Some monothematic types of delusions may arise because subjects have unusual experiences. The role of this experiential component in the pathogenesis of delusion is still not understood. Focussing on delusions of alien control, we outline a model for reality testing competence on unusual experiences. We propose that nascent delusions arise when there are local failures of reality testing performance, and that monothematic delusions arise as normal responses to these. In the course of this we address questions concerning the (...) tenacity with which delusions are maintained, their often bizarre content, the patients' inability to dismiss them, and their often circumscribed character. (shrink)
The multiple detections of gravitational waves by LIGO (the Laser Interferometer Gravitational-Wave Observatory), operated by Caltech and MIT, have been acclaimed as confirming Einstein's prediction, a century ago, that gravitational waves propagating as ripples in spacetime would be detected. Yunes and Pretorius (2009) investigate whether LIGO's template-based searches encode fundamental assumptions, especially the assumption that the background theory of general relativity is an accurate description of the phenomena detected in the search. They construct the parametrized post-Einsteinian (ppE) framework in response, (...) which broadens those assumptions and allows for wider testing under more flexible assumptions. Their methods are consistent with work on confirmation and testing found in Carnap (1936), Hempel (1969), and Stein (1992, 1994), with the following principles in common: that confirmation is distinct from testing, and that, counterintuitively, revising a theory's formal basis can make it more broadly empirically testable. These views encourage a method according to which theories can be made abstract, to define families of general structures for the purpose of testing. With the development of the ppE framework and related approaches, multi-messenger astronomy is a catalyst for deep reasoning about the limits and potential of the theoretical framework of general relativity. (shrink)
This paper takes part in the methodological debate concerning the nature and the justification of hypotheses about computational systems in software engineering by providing an epistemological analysis of Software Testing, the practice of observing the programs’ executions to examine whether they fulfil software requirements. Property specifications articulating such requirements are shown to involve falsifiable hypotheses about software systems that are evaluated by means of tests which are likely to falsify those hypotheses. Software Reliability metrics, used to measure the growth (...) of probability that given failures will occur at specified times as new executions are observed, is shown to involve a Bayesian confirmation of falsifiable hypotheses on programs. Coverage criteria, used to select those input values with which the system under test is to be launched, are understood as theory-laden principles guiding software tests, here compared to scientific experiments. Redundant computations, fault seeding models and formal methods used in software engineering to evaluate test results are taken to be instantiations of some epistemological strategies used in scientific experiments to distinguish between valid and non-valid experimental outcomes. The final part of the paper explores the problem, advanced in the context of the philosophy of technology, of defining the epistemological status of software engineering by conceiving it as a scientifically attested technology. (shrink)
Programs of drug testing welfare recipients are increasingly common in US states and have been considered elsewhere. Though often intensely debated, such programs are complicated to evaluate because their aims are ambiguous – aims like saving money may be in tension with aims like referring people to treatment. We assess such programs using a proportionality approach, which requires that for ethical acceptability a practice must be: reasonably likely to meet its aims, sufficiently important in purpose as to outweigh harms (...) incurred, and lower in costs than feasible alternatives. In the light of empirical findings, we argue that the programs fail the three requirements. Pursuing recreational drug users is not important in the light of costs incurred, while dependent users who may require referral are usually identifiable without testing and typically need a broader approach than one focussing on drugs. Drug testing of welfare recipients is therefore not ethically acceptable policy. (shrink)
I examine, from Mayo's severe testing perspective, the case found in the Intergovernmental Panel on Climate Change fourth report for the claim that increases in anthropogenic greenhouse gas concentrations caused most of the post-1950 global warming. My examination begins to provide an alternative to standard, probabilistic assessments of OUR FAULT. It also brings out some of the limitations of variety of evidence considerations in assessing this and other hypotheses about the causes of climate change, and illuminates the epistemology of (...) optimal fingerprinting studies. Finally, it shows that some features of Mayo's perspective should be kept in whatever approach is preferred for assessing hypotheses about the causes of climate change. (shrink)
Broad genome-wide testing is increasingly finding its way to the public through the online direct-to-consumer marketing of so-called personal genome tests. Personal genome tests estimate genetic susceptibilities to multiple diseases and other phenotypic traits simultaneously. Providers commonly make use of Terms of Service agreements rather than informed consent procedures. However, to protect consumers from the potential physical, psychological and social harms associated with personal genome testing and to promote autonomous decision-making with regard to the testing offer, we (...) argue that current practices of information provision are insufficient and that there is a place – and a need – for informed consent in personal genome testing, also when it is offered commercially. The increasing quantity, complexity and diversity of most testing offers, however, pose challenges for information provision and informed consent. Both specific and generic models for informed consent fail to meet its moral aims when applied to personal genome testing. Consumers should be enabled to know the limitations, risks and implications of personal genome testing and should be given control over the genetic information they do or do not wish to obtain. We present the outline of a new model for informed consent which can meet both the norm of providing sufficient information and the norm of providing understandable information. The model can be used for personal genome testing, but will also be applicable to other, future forms of broad genetic testing or screening in commercial and clinical settings. (shrink)
The paper examines the claim that significance testing violates the Principle of Total Evidence. I argue that p-values violate PTE for two-sided tests but satisfy PTE for one-sided tests invoking a sufficient test statistic independent of the preferred theory of evidence. While the focus of the paper is to evaluate a particular claim about the relationship of significance testing and PTE, I clarify the reading of this methodological principle along the way.
This paper aims to critique the phenomenon of advanced patient autonomy and choice in healthcare within the specific context of self-testing devices. A growing number of self-testing medical devices are currently available for home use. The premise underpinning many of these devices is that they assist individuals to be more autonomous in the assessment and management of their health. Increased patient autonomy is assumed to be a good thing. We take issue with this assumption and argue that self- (...) class='Hi'>testing provides a specific example how increased patient autonomy and choice within healthcare might not best serve the patient population. We propose that current interpretations of autonomy in healthcare are based on negative accounts of liberty to the detriment of a more relational understanding. We also propose that Kantian philosophy is often applied to the healthcare arena in an inappropriate manner. We draw on the philosophical literature and examples from the self-testing process to support these claims. We conclude by offering an alternative account of autonomy based on the interrelated concepts of relationality, care and responsibility. (shrink)
Non-invasive prenatal testing is an emerging form of prenatal genetic testing that provides information about the genetic constitution of a foetus without the risk of pregnancy loss as a direct result of the test procedure. As with other prenatal tests, information from NIPT can help to make a decision about termination of pregnancy, plan contingencies for birth or prepare parents to raise a child with a genetic condition. NIPT can also be used by women and couples to test (...) purely ‘for information’. Here, no particular action is envisaged following the test; it is motivated entirely by an interest in the result. The fact that NIPT can be performed without posing a risk to the pregnancy could give rise to an increase in such requests. In this paper, we examine the ethical aspects of using NIPT ‘purely for information’, including the competing interests of the prospective parents and the future child, and the acceptability of testing for ‘frivolous’ reasons. Drawing on several clinical scenarios, we claim that arguments about testing children for genetic conditions are relevant to this debate. In addition, we raise ethical concerns over the potential for objectification of the child. We conclude that, in most cases, using NIPT to test for adult-onset conditions, carrier status or non-serious traits presenting in childhood would be unacceptable. (shrink)
As knowledge increases about the human genome,prenatal genetic testing will become cheaper,safer and more comprehensive. It is likelythat there will be a great deal of support formaking prenatal testing for a wide range ofgenetic disorders a routine part of antenatalcare. Such routine testing is necessarilycoercive in nature and does not involve thesame standard of consent as is required inother health care settings. This paper askswhether this level of coercion is ethicallyjustifiable in this case, or whether pregnantwomen have (...) a right to remain in ignorance ofthe genetic make-up of the fetus they arecarrying. While information gained by genetictesting may be useful for pregnant women whenmaking decisions about their pregnancy, it doesnot prevent harm to future children. It isargued that as this kind of testing providesinformation in the interests of the pregnantwomen and not in the interests of any futurechild, the same standards of consent that arenormally required for genetic testing should berequired in this instance. (shrink)
Automated Software Testing (AST) using Model Checking is in this article epistemologically analysed in order to argue in favour of a model-based reasoning paradigm in computer science. Preliminarily, it is shown how both deductive and inductive reasoning are insufficient to determine whether a given piece of software is correct with respect to specified behavioural properties. Models algorithmically checked in Model Checking to select executions to be observed in Software Testing are acknowledged as analogical models which establish isomorphic relations (...) with the target system’s data set. Analogical models developed in AST are presented as abductive models providing hypothetical explanations to observed executions. The model assumption—algorithmic check—software testing process is understood as the abduction—deduction—induction process defining the selective abduction and turned to isolate a set of model-based hypotheses concerning the target system behaviours. A manipulative abduction process is finally recognized in the practice of adapting, abstracting and refining models that do not provide successful predictions. (shrink)
ABSTRACTMother‐to‐child transmission of HIV represents a particularly dramatic aspect of the HIV epidemic with an estimated 600,000 newborns infected yearly, 90% of them living in sub‐Saharan Africa. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. MTCT is responsible for 90% of these infections. Two‐thirds of the MTCT are believed to occur during pregnancy and delivery, and about one‐third through breastfeeding. As the number of women of child bearing age infected with (...) HIV rises, so does the number of infected children. It is apparent that voluntary testing in Botswana has made some valuable inroads in decreasing perinatal HIV transmission, but the statistics showing the increased rate of HIV infection among women 15–24 years of age are not very promising. After reviewing all the pertinent scientific data it is clear that mandatory HIV testing of all pregnant women in conjunction with the implementation of a full package of interventions would save thousands of lives – mothers, newborns and others who could be infected as a result of these women not being aware of their HIV status. If the protection and preservation of human life is a priority in Botswana, then it is time to allow for mandatory HIV testing of all pregnant women, before it is too late for those who are the most vulnerable. To do less would be medically inappropriate and ethically irresponsible. (shrink)
Despite recent advances in ways to prevent transmission of HIV from a mother to her child during pregnancy, infants continue to be born and become infected with HIV, particularly in southern Africa where HIV prevalence is the highest in the world. In this region, emphasis has shifted from voluntary HIV counselling and testing to routine testing of women during pregnancy. There have also been proposals for mandatory testing. Could mandatory testing ever be an option, even in (...) high-prevalence settings? Many previous examinations of mandatory testing have dealt with it in the context of low HIV prevalence and a well-resourced health care system. In this discussion, different assumptions are made. Within this context, where mandatory testing may be a strategy of last resort, the objections to it are reviewed. Special attention is paid in the discussion to the entrenched vulnerability of women in much of southern Africa and how this contributes to both HIV prevalence and ongoing challenges for preventing HIV transmission during pregnancy. While mandatory testing is ethically plausible, particularly when coupled with guaranteed access to treatment and care, the discussion argues that the moment to employ this strategy has not yet come. Many barriers remain for pregnant women in terms of access to testing, treatment and care, most acutely in the southern African setting, despite the presence of national and international human rights instruments aimed at empowering women and removing such barriers. While this situation persists, mandatory HIV testing during pregnancy cannot be justified. (shrink)
Genetic testing in the workplace is a technology both full of promise and fraught with ethical peril. Though not yet common, it is likely to become increasingly so. We survey the key arguments in favour of such testing, along with the most significant ethical worries. We further propose a set of pragmatic criteria, which, if met, would make it permissible for employers to offer (but not to require) workplace genetic testing.
As genetic testing for the presence of potentially health-affecting mutations becomes available for more genetic conditions, many people will soon be faced with the decision of whether or not to have a genetic test. Making an informed decision requires an understanding and evaluation of the arguments for and against having the test. As a case in point, this paper considers argumentation involving the decision of whether to have a BRCA gene test, one of the first commercially available genetic tests. (...) First, argumentation in a five-page patient brochure from a for-profit company that provides BRCA gene testing, is analyzed. Next, for comparison, argumentation on BRCA testing in materials for healthcare consumers written by a not-for-profit health plan and a government organization, is analyzed. In view of the challenges identified by considering these examples, this article discusses how argumentation-oriented computer systems may be able to help the healthcare consumer to make informed decisions about genetic testing. (shrink)
The debate over the genetic testing of minors has developed into a major bioethical topic. Although several controversial questions remain unanswered, a degree of consensus has been reached regarding the policies on genetic testing of minors. Recently, several commentators have suggested that these policies are overly restrictive, too narrow in focus, and even in conflict with the limited empirical evidence that exists on this issue. We respond to these arguments in this paper, by first offering a clarification of (...) three key concepts—autonomy of the minor, future autonomy, and parental authority—which must be disentangled. We then respond to the arguments by noting the uncertainty of the value of predictive genetic information, and by assessing the psychosocial risks still involved in genetic testing of minors, which are also largely unknown. We conclude that the current consensus position is justified at this stage, in light of the predictions of harm resulting from genetic testing of minors that have not been adequately proved to be unwarranted. (shrink)
Prenatal care and the practice of prenatal genetic testing are about to be changed fundamentally. Due to several ground-breaking technological developments prenatal screening and diagnosis (PND) will soon be offered earlier in gestation, with less procedure-related risks and for a profoundly enlarged variety of targets. In this paper it is argued that the existing normative framework for prenatal screening and diagnosis cannot answer adequately to these new developments. In concentrating on issues of informed consent and the reproductive autonomy of (...) the pregnant women the ethical debate misses problems related to the clinical pathway as a whole and to implicit normative attributions to clinical actions or the function of health care professionals. If, however, ethical debate would focus on the clinical context and on the ends of PND to a larger extent, it would be able to provide a more comprehensive analysis of the ethical challenges especially of the new technologies in order to be more adequately prepared for their implementation. (shrink)
Our programmatic article on Homo heuristicus (Gigerenzer & Brighton, 2009) included a methodological section specifying three minimum criteria for testing heuristics: competitive tests, individual-level tests, and tests of adaptive selection of heuristics. Using Richter and Späth’s (2006) study on the recognition heuristic, we illustrated how violations of these criteria can lead to unsupported conclusions. In their comment, Hilbig and Richter conduct a reanalysis, but again without competitive testing. They neither test nor specify the compensatory model of inference they (...) argue for. Instead, they test whether participants use the recognition heuristic in an unrealistic 100% (or 96%) of cases, report that only some people exhibit this level of consistency, and conclude that most people would follow a compensatory strategy. We know of no model of judgment that predicts 96% correctly. The curious methodological practice of adopting an unrealistic measure of success to argue against a competing model, and to interpret such a finding as a triumph for a preferred but unspecified model, can only hinder progress. Marewski, Gaissmaier, Schooler, Goldstein, and Gigerenzer (2010), in contrast, specified five compensatory models, compared them with the recognition heuristic, and found that the recognition heuristic predicted inferences most accurately. (shrink)
Analyzing three key cases that arose in 1993, I argue that the practice of sending in "testers" -- persons posing as job applicants -- to ferret out workplace discrimination is easier to defend from an ethical standpoint in an agency's investigation stems from an actual complaint. By contrast, defendants may rightfully challenge the legitimacy of the procedures used for "test" subjects when an investigation is based solely on the general goals of an antidiscrimination agency.
A common way of testing the inner sense theory of introspection exploits the possibility of damage to inner sense. Such damage is expected to lead to first-personal deficits/impairments of one kind or another. I raise various problems for this way of testing the theory. The main difficulty, I argue, stems from the existence of the method subserving confabulation.
Recent global advances in available technology to prevent mother-to-child HIV transmission necessitate a rethinking of contemporary and previous ethical debates on HIV testing as a means to preventing vertical transmission. In this paper, we will provide an ethical analysis of HIV-testing strategies of pregnant women. First, we argue that provider-initiated opt-out HIV testing seems to be the most effective HIV test strategy. The flip-side of an opt-out strategy is that it may end up as involuntary testing (...) in a clinical setting. We analyse this ethical puzzle from a novel perspective, taking into account the moral importance of certain hypothetical preferences of the child, as well as the moral importance of certain actual preferences of the mother. Finally, we balance the conflicting concerns and try to arrive at an ethically sound solution to this dilemma. Our aim is to introduce a novel perspective from which to analyse testing strategies, and to explore the implications and possible benefits of our proposal. The conclusion from our analysis is that policies that recommend provider-initiated opt-out HIV testing of pregnant mothers, with a risk of becoming involuntary testing in a clinical setting, are acceptable. The rationale behind this is that the increased availability of very effective and inexpensive life-saving drugs makes the ethical problems raised by the possible intrusiveness of HIV testing less important than the child's hypothetical preferences to be born healthy. Health care providers, therefore, have a duty to offer both opt-out HIV testing and available PMTCT (preventing mother-to-child transmission) interventions. (shrink)
In order to tesl for critical thinking dispositions, the presence of the requisite critical thinking abilities must first be established. Otherwise, it is always a plausible counterexplanation of failure to use certain abilities that they were not possessed. If a person spontaneously uses some ability on a task, then it is often legitimate to conclude that the person has both the ability and the disposition to use it. However, if the person does not use the ability spontaneously, the conclusion is (...) ambiguous. The person might not have the ability, or might have the ability but not the disposition to use it, or not the disposition to use it in the specific circumstances of the presented task. This paper proposes methods of critical thinking testing designed to deal with each of these possibilities. (shrink)
The study examined the knowledge and attitudes to personal genomics testing for complex diseases among Nigerians and identified how the knowledge and attitudes vary with gender, age, religion, education and related factors.
In both theoretical and applied modeling in behavioral sciences, it is common to choose a mathematical specification of functional form and distribution of unobservables on grounds of analytic convenience without support from explicit theoretical postulates. This article discusses the issue of deriving particular qualitative hypotheses about functional form restrictions in structural models from intuitive theoretical axioms. In particular, we focus on a family of postulates known as dimensional invariance. Subsequently, we discuss how specific qualitative postulates can be reformulated so as (...) to allow for conventional statistical hypothesis testing, and we also derive details of a particular likelihood ratio test procedure. An empirical application of the testing procedure is carried out, based on data from a Stated Preference survey. (shrink)
The application of genetic technologies in China, especially in the area of prenatal genetic testing, is rapidly increasing in China. In the wealthy regions of China, prenatal genetic testing is already very widely adopted. We argue that the government should actively promote prenatal genetic testing to the poor areas of the country. In fact, the government should prioritize resources first to make prenatal genetic testing a standard routine care with an opt-out model in these area. Healthcare (...) professions would be required to inform pregnant women about the availability of genetic testing and provide free testing on a routine basis unless the parents choose not to do so. We argue that this proposal will allow parents to make a more informed decision about their reproductive choices. Secondarily, this proposal will attract more healthcare professionals and other healthcare resources to improve the healthcare infrastructures in the less-developed regions of the country. This will help to reduce the inequity of accessing healthcare services between in different regions of China. We further argue that this policy proposal is not practicing eugenics. (shrink)
Intensive professional testing of children with disabilities is becoming increasingly prominent within the field of children’s rehabilitation. In this paper we question the high quality ascribed to standardized assessment procedures. We explore testing practices using a hermeneutic-phenomenological approach analyzing data from interviews and participant observations among 20 children with disabilities and their parents. All the participating children have extensive experience from being tested. This study reveals that the practices of testing have certain limitations when confronted with the (...) lived experience of those who are being tested. Testing seems to transmit the experts’ view of what is important, correct and admirable, and the way in which an individual child fulfills such requirements and fits in with the predetermined standard. Regular testing may result in insecurity on the part of the tested individual, and possibly to a lack of confidence in their body and the way it functions. For the individual being tested the meaning of testing is primarily related to passing or not passing the test requirements. Given the meaning of testing, children with disabilities may experience repeated testing as an ordeal that they are expected to put up with. By illuminating the experiences of the ones exposed to testing, this paper offers new insight for professionals to gauge more accurately the quality of contemporary testing practice. (shrink)
Harvey Siegel argues that minimum competency testing (MCT) is incompatible with strong sense critical thinking. His arguments are reviewed and contrasted with positions held by John E. McPeck and Michael Scriven. Siegel's arguments seem directed against the prevailing form of MCT. However, alternative formats which allow for the aggregate and context-sensitive nature of critical thinking are not doomed to the arbitrariness Siegel finds. MCT may be a legitimate and useful means for furthering critical thinking as one of our educational (...) ideals. (shrink)
An increasing number of children are adopted in the United States from countries where both medical care and environmental conditions are extremely poor. In response to worries about the accuracy of medical histories, prospective adoptive parents increasingly request genetic testing of children prior to adoption. Though a general consensus on the ethics of pre-adoption genetic testing (PAGT) argues against permitting genetic testing on children available for adoption that is not also permitted for children in general, a view (...) gaining traction argues for expanding the tests permitted. The reasoning behind this view is that the State has a duty to provide a child with parents who are the best “match,” and thus all information that advances this end should be obtained. While the matching argument aims to promote the best interests of children, I show how it rests on the claim that what is in the best interests of children available for adoption is for prospective adoptive parents to have their genetic preferences satisfied such that the “genetics” of the children they end up adopting accurately reflects those preferences. Instead of protecting a vulnerable population, I conclude, PAGT contributes to the risks of harm such children face as it encourages people with strong genetic preferences to adopt children whose genetic backgrounds will always be uncertain. (shrink)
Scientists, the medical profession, philosophers, social scientists, policy makers, and the public at large have been quick to embrace the accomplishments of genetic science. The enthusiasm for the new biotechnologies is not unrelated to their worthy goal. The belief that the new genetic technologies will help to decrease human suffering by improving the public’s health has been a significant influence in the acceptance of technologies such as genetic testing and screening. But accepting this end should not blind us to (...) the need for an evaluation of whether a particular means is adequate to achieve it. Lack of such evaluation notwithstanding, discussions of the ethical, legal, and social implications have tended to presuppose that the development and implementation of genetic testing will be an appropriate means to reduce human suffering in significant ways. I argue here that such an assumption is mistaken. In part this is the case because human biology is more complex than sometimes it is made to appear in these debates. But, the idea that human suffering resulting from disease can be reduced in significant ways with the use of genetic testing also ignores the social contexts in which these technologies are being developed and implemented. (shrink)
Non-therapeutic genetic testing in childhood presents a “myriad of ethical questions”; questions which are discussed and resolved in professional policy and position statements. In this paper we consider an underdiscussed but strongly influential feature of policy-making, the role of selective case and exemplar in the production of general recommendations. Our analysis, in the tradition of rhetoric and argumentation, examines the predominate use of three particular disease exemplar to argue for or against particular genetic tests. We discuss the influence these (...) choices have on the type and strength of subsequent recommendations. We argue that there are lessons to be drawn about how genetic diseases are conceptualised and we caution against the geneticisation of medical policy making. (shrink)
Predictive genetic testing may confront those affected with difficult life situations that they have not experienced before. These life situations may be interpreted as ‘absurd’. In this paper we present a case study of a predictive test situation, showing the perspective of a woman going through the process of deciding for or against taking the test, and struggling with feelings of alienation. To interpret her experiences, we refer to the concept of absurdity, developed by the French Philosopher Albert Camus. (...) Camus' writings on absurdity appear to resonate with patients' stories when they talk about their body and experiences of illness. In this paper we draw on Camus' philosophical essay ‘The Myth of Sisyphus’, and compare the absurd experiences of Sisyphus with the interviewee's story. This comparison opens up a field of ethical reflection. We demonstrate that Camus' concept of absurdity offers a new and promising approach to understanding the fragility of patients' situations, especially in the field of predictive testing. We show that people affected might find new meaning through narratives that help them to reconstruct the absurd without totally overcoming it. In conclusion, we will draw out some normative consequences of our narrative approach. (shrink)
The purpose of this study was to explore the views of members of the general public regarding ethical issues in adult predictive genetic testing. The literature pertaining to ethical issues regarding to adult predictive genetic testing is largely restricted to the views of ‘experts’ who have emphasized informed consent, patent issues, and insurance discrimination. Occasionally the views of patients who have undergone genetic counselling and testing have been elicited, adding psychosocial and family issues. However, the general public (...) has not had the opportunity to contribute. In order to explore theatre as a health policy research tool, 1,200 audience members attended the play ‘Sarah’s Daughters’ in seven Canadian cities, following which audience discussions were audiotaped. This study performed a secondary qualitative analysis of the data to identify the ethical issues of adult predictive genetic testing important to members of the general public. The identified issues were: (1) need for public education; (2) choice to undergo genetic counselling and testing; (3) access to genetic counselling and testing; and (4) obligations regarding the handling of genetic information. Audience members emphasized public education and access to information regarding potential choices, which was different from the emphasis on informed consent and other ethical issues prominent in the literature. Members of the general public emphasized ethical issues that were different than those identified by experts and patients. It is essential that members of the public be included in complex and controversial public policy decisions. (shrink)
In this article, I claim that at least some young people have the requisite capacity for political participation, and that the exclusion of these young people is in breach of the reasonable expectation that all capable citizens are included in democratic processes. I suggest implementing a capacity test for those under the current age of majority. I outline a system of capacity testing for the youth, distinguish this proposal from prior attempts to justify capacity testing and argue that (...) a suitably constrained capacity testing regime is not simply defensible, but superior to the current system, which arbitrarily excludes some capable members of society from participation. Finally, I explain why only this limited capacity testing regime is acceptable. (shrink)
One moot point in bioethical debates about genetic testing concerns the conditions that have to be fulfilled to make individual genetic testing or individual participation in genetic screening programs truly voluntary. Though there is a relatively broad consensus about the non-viability of views on the extremes of the spectrum of opinions, there is considerable disagreement in the middle. This mirrors the difficulties in defining satisfactory demarcation lines between autonomous choice, pressured choice and coercion in cases in which the (...) decision to participate is triggered, wholly or partly, by factors such as material incentives, urgent health needs, massive social expectations, or moral pressure from relatives. In this contribution, some of the semantic conditions and ethical principles concerning coercion are explored with a view to applying them to genetic testing, especially in the context of insurance and participation in clinical trials. (shrink)
Several difficulties have been raised concerning applicability of Glymour's model to developing and "un-natural" sciences, those contexts in which he claims it should be most clearly instantiated. An analysis of testing in such a field, archaeology, indicates that while bootstrapping may be realized in general outline, practice necessarily departs from the ideal in at least three important respects 1) it is not strictly theory contained, 2) the theory-mediated inference from evidence to test hypothesis is not exclusively deductive and, 3) (...) structural considerations do not displace or take precedence over substantive considerations. These points of divergence reflect the fact that bootstrapping in developing and exploratory sciences is as much a process of theory construction as of theory testing. (shrink)
I will argue in what follows, following the insights of James Marshall on busno‐cratic power, that resistance to this new power is already well underway, and that this resistance is potentially problematic and potentially transgressive 1 . The self is not only a chooser in busno‐cratic land, it is also re‐commodifying itself and in so doing, beginning to struggle at the limits of its commodified situation. I will argue that commodified selves, as much as they are constrained, are also potent (...) sites for resistance. Part of that resistance is being waged in the terrain of the high stakes test, where the self that could ‘choose’ runs headlong into a product that definitively limits its range of choice. In order to engage critically with this resistance, I examine the cracks in the monolithic power of testing, cracks that point to the uncertainty of numbers and the ambivalent anxieties of test takers. (shrink)
Safety testing of biological pharmaceuticals is often carried out by contract testing laboratories which perform these tests on behalf of the drug’s developer. These laboratories are confronted with a number of ethical issues related to selling their services, maintaining confidentiality, and the handling of results. This paper outlines these issues, and, by way of illustration, discusses how one such laboratory addresses them.
This paper provides an empirical account of commercial genetic testing in China. Commercial predictive genetic testing has emerged and is developing rapidly in China, but there is no strict and effective governance. This raises a number of serious social and ethical issues as a consequence of the enormous potential market for such tests. The paper demonstrates that the commercialization of genetic testing and the lack of adequate regulation have created an environment in which dubious advertising practices and (...) misleading and unprofessional medical advice are commonplace. The consequences of these ethically problematic activities for the users of predictive tests are unknown. The paper concludes with a bioethical and social science perspective on the ethical governance issues raised by the dissemination and utilization of commercial genetic testing in Chinese society. (shrink)
Contemporary education now appears to be dominated by the continual drive for improvement measured against the assessment of what students have learned. It is our contention that a foundational relation with assessment organises contemporary education. Here we draw on a 'way of thinking' that is deconstructive in its intent. Such thinking makes clear the vicious circularity of the argument for improvement, wherein assessment valorised in discourses of improvement provides not only a rationalisation for improvement via assessment, but also the very (...) means of achieving such possibilities via targets grounded in limited specifications of assessment. On reading Heidegger's 'question concerning technology' we sought to reconsider the vicious circle of improvement in relation to Being. We claim that the means-ends driven technology of assessment, rather than being at our disposal and under our control, only serves to reveals the Real to us in accordance with the restricting principle of reason. The principle of reason, we argue, grounds 'Enframing' that ranks and orders the very beings of education as objects to produce an objective 'world as picture', rather than opening the possibility of their identity as belongings with a movement of difference. So, 'improvement' becomes normative and binding for institutions and practices on grounds of the principle of assessment, and renders agents of education as functionaries of 'Enframing'. (shrink)
ZusammenfassungDie Zulässigkeit genetischer Untersuchungen an Arbeitnehmern wird in Deutschland neu diskutiert, nachdem einer hessischen Lehrerin die Verbeamtung auf Probe zunächst verweigert wurde, weil ihr Vater an der Huntington-Krankheit leidet. Es soll untersucht werden, ob eine gesetzliche Regelung genetischer Untersuchungen in der Arbeitsmedizin wünschenswert ist und welche ethischen Maßstäbe dabei zu berücksichtigen wären. Gendiagnostische Untersuchungsverfahren im engeren Sinn finden noch keine breite Anwendung in der Arbeits- und Betriebsmedizin. Die Nutzung genetischer Informationen gehört aber auch hier zum Standard. Damit sind verschiedene ethische (...) Konflikte verbunden, die insbesondere die Bereiche Autonomie und Diskriminierung betreffen. Gesetzliche Regelungen sollten sich daher nicht an der jeweiligen gendiagnostischen Technologie orientieren, sondern an der prognostisch-prädiktiven Qualität genetischen Wissens. Das Machtungleichgewicht am Arbeitsplatz und die immanenten Interessenkonflikte machen gesetzliche Regelungen erforderlich, die angesichts der zunehmenden Verfügbarkeit prädiktiver medizinischer Informationen Personenrechte schützen und einen fairen Interessenausgleich fördern. (shrink)
“Dutch Book” arguments and references to gambling theorems are typical in the debate between Bayesians and scientists committed to “classical” statistical methods. These arguments have rarely convinced non-Bayesian scientists to abandon certain conventional practices, partially because many scientists feel that gambling theorems have little relevance to their research activities. In other words, scientists “don’t bet.” This article examines one attempt, by Schervish, Seidenfeld, and Kadane, to progress beyond such apparent stalemates by connecting “Dutch Book”–type mathematical results with principles actually endorsed (...) by practicing experimentalists. (shrink)
Should a growing market for genetic self-tests be welcomed or feared? From the point of view of personal autonomy the increasing availability of predictive health information seems promising. Yet it is frequently pointed out that genetic information about future health may cause anxiety, distress and even loss of “life-hopes.” In this article the argument that genetic self-tests undermine personal autonomy is assessed and criticized. I contend that opportunities for autonomous choice are not reduced by genetic information but by misperceptions and (...) misunderstandings of the results of genetic tests. Since the interpretation of genetic information is sometimes distorted by the information provided about the genetic products, more attention should be given to deceitful marketing that overblows the utility of genetic products. Yet personal autonomy is reduced neither by genetic tests nor by genetic information and there is consequently no compelling case for the conclusion that genetic self-tests should be prohibited. (shrink)
Mehlman and Li offer a framework for approaching the bioethical issues raised by the military use of genomics that is compellingly grounded in both the contemporary civilian and military ethics of medical research, arguing that military commanders must be bound by the two principles of paternal- ism and proportionality. I agree fully. But I argue here that this is a much higher bar than we may fully realize. Just as the principle of proportionality relies upon a thorough assessment of harms (...) caused and military advantage gained, the use of genomic research, on Mehlman and Li’s view, will require an accurate understanding of the connection between genotypes and phenotypes – accurate enough to ameliorate the risk undertaken by our armed forces in being subject to such research. Recent conceptual work in evolutionary theory and the philosophy of biology, however, renders it doubtful that such knowledge is forthcoming. The complexity of the relationship between genotypic factors and realized traits (the so-called ‘G→P map’) makes the estimation of potential military advantage, as well as potential harm to our troops, incredibly challenging. Such fundamental conceptual challenges call into question our ability to ever satisfactorily satisfy the demands of a sufficiently rigorous ethical standard. (shrink)