The ethics of medical care and biomedical research are rapidly becoming global. This volume gathers some of the world's leading bioethicists to explore many of the new questions raised by the internationalization of medical care and biomedical research. Among the topics covered are the impact of globalization on the norms of medical ethics, the conduct of international research, the ethics of international collaborations, challenges to medical professionalism in the international setting, and the relation of religion to global bioethics.

This paper examines a variety of social scientific studies purporting to demonstrate that transracial adoption is in the best interests of children. Finding flaws in these studies and the ethical and political arguments based upon such scientific findings, we argue for adoption practices and policies that respect the racial and ethnic identities of children of color and their communities of origin.

Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.

The aim of this study was to test red - green dichromats' ability to discriminate between illuminant and surface-reflectance changes in natural scenes. Stimuli were simulations of natural scenes presented on a colour monitor with 10-bit resolution per gun. The natural scenes were obtained with a fast hyperspectral imaging system. Six different scenes (including rocks, foliage, and buildings) were tested. In each trial, two images were presented in sequence, each for 1 s, with no interval. The images differed in the (...) phase of daylight on the scene: first with correlated colour temperature 25 000 K, then 6 700 K. The spectral reflectance of a region in the second image was changed randomly, consistent with a local change in daylight. The observer's task was to decide whether a particular surface in the successive images was the same (pure illuminant change) or different (illuminant change with a surface-reflectance change). The performance of four deuteranopes and five protanopes varied considerably across the scenes tested, with mean colour constancy indices (± 1 SEM) of 0.48 (± 0.13) and 0.19 (± 0.10), respectively (1.0 representing ideal performance). Deuteranopes seemed less disadvantaged than protanopes, performing close to normal with some scenes. (shrink)

To localize wheat ESTs on chromosomes, 882 homoeologous group 6-specific ESTs were identified by physically mapping 7965 singletons from 37 cDNA libraries on 146 chromosome, arm, and sub-arm aneuploid and deletion stocks. The 882 ESTs were physically mapped to 25 regions flanked by 23 deletion breakpoints. Of the 5154 restriction fragments detected by 882 ESTs, 2043 were localized to group 6 chromosomes and 806 were mapped on other chromosome groups. The number of loci mapped was greatest on chromosome 6B and (...) least on 6D. The 264 ESTs that detected orthologous loci on all three homoeologs using one restriction enzyme were used to construct a consensus physical map. The physical distribution of ESTs was uneven on chromosomes with a tendency toward higher densities in the distal halves of chromosome arms. About 43% of the wheat group 6 ESTs identified rice homologs upon comparisons of genome sequences. Fifty-eight percent of these ESTs were present on rice chromosome 2 and the remaining were on other rice chromosomes. Even within the group 6 bins, rice chromosomal blocks identified by 1-6 wheat ESTs were homologous to up to 11 rice chromosomes. These rice-block contigs were used to resolve the order of wheat ESTs within each bin. (shrink)

In the course of an immune response, antibodies undergo affinity maturation in order to increase their efficiency in neutralizing foreign invaders. Affinity maturation occurs by the introduction of multiple point mutations in the variable region gene that encodes the antigen binding site. This somatic hypermutation is restricted to immunoglobulin genes and occurs at very high rates. The precise molecular basis of this process remains obscure. However, recent studies using a variety of in vivo and in vitro systems have revealed important (...) regulatory regions, base motifs that are preferred targets of mutation and evidence that transcription may play an active role in hypermutation. BioEssays 20:227–234, 1998. © 1998 John Wiley & Sons, Inc. (shrink)

In this study Professor Michalson attempts to clarify the complex tangle of issues connected with Kant's doctrines of radical evil and moral regeneration, and to set the problems resulting from these doctrines in an interpretive framework that tries to make sense of the instability of his overall position. In his late work Religion Within the Limits of Reason Alone, Kant charts out these doctrines in a manner that represents a fresh development in his own thinking on moral and relgious matters, (...) apparently at variance with the mainstream Enlightenment outlook which Kant otherwise embodies. His position appears to amount to a retrieval of the supposedly outmoded Christian doctrine of original sin, and this ambivalence is seen to stem from his desire to do justice both to the Protestant Christian, and the Enlightenment rationalist, tradition, which weigh equally heavily upon him. In this study Professor Michalson attempts to clarify the complex tangle of issues connected with Kant's doctrines of radical evil and moral regeneration, and to set the problems resulting from these doctrines in an interpretive framework that tries to make sense of the instability of his overall position. (shrink)

Returning genomic research results to family members raises complex questions. Genomic research on life-limiting conditions such as cancer, and research involving storage and reanalysis of data and specimens long into the future, makes these questions pressing. This author group, funded by an NIH grant, published consensus recommendations presenting a framework. This follow-up paper offers concrete guidance and tools for implementation. The group collected and analyzed relevant documents and guidance, including tools from the Clinical Sequencing Exploratory Research Consortium. The authors then (...) negotiated a consensus toolkit of processes and documents. That toolkit offers sample consent and notification documents plus decision flow-charts to address return of results to family of living and deceased participants, in adult and pediatric research. Core concerns are eliciting participant preferences on sharing results with family and on choice of a representative to make decisions about sharing after participant death. (shrink)

For more than 30 years, beginning with the Reagan administration's refusal to support and provide oversight for embryo research, and continuing to the present in congressionally imposed limits on funding for such research, progress in infertility medicine and the development of stem cell therapies has been seriously delayed by a series of political interventions. In almost all cases, these interventions result from a view of the moral status of human embryo premised largely on religious assumptions. Although some believe that these (...) interventions are valid expressions of religious values in the public sector, it is argued here that they, in fact, contradict Rawls's conception of public reasoning. Both the prohibition of research involving the human embryo as well as bans on federal funding for embryo-related research place the particular religious views of some citizens above the pressing health needs of almost all, and thus violate the ideal of civility implicit in the Rawlsian standard. (shrink)

We describe the educational character and leadership development processes used by the United States Air Force Academy that other educational institutions may find useful. Our processes include an integrated educational curriculum designed to complement and integrate the experiential learning that results in achieving specific organizational outcomes, co-curricular activities in cadet living, and a specific focus on the ethical development of leaders’ respect for human dignity and cultural competency as well as the mechanisms to assess and refine our processes.

The focus of this study was to analyze the content, distribution, and comparative genome relationships of 996 chromosome bin-mapped expressed sequence tags accounting for 2266 restriction fragments on the homoeologous group 3 chromosomes of hexaploid wheat. Of these loci, 634, 884, and 748 were mapped on chromosomes 3A, 3B, and 3D, respectively. The individual chromosome bin maps revealed bins with a high density of mapped ESTs in the distal region and bins of low density in the proximal region of the (...) chromosome arms, with the exception of 3DS and 3DL. These distributions were more localized on the higher-resolution group 3 consensus map with intermediate regions of high-mapped-EST density on both chromosome arms. Gene ontology classification of mapped ESTs was not significantly different for homoeologous group 3 chromosomes compared to the other groups. A combined analysis of the individual bin maps using 537 of the mapped ESTs revealed rearrangements between the group 3 chromosomes. Approximately 232 of the consensus mapped ESTs matched sequences on rice chromosome 1 and revealed large- and small-scale differences in gene order. Of the group 3 mapped EST unigenes ∼21 and 32% matched the Arabidopsis coding regions and proteins, respectively, but no chromosome-level gene order conservation was detected. (shrink)

Advance refusals of life-sustaining treatment involve three potentially conflicting interests: those of the patient; those of the doctor; and those of the law. The state's interest in protecting life can clash with the patient's right to self determination which, in turn, can conflict with the doctor's desire to act in the patient's best interests. Against this background, we present the case of a patient who was treated (arguably) contrary to his advance refusal but in accordance with English law.

A major theme in rap lyrics is that the only way to survive is to use your head, be aware, know what’s going on around you. That simple idea packs a lot of background. The most obvious ideas about knowledge turn out if you look at them close up to be pretty questionable. For example: How do we get knowledge about the world? A natural and ancient answer to this question is that much if not all of our knowledge comes (...) from our senses. So for example the nose gives us knowledge of what things smell like, and if all goes well, also indicates whether the thing we’re smelling is healthy, tasty, or noxious. Likewise, the eyes tell us the color and shape of things, and thereby give us information about whether those things are useful, dangerous, and so on. Like everybody else, rappers know all this. Or do they? Maybe some rappers know that this isn’t really so. I’m not talking about Extra-Sensory Perception, channeling, auras, or about what. (shrink)

It has long been recognized that Soren Kierkegaard's Fear and Trembling is a cryptogram. Encoded within a series of reflections and commentaries on Genesis 22 is a deeper message directed at a reader or readers presumably capable of deciphering the hidden meaning. That this is true is suggested by the book's epigraph: ‘What Tarquinius Superbus said in the garden by means of the poppies, the son understood but the messenger did not.’.

This collection of essays, offered in honor of the distinguished career of prominent political philosophy professor Clifford Orwin, brings together internationally renowned scholars to provide a wide context and discuss various aspects of the virtue of “humanity” through the history of political philosophy.

This collection of essays, offered in honor of the distinguished career of prominent political philosophy professor Clifford Orwin, brings together internationally renowned scholars to provide a wide context and discuss various aspects of the virtue of “humanity” through the history of political philosophy.

When the COVID-19 surge hit New York City hospitals, the Division of Medical Ethics at Weill Cornell Medical College, and our affiliated ethics consultation services, faced waves of ethical issues sweeping forward with intensity and urgency. In this article, we describe our experience over an eight-week period (16 March through 10 May 2020), and describe three types of services: clinical ethics consultation (CEC); service practice communications/interventions (SPCI); and organizational ethics advisement (OEA). We tell this narrative through the prism of time, (...) describing the evolution of ethical issues and trends as the pandemic unfolded. We delineate three phases: anticipation and preparation, crisis management, and reflection and adjustment. The first phase focused predominantly on ways to address impending resource shortages and to plan for remote ethics consultation, and CECs focused on code status discussions with surrogates. The second phase was characterized by the dramatic convergence of a rapid increase in the number of critically ill patients, a growing scarcity of resources, and the reassignment/ redeployment of staff outside their specialty areas. The third phase was characterized by the recognition that while the worst of the crisis was waning, its medium- and long-term consequences continued to pose immense challenges. We note that there were times during the crisis that serving in the role of clinical ethics consultant created a sense of dis-ease as novel as the coronavirus itself. In retrospect we learned that our activities far exceeded the familiar terrain of clinical ethics consultation and extended into other spheres of organizational life in novel ways that were unanticipated before this pandemic. To that end, we defined and categorized a middle level of ethics consultation, which we have termed service practice communication intervention (SPCI). This is an underappreciated dimension of the work that ethics consult services are capable of in times of crisis. We believe that the pandemic has revealed the many enduring ways that ethics consultation services can more robustly contribute to the ethical life of their institutions moving forward. (shrink)

Cancers rely on multiple, heterogeneous processes at different scales, pertaining to many biomedical fields. Therefore, understanding cancer is necessarily an interdisciplinary task that requires placing specialised experimental and clinical research into a broader conceptual, theoretical, and methodological framework. Without such a framework, oncology will collect piecemeal results, with scant dialogue between the different scientific communities studying cancer. We argue that one important way forward in service of a more successful dialogue is through greater integration of applied sciences (experimental and clinical) (...) with conceptual and theoretical approaches, informed by philosophical methods. By way of illustration, we explore six central themes: (i) the role of mutations in cancer; (ii) the clonal evolution of cancer cells; (iii) the relationship between cancer and multicellularity; (iv) the tumour microenvironment; (v) the immune system; and (vi) stem cells. In each case, we examine open questions in the scientific literature through a philosophical methodology and show the benefit of such a synergy for the scientific and medical understanding of cancer. (shrink)

Preparing the Next Generation of Oral Historians is an invaluable resource to educators seeking to bring history alive for students at all levels. Filled with insightful reflections on teaching oral history, it offers practical suggestions for educators seeking to create curricula, engage students, gather community support, and meet educational standards. By the close of the book, readers will be able to successfully incorporate oral history projects in their own classrooms.

The US neutrino community gathered at the Workshop on the Intermediate Neutrino Program at Brookhaven National Laboratory February 4-6, 2015 to explore opportunities in neutrino physics over the next five to ten years. Scientists from particle, astroparticle and nuclear physics participated in the workshop. The workshop examined promising opportunities for neutrino physics in the intermediate term, including possible new small to mid-scale experiments, US contributions to large experiments, upgrades to existing experiments, R&D plans and theory. The workshop was organized into (...) two sets of parallel working group sessions, divided by physics topics and technology. Physics working groups covered topics on Sterile Neutrinos, Neutrino Mixing, Neutrino Interactions, Neutrino Properties and Astrophysical Neutrinos. Technology sessions were organized into Theory, Short-Baseline Accelerator Neutrinos, Reactor Neutrinos, Detector R&D and Source, Cyclotron and Meson Decay at Rest sessions.This report summarizes discussion and conclusions from the workshop. (shrink)

Definitions of art tend to take the phenomenon at face value, with philosophers aspiring to accommodate their theories to the artistic facts no matter how bizarre. The result, as for instance in the work of Dickie, is a definition of art neutral on the questions whether any of it is any good, and why anyone would bother to produce it. Zangwill bucks this trend by insisting that the method of definition-and-counterexample that drives much of the field is out of date, (...) and by contending that any good theory of art should explain why making and appreciating it is worth our while. The result is an account of art that foregrounds aesthetic value while striving to show why art production and appreciation are rational activities.Zangwill sees the tradition he wishes to rebut as guided by the method of ‘extensional adequacy’, that is, ‘ … a theory of art that classifies as art all or most of the things we intuitively call “art”, and that excludes all or most of the things that we intuitively do not call “art” ’. This is jarring, since that tradition aims for intensional adequacy, as shown by the fact that a critic of a given theory is allowed to proffer hypothetical rather than just actual cases in aid of that critique. Zangwill's error does not, however, undermine the gravamen of his challenge, which is this. Insofar as we are after a theory of art rather than a description of the …. (shrink)

This book updates and adds to the classic Social Movements of the Sixties and Seventies, showing how social movement theory has grown and changed.

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

The claim that " Everyone's doing it" is frequently offered as a reason for engaging in behavior that is widespread but less-than-ideal. This is particularly true in business, where competitors' conduct often forces hard choices on managers. When is the claim " Everyone's doing it" a morally valid reason for following others' lead? This discussion proposes and develops five prima facie conditions to identify when the existence of prevalent but otherwise undesirable behavior provides a moral justification for our engaging in (...) such behavior ourselves. The balance of the discussion focuses on testing these conditions by applying them to aseries of representative cases in business ethics. (shrink)

This report describes the rationale, approaches, organization, and resource development leading to a large-scale deletion bin map of the hexaploid wheat genome. Accompanying reports in this issue detail results from chromosome bin-mapping of expressed sequence tags representing genes onto the seven homoeologous chromosome groups and a global analysis of the entire mapped wheat EST data set. Among the resources developed were the first extensive public wheat EST collection. Described are protocols for sequencing, sequence processing, EST nomenclature, and the assembly of (...) ESTs into contigs. These contigs plus singletons were used for selection of distinct sequence motif unigenes. Selected ESTs were rearrayed, validated by 5′ and 3′ sequencing, and amplified for probing a series of wheat aneuploid and deletion stocks. Images and data for all Southern hybridizations were deposited in databases and were used by the coordinators for each of the seven homoeologous chromosome groups to validate the mapping results. Results from this project have established the foundation for future developments in wheat genomics. (shrink)

Since 9/11, citizens of all nations have been searching for a democratic public philosophy that provides practical and inspiring answers to the problems of the twenty-first century. Drawing on the wisdom of past and present pragmatist thinkers, Judith M. Green maps a contemporary form of citizenship that emphasizes participation and cooperation and reclaims the critical role of social movements and nongovernmental organizations. Starting with empowering processes of storytelling, truth and reconciliation, and collaborative vision-questing that allow individuals to give voice and (...) new meaning to their loss, anxiety, and hope, Green frames cooperative inquiries to guide transformative actions. From this "second strand" of the democratic experience, leaders and participating citizens can help to shape a more desirable democratic future. In dialogue with Richard Rorty, Judith Butler, James Baldwin, Martin Luther King Jr., Elie Wiesel, Viktor Frankl, Cornel West, and other contemporary thinkers, Green defines the need for deeper understanding and fulfillment of the potentials of the democratic ideal. Drawing insights from Thomas Jefferson, Walt Whitman, William James, John Dewey, Jane Adams, and other earlier thinkers, Green frames a pragmatist understanding of emerging realities and possibilities, growing wells of shared truths, multifaceted histories, and mutually transformative experiences of citizenship. Employing examples from America's complex history and from recent world events, Green locates four sites for effective citizen activism: government at all levels, nonprofit organizations, issue-focused campaigns and social movements, and daily urban living. Green shows how citizens can revive social hope and deepen the democratic experience by drawing on their own knowledge and developing their capabilities through inclusive civic participation. (shrink)

Until recently, genetics counselors and medical geneticists considered themselves lucky if they could provide parents with predictive information about a small number of severe genetic disorders. Testing and counseling were indicated primarily for conditions of thithis s sort. Out of respect for the autonomy of parental reproductive decision making, the prevailing ethic of genetic counseling stressed nondirectiveness and value neutrality As summarized by Arthur Caplan, the hallmarks of this stance includea willingness to provide testing and counseling to all who voluntarily (...) seek it, the presentation of information concerning findings in a manner that is balanced and comprehensible to patients or clients, the fair and balanced presentation of all options for action if a problem is discovered, a willingness to answer all questions asked by those seeking services, and an obligation to protect privacy and confidentiality at all times regardless of societal needs or benefits. (shrink)

Until recently, genetics counselors and medical geneticists considered themselves lucky if they could provide parents with predictive information about a small number of severe genetic disorders. Testing and counseling were indicated primarily for conditions of thithis s sort. Out of respect for the autonomy of parental reproductive decision making, the prevailing ethic of genetic counseling stressed nondirectiveness and value neutrality As summarized by Arthur Caplan, the hallmarks of this stance includea willingness to provide testing and counseling to all who voluntarily (...) seek it, the presentation of information concerning findings in a manner that is balanced and comprehensible to patients or clients, the fair and balanced presentation of all options for action if a problem is discovered, a willingness to answer all questions asked by those seeking services, and an obligation to protect privacy and confidentiality at all times regardless of societal needs or benefits. (shrink)

Nostalgia, a sentimental longing for one’s past, can serve as a resource for individuals coping with discomforting experiences. The experience of bereavement poses psychological and physical risks....

Deeply understood, democracy is more than a "formal" institutional framework for which America provides the model, acting as a preferable alternative to the modern totalitarian regimes that have distorted social life around the world. At its core, as John Dewey understood, democracy is a realistic ideal, a desired and desirable future possibility that is yet-to-be. In this period of global crises in differing cultures, a shared environment, and an increasingly globalized political economy, this book provides a clear contemporary articulation of (...) deep democracy that can guide an evolutionary deepening of democratic institutions, of habits of the heart, and of the processes of education and social inquiry that support them. (shrink)

This discussion is a critical assessment of the methods employed by some leading writers in the field of bioethics. The author agrees with those in the field who regard its primary or essential method as moral philosophy, but he nevertheless finds a prevalent tendency among bioethical writers merely to apply received moral principles to issues and to avoid penetrating theoretical analysis, even when such analysis is unavoidably required. He explains these deficiencies in terms of the exigencies of interdisciplinary work and (...) the affinity of much early bioethics with policy- or legislatively-oriented "public ethics". The discussion ends with a call for increased theoretical sophistication in this field. Keywords: bioethics, ethics, medical ethics, method CiteULike Connotea Del.icio.us What's this? (shrink)