We report on the case of a 2-year-old female, the youngest person ever to undergo ovarian tissue cryopreservation (OTC). This patient was diagnosed with a rare form of sickle cell disease, which required a bone-marrow transplant, and late effects included high risk of future infertility or complete sterility. Ethical concerns are raised, as the patient's mother made the decision for OTC on the patient's behalf with the intention that this would secure the option of biological childbearing in the future. Based (...) on Beauchamp and Childress's principlism approach of respect for autonomy, nonmaleficence, beneficence, and justice, pursing OTC was ethically justified. (shrink)

We applaud Notini and colleagues for highlighting the clinical and ethical complexities of a case in which a non-binary individual desires indefinite treatment with puberty blockers.1 While we agree discontinuing treatment may cause psychological distress, we believe there are potential physical and neurocognitive harms caused by prolonged treatment that have been underestimated given the limited research conducted to date. Specifically, the impact of permanent pubertal suppression on the brain and decision-making capacity should be considered. In this context, we outline the (...) potential risks of ongoing pubertal suppression on bone and cardiovascular health, sexual and reproductive function, and brain development—all noted in the article but perhaps in an overly simplistic manner.1 First, the authors’ note OPS will almost certainly result in reduced bone density.1 Although we agree the absolute fracture risk is low in studies among older adults, there is less clarity about implications during adolescence and young adulthood when peak bone accrual occurs.2 Further, the authors propose ongoing monitoring with bone density scans, but no clear guidelines for clinicians if bone density becomes critically low—so we ask, at what point would a potential fracture risk outweigh the proposed benefits …. (shrink)

We applaud Notini and colleagues for highlighting the clinical and ethical complexities of a case in which a non-binary individual desires indefinite treatment with puberty blockers. 1 While we agree discontinuing treatment may cause psychological distress, we believe there are potential physical and neurocognitive harms caused by prolonged treatment that have been underestimated given the limited research conducted to date. Specifically, the impact of permanent pubertal suppression on the brain and decision-making capacity should be considered. In this context, we outline (...) the potential risks of ongoing pubertal suppression on bone and cardiovascular health, sexual and reproductive function, and brain development—all noted in the article but perhaps in an overly simplistic manner. 1 First, the authors’ note OPS will almost certainly result in reduced bone density. 1 Although we agree the absolute fracture risk is low in studies among older adults, there is less clarity about... (shrink)

De Bie et al. provide a novel framework for assessing ethical considerations in artificial womb technology (AWT) based on four phases of human prenatal development (DeBie 2023). As the authors note...

Harms and risks to groups and third-parties can be significant in the context of research, particularly in data-centric studies involving genomic, artificial intelligence, and/or machine learning technologies. This article explores whether and how United States federal regulations should be adapted to better align with current ethical thinking and protect group interests. Three aspects of the Common Rule deserve attention and reconsideration with respect to group interests: institutional review board (IRB) assessment of the risks/benefits of research; disclosure requirements in the informed (...) consent process; and criteria for waivers of informed consent. In accordance with respect for persons and communities, investigators and IRBs should systematically consider potential group harm when designing and reviewing protocols, respectively. Research participants should be informed about any potential group harm in the consent process. We call for additional public discussion, empirical research, and normative analysis on these issues to determine the right regulatory and policy path forward. (shrink)

Rapid tissue donation (RTD) is an advancing oncology research procedure for collecting tumors, metastases, and unaffected tissue 2–6 h after death. Researchers can better determine rates of progression, response to treatment, and polymorphic differences among patients. Cancer patients may inquire about posthumous body donation for research to offer a personal contribution to research; however, there are barriers to recruiting for an RTD program. Physicians must reassure the patient that their treatment options and quality of care will not be compromised due (...) to participating in RTD. In this commentary we discuss how theories of altruism may explain cancer patients’ desire to participate in an RTD program, the ethical concerns of health care professionals and patients and the use of altruism as a recruitment strategy. We offer recommendations for examining the cultural and ethical climate of the institution prior to initiating such a program such as examining the relationship of healthcare professionals and patients, identifying ethical concerns, and examining ways to promote acceptance and buy-in across professionals, patients, and families. (shrink)

As the technology for ectogenesis continues to advance, the ethical implications of such developments should be thoroughly and proactively explored. The possibility of full ectogenesis remains hypothetical at present, and myriad concerns regarding the safety and efficacy of the technology must be evaluated and addressed, while pressing moral considerations should be fully deliberated. However, it is conceivable that the technology may become sufficiently well established in the future and that eventually full ectogenesis might be deemed ethically acceptable as a reproductive (...) alternative to gestation within a human womb under certain circumstances. If the safety and efficacy of full ectogenesis are established, if ethical dilemmas are sufficiently well addressed, and if the technology is offered as a reproductive option to cisgender heterosexual individuals or couples desiring to become parents, there is a moral obligation grounded in social justice to ensure that full ectogenesis be made available to individuals or couples identifying as members of sexual‐ or gender‐minority groups who likewise seek to pursue parenthood. We examine the history of access to current family‐building options, including assisted reproductive technology, surrogacy and adoption, for these populations and conclude that in the absence of robust empirical evidence suggesting an increased risk of harm to children of individuals and couples who identify as members of sexual‐ or gender‐minority groups, equitable access to ectogenesis as a pathway to parenthood for sexual and gender minorities must be assured as a matter of reproductive justice. (shrink)

A 16-year-old adolescent who identifies as transgender wishes to consider fertility preservation prior to the use of gender-affirming hormones. The adolescent’s parents are divorced, and one parent supports fertility preservation while the other does not. This case explores the minor’s future reproductive autonomy and parental decision making in a field where there is limited evidence of known harms and benefits to the use of fertility preservation in the transgender population and about future potential regret from lack of consideration of fertility (...) preservation during the prime window of opportunity. This case is created from a composite of cases seen at multiple institutions. (shrink)

Public debates about abortion emphasize choice. Privately, when people face that decision, how much choice do they feel they have?We are part of a team who provide abortions at the oldest public ho...

Uterus transplantation is an emerging technology adding to the arsenal of treatments for infertility; specifically the only available treatment for uterine factor infertility. Ethical investigations concerning risks to uteri donors and transplant recipients have been discussed in the literature. However, missing from the discourse is the potential of uterus transplantation in other groups of genetically XY women who experience uterine factor infertility. There have been philosophical inquiries concerning uterus transplantation in genetically XY women, which includes transgender women and women with (...) complete androgen insufficiency syndrome. We discuss the potential medical steps necessary and associated risks for uterus transplantation in genetically XY women. Presently, the medical technology does not exist to make uterus transplantation a safe and effective option for genetically XY women, however this group should not be summarily excluded from participation in trials. Laboratory research is needed to better understand and reduce medical risk and widen the field to all women who face uterine factor infertility. (shrink)

In preparation for the development of a rapid tissue donation programme, we surveyed healthcare providers in our institution about knowledge and attitudes related to RTD with lung cancer patients. A 31-item web based survey was developed collecting data on demographics, knowledge and attitudes about RTD. The survey contained three items measuring participants’ knowledge about RTD, five items assessing attitudes towards RTD recruitment and six items assessing HCPs’ level of agreement with factors influencing decisions to discuss RTD. Response options were presented (...) on a 5-point Likert scale. Ninety-one HCPs participated in the study. 66% indicated they had never heard of RTD prior to the survey, 78% rated knowledge of RTD as none or limited and 95.6% reported not having ethical or religious concerns about discussing RTD with patients. The majority were either not comfortable or not sure if they felt comfortable discussing RTD with cancer patients . 56.1% indicated their knowledge of RTD would play an integral role in their decision to discuss RTD with patients. 71.4% reported concerns with RTD discussion and the emotional state of the patient. Physicians and nurses play an important role in initiating conversations about recruitment and donation to research that can ultimately influence uptake. Increasing HCP knowledge about RTD is a necessary step towards building an RTD programme. Our study provides important information about characteristics associated with low levels of knowledge and practice related to RTD where additional education and training may be warranted. (shrink)

Philosophy & Public Affairs, Volume 50, Issue 1, Page 6-49, Winter 2022.

Do the ethical features of an artwork bear on its aesthetic value? This movie endorses misogyny, that song is a civil rights anthem, the clay constituting this statue was extracted with underpaid labor—are facts like these the proper bases for aesthetic evaluation? I argue that this debate has suffered from a false presupposition: that if the answer is yes (for at least some such ethical features), such considerations feature as pro tanto contributions to an artwork's overall aesthetic value, i.e., as (...) merits or flaws which make something have more or less overall aesthetic value. As the case of ethically laden, aesthetic evaluation makes clear, however, good aesthetic judgement is irreducibly multi-dimensional, e.g., "the movie has an engaging soundtrack, tasteful camera work, and takes a misogynistically prurient perspective on its female lead.'' Such a "non-summative" judgement refuses to reduce those various dimensions of aesthetic value to a single aggregate aesthetic evaluation, like "it's a 6/10" or "it's a pretty good movie!" I defend both the modest claim that such non-summative evaluations are not mistaken and the extremist claim that summative (i.e., unidimensional) aesthetic evaluation is defective by considering other domains of normative assessment in which summing seems inappropriate, notably including evaluations of people's character. (shrink)

In this paper I argue that warrant for Lewis’ principle of recombination presupposes warrant for a combinatorial analysis of intrinsicality, which in turn presupposes warrant for the principle of recombination. This, I claim, leads to a vicious circularity: warrant for neither doctrine can get off the ground.

The Scottish Mental Health Arts and Film Festival has seen hundreds of arts, public and community groups coproduce over 300 events to over 25,000 audience members. Integral to this arts-based approach, in contrast to social marketing or public education models, is the notion that mental health is an essentially contested concept whereby meanings are negotiated and debate encouraged. With emerging evidence that the festival is an ef ective way of engaging people intellectually and emotionally, we explore ethical issues, challenges and (...) paradoxes that have emerged as the festival has developed. Consideration is given to issues of power, purpose, opportunity costs, reach, impact, programming risks, and participation from those with experience of mental ill-health. Throughout, we explore practical implications for funding, managing, programming, marketing and evaluation of this and similar endeavours. (shrink)

: Method in Catholic bioethics is distinguished by a specific philosophical and theological anthropology. Human beings are not to be considered simply as selves, but as selves in relation to God and each other. This essay reflects on that claim by reviewing four areas of concern from Catholic social teaching: common good, human dignity, option for the poor, and stewardship.

This book presents a view of the concepts in the Kantian scheme of things. The author attempts to show that Kant has not established the necessity of thinking human freedom in the theoretical sphere as would seem to be demanded by the inner logic of the first Critique and by the concept of autonomy in the second Critique.

Plagiarism and other transgressions of the norms of academic integrity appear to be a persistent problem among upper secondary students. Numerous surveys have revealed high levels of infringement of what appear to be clearly stated rules. Less attention has been given to students’ understanding of academic integrity, and to the potential misconceptions and false beliefs that may make it difficult for them to comply with existing rules and handle complex real-life situations.In this paper we report findings from a survey of (...) European upper secondary students’ views on issues relating to academic integrity. We relate these findings to the students’ training about academic integrity, self-reported level of questionable behavior and country of study.A total of 1654 students at 51 institutions located in 6 European countries participated in the study. The participants generally believed they had a good understanding of the rules applying to them and knew how to behave in compliance with norms of academic integrity. The results indicate, however, that often, in practice, this belief was mistaken. Many students had an inadequate understanding of core elements of academic integrity. They were uncertain about how to act, and they struggled in the handling of complex situations that require context-sensitive judgement. While some differences between countries were identified, they were modest and exhibited no clear pattern. Our results also suggest that reducing students’ level of uncertainty and, to a lesser degree, improving their level of knowledge could lead them to engage less in certain types of questionable behaviours. Surprisingly, the effect of academic training is modest and ambiguous. The study also confirms that perception of peer behaviour has the strongest association with student engagement in questionable behaviours. Thus, academic integrity at the upper secondary level cannot be explained simply in terms of individual ethics or knowledge. (shrink)

This book provides practical and research-based chapters that offer greater clarity about the particular kinds of teacher reflection that matter and avoids talking about teacher reflection generically, which implies that all kinds of reflection are of equal value.

Good academic practice is more than the avoidance of clear-cut cheating. It also involves navigation of the gray zones between cheating and good practice. The existing literature has left students’ understanding of gray zone practices largely unexplored. To begin filling in this gap, we present results from a questionnaire study involving N = 1639 undergraduate students from seven European countries representing all major disciplines. We show that large numbers of these students are unable to identify gray area issues and lack (...) sensitivity to the context dependence of these. We also show that a considerable proportion of students have a poor understanding of concepts like plagiarism and falsification, not only in gray zone scenarios, but also in cases of relatively clear-cut cheating. Our results are similar across the faculties and countries of study, and even for students who have attended academic integrity training. We discuss the implications of this for academic integrity training. (shrink)

© 2017. The American Astronomical Society. All rights reserved.We present new observations of the low-mass companion to HD 984 taken with the Gemini Planet Imager as a part of the GPI Exoplanet Survey campaign. Images of HD 984 B were obtained in the J and H bands. Combined with archival epochs from 2012 and 2014, we fit the first orbit to the companion to find an 18 au orbit with a 68% confidence interval between 14 and 28 au, an eccentricity (...) of 0.18 with a 68% confidence interval between 0.05 and 0.47, and an inclination of 119°with a 68% confidence interval between 114°and 125°. To address the considerable spectral covariance in both spectra, we present a method of splitting the spectra into low and high frequencies to analyze the spectral structure at different spatial frequencies with the proper spectral noise correlation. Using the split spectra, we compare them to known spectral types using field brown dwarf and low-mass star spectra and find a best-fit match of a field gravity M6.5 ±1.5 spectral type with a corresponding temperature of K. Photometry of the companion yields a luminosity of log=2.88 ± 0.07 dex with DUSTY models. Mass estimates, again from DUSTY models, find an age-dependent mass of 34 ±1 to 95 ±4 M Jup. These results are consistent with previous measurements of the object. (shrink)

Stable URL: http://links.jstor.org/sici?sici=0048-3915%28198923%2918%3A4%3C334%3AAIACTD%3E2.0.CO%3B2-P..

This study examined the hypothesis that a key process in conditional reasoning with concrete premises involves on-line retrieval of information about potential alternate antecedents. Participants were asked to solve reasoning problems with causal conditional premises (If cause P then effect Q). These premises were inserted into short contexts. The availability of potential alternatives was varied from one context to another by adding statements that explicitly invalidated one or more of these alternatives (i.e., other causes that lead to the effect Q). (...) The invalidated alternatives differed in the degree of their semantic association to the consequent term (Q). The results show that the effect of invalidating one or more potential alternatives on the two uncertain logical forms, AC and DA, was largely determined by their relative associative strength. These results strongly support a model for conditional reasoning with causal premises that supposes that a key element in responding to the uncertain logical forms is on-line retrieval of at least one potential alternative antecedent. (shrink)

This unique volume collects some of the best recent work on the philosophical challenge that religious diversity poses for religious belief. Featuring contributors from philosophy, religious studies, and theology, it is unified by the way in which many of the authors engage in sustained critical examination of one another's positions. John Hick's pluralism provides one focal point of the collection. Hick argues that all the major religious traditions make contact with the same ultimate reality, each encountering it through a variety (...) of culturally shaped forms of thought and experience but all offering equally effective paths to salvation or liberation. Another central position is William P. Alston's defense of the Christian practice of forming beliefs about manifestations of God in response to experiences of divine presence or activity. Articles by Hick and Alston develop their arguments and other selections respond, criticizing or defending various aspects of one or both positions. Religious skepticism, religious exclusivism, religious inclusivism, and other perspectives are also represented. In the introduction, the editors suggest connections among the articles and report on additional exchanges between the contributors. The only anthology that provides comprehensive coverage of the current philosophical debate about religious diversity, The Philosophical Challenge of Religious Diversity is ideal for courses and seminars on the philosophy of religion, philosophical theology, and world religions. (shrink)