and water reached the Capitol in a new aqueduct which Marcius himself had built. A statue of Marcius was erected in later times on the Capitol, behind the temple of Jupiter, to commemorate this grand achievement.1 An everlasting glory was in fact to be his in the name of the aqueduct whose waters earned poets' praises. (shrink)

This volume contains the contributions of philosophers and psychologists to one of the Rice University semicentennial symposia and includes the papers of Koch, MacLeod, Skinner, Rodgers, Malcolm and Scriven. Discussion from the audience and among the participants is recorded, and the general result of both is a blurring of distinctions between behaviorism and phenomenology. The peculiar logical character of first person utterances is duly considered and provides the backdrop for much of the rehash of the private-public problem in philosophy and (...) psychology.—C. V. (shrink)

Henry Charlton Bastian's support for spontaneous generation is shown to have developed from his commitment to the new evolutionary science of Darwin, Spencer, Huxley and Tyndall. Tracing Bastian's early career development shows that he was one of the most talented rising young stars among the Darwinians in the 1860s. His argument for a logically necessary link between evolution and spontaneous generation was widely believed among those sympathetic to Darwin's ideas. Spontaneous generation implied materialism to many, however, and it had (...) associations in Britain with radical politics and amateur science. Huxley and the X Club were trying to create a public posture of Darwinism that kept it at arm's length from those negative associations. Thus, the conflict that developed when Huxley and the X Club opposed Bastian was at least as much about factional in-fighting among the Darwinians as it was about the experiments under dispute. Huxley's strategy to defeat Bastian and define his position as "non-Darwinian" contributed significantly to the shaping of Huxley's famous address "Biogenesis and Abiogenesis." Rhetorically separating Darwinism from Bastian was thus responsible for Huxley's first clear public statement that a naturalistic origin of life was compatible with Darwin's ideas, but only in the earth's distant past. The final separation of the discourse on the meaning of Brownian movement and "active molecules" from any possible link with spontaneous generation also grew out of Huxley's strategy to defeat Bastian. Clashes between Bastian and the X Club are described at the BAAS, the Royal Society, and in the pages of "Nature" and other journals. (shrink)

Jecker et al. (2024) offer seven principles with which to guide conference organizers and assess how ethically a conference is organized. While focused on bioethics, these principles are relevant t...

Parsa-Parsi et al bring attention to the World Medical Association (WMA) and transparency to its International Code of Medical Ethics (ICoME) revisions.1 We value their report and the revised ICoME but explain here that the ICoME cannot reflect consensus among all WMA members, or the wider medical profession, given structural and epistemic injustices that restrain low-income and middle-income country (LMIC) physicians from participating in activities such as WMA revisions. Such injustices overlook experiences and contributions of those from LMICs and marginalised (...) groups, hindering their access to and influence within medicine.2 They also undermine access to information about, and from, the WMA. Recruiting new members from, and better engaging members in, LMICs would strengthen the WMA and its influence across the medical profession, and better elevate environmental sustainability as a biomedical and bioethical concern. This would be beneficial because there is controversy among physicians, bioethicists and other stakeholders about the relevance of environmental sustainability to medicine.3 4 That its addition to the ICoME was ‘uncontentious’ hints at structural and epistemic injustices in the revision process and homogeneity of those most involved in the revisions. Based on our observations as medical educators, it appears that few medical students and physicians at our institution, and few across the Caribbean and …. (shrink)

God and the City, based on the Aquinas Lecture delivered at the University of Dallas in 2022, aims to think about politics ontologically. In other words, it seeks to reflect on, not some political theory or other, nor on the legitimacy of political action or the distinctiveness of particular regimes, but on the nature of political order as such, and how this order implicates the fundamental questions of existence, those concerning man, being, and God. Aristotle, and Aquinas after him, identified (...) metaphysics and politics as "architectonic" sciences, since each concerns in some respect the whole of reality, of which the particular sciences study a part. Chapter one of this book argues that, just as metaphysics, in studying being as a whole, cannot but address the question of God in some respect, so too does politics, the ordering of human life as a whole, necessarily implicate the existence of God. In this regard, the modern liberal project has deluded itself in attempting to render religion a private, rather than a genuinely political, matter. We cannot organize human existence without making some claim, whether implicitly or explicitly, about the nature of God and God's relation to the world. The second chapter approaches this theme from the anthropological dimension. As Plato affirmed, the "city is the soul writ large": if man is religious by nature, he cannot be properly understood, and the human good cannot be properly secured and fostered, if the "God question" is "bracketed out" of the properly political order. Moreover, if we fail to recognize the essentially political dimension of relation to God, we will be unable properly to grasp the presence of God in the (ecclesial and sacramental) Body of Christ: God cannot be real in the Church as Church unless he is also real in the city as city (and vice versa). In his De regno, Aquinas famously affirms that "the king is to be in the kingdom what the soul is in the body and what God is in the world." Chapter three offers a careful study of the body-soul relationship in order to illuminate, on the one hand, the nature of political authority, and, on the other, the precise way that God is present in human community. (shrink)

On 6 September 1966, the prime minister of South Africa, Dr HF Verwoerd was killed by Mr Tsafendas, a Portuguese national of Greek descent, in parliament by stabbing him in the chest. Mr Tsafendas was a messenger in parliament. At the enquiry trial of Mr Tsafendas, he was found unfit to stand trial on the ground that he suffered from schizophrenia. The psychiatric evidence during the enquiry trial was reviewed and discussed under the following headings: Diagnosis of schizophrenia; Consideration of (...) cultural factors in forensic psychiatric settings; Delusional infestation v. extreme overvalued beliefs; Simulation of psychosis; Ethical considerations in criminal capacity and trial competency assessments. Lessons from the Mr Tsafendas enquiry trial for forensic psychiatrists where a defendant previously diagnosed with schizophrenia commits a prominent political murder, are summarised. It is emphasised that the personhood of an accused referred for forensic observation should be respected and protected, instead of focusing exclusively on a specific diagnosis. (shrink)

Decency remains one of the most prevalent yet least understood terms in today's political discourse. In evoking respect, kindness, courage, integrity, reason, and tolerance, it has long expressed an unquestioned duty and belief in promoting and protecting the dignity of all persons. Today this unquestioned belief is in crisis. Tribalism and identity politics have both hindered and threatened its moral stability and efficacy. Still, many continue to undertheorize its political character by isolating it from the effects of identity politics. Decency (...) and Difference argues that decency is a primary source of the political tension that has long shaped the struggles for power, identity, and justice in the global arena. It distinguishes among basic, conservative, and liberal strands of decency to critically examine the many conflicting and competing applications of decency in global politics. Together these different stands reflect a long and uneven evolution from the British and American Empire to a global network of justice. By engaging the contradictions of the progressive and retrogressive qualities of decency and the role played by emotion and affect in driving these contradictions, the book exposes the propriety gaps of decency and the disparate ways that it is practiced in global politics. The book thus addresses the global challenge of reconciling different political proprieties and configuring a diverse political ethic of decency. (shrink)

Sport categorization is often justified by benefits such as increased fairness or inclusion. Taking inspiration from John Rawls, Sigmund Loland’s fair equality of opportunity principle in sport (FEOPs) is a tool for determining whether the existence of an inequality ethically justifies the institution of a new category in any given sport. It is an elegant ethical normative framework, but since FEOPs does not account explicitly for athlete safety (i.e. athlete physical and mental wellbeing), we are left in an ethically dubious (...) situation where the risk of harm associated with a categorization regime might in fact prove to be greater than the risk of harm present within the sport before its introduction. To address this critical gap, I propose the ‘scales of ignorance’ ethical normative framework to weigh the relative risk of harm within a sport, crucially inserting athlete safety into the discourse surrounding ethical justification for categorization in sport. The current paper is the first explicit formulation of assessment and ethical justification of risk of harm in the familiar logic of FEOPs. The scales of ignorance framework can also be used independently of Loland’s approach. Two new concepts are also proposed: ‘insidious risk of harm’ and ‘pernicious risk of harm’. (shrink)

Glowacki defines peace as harmonious relationships between groups maintained without the threat of violence, where groups can be anything from families to nation states. However, defining such contentious concepts like “peace” and “groups” is a difficult task, and we discuss the implications of Glowacki's definitions for understanding intergroup relationships and their evolutionary history.

Recently, approach-avoidance tendencies and visual perception biases have been increasingly studied using bistable point-light walkers (PLWs). Prior studies have found a facing-the-viewer bias when one is primed with general threat stimuli (e.g. angry faces), explained by the “error management theory”, as failing to detect a threat as approaching is riskier than the opposite. Importantly, no study has explored how disease threat – linked to the behavioural immune system – might affect this bias. This study aimed to explore whether disease-signalling cues (...) can alter how we perceive the motion direction of ambiguous PLWs. Throughout 3 experiments, participants indicated the motion direction of a bistable PLW previously primed with a control or disease-signalling stimuli – that is, face with a surgical mask (Experiment 1), sickness sound (Experiment 2), or face with a disease cue (Experiment 3). Results showed that sickness cues do not significantly modulate the perception of approach-avoidance behaviours. However, a pattern emerged in Experiments 2 and 3, suggesting that sickness stimuli led to more facing away percepts. Unlike other types of threat, this implies that disease-related threat stimuli might trigger a distinct perceptual bias, indicating a preference to avoid a possible infection source. Nonetheless, this finding warrants future investigations. (shrink)