BackgroundThe use of genetic test results in risk-rated insurance is a significant concern internationally, with many countries banning or restricting the use of genetic test results in underwriting. In Australia, life insurers’ use of genetic test results is legal and self-regulated by the insurance industry (Financial Services Council (FSC)). In 2018, an Australian Parliamentary Inquiry recommended that insurers’ use of genetic test results in underwriting should be prohibited. In 2019, the FSC introduced an industry self-regulated moratorium on the use of (...) genetic test results. In the absence of government oversight, it is critical that the impact, effectiveness and appropriateness of the moratorium is monitored. Here we describe the protocol of our government-funded research project, which will serve that critical function between 2020 and 2023.MethodsA realist evaluation framework was developed for the project, using a context-mechanism-outcome (CMO) approach, to systematically assess the impact of the moratorium for a range of stakeholders. Outcomes which need to be achieved for the moratorium to accomplish its intended aims were identified, and specific data collection measures methods were developed to gather the evidence from relevant stakeholder groups (consumers, health professionals, financial industry and genetic research community) to determine if aims are achieved. Results from each arm of the study will be analysed and published in peer-reviewed journals as they become available.DiscussionThe A-GLIMMER project will provide essential monitoring of the impact and effectiveness of the self-regulated insurance moratorium. On completion of the study (3 years) a Stakeholder Report will be compiled. The Stakeholder Report will synthesise the evidence gathered in each arm of the study and use the CMO framework to evaluate the extent to which each of the outcomes have been achieved, and make evidence-based recommendations to the Australian federal government, life insurance industry and other stakeholders. (shrink)

The _Turba Philosophorum_ is at the confluence of many Greek traditions, and bears testimony both to the history of the transmission of Greek knowledge, and of its reception in Egypt in the ninth century.

In his article ‘God and Probability’, 1 Hugh Mellor introduced the notion of the ‘bridge-hand fallacy’, allegedly committed by those who think they can appeal to probabilities in arguments for design. I should like to give this notion another airing, partly because of its recent criticism in two interesting books - R. G. Swinburne' The Existence of God and D. J. Bartholomew's God of Chance - and partly because it seems worth asking how it fares in relation to the most (...) recent examples of design argument, namely those which appeal to the so-called ‘anthropic principle’ in cosmology. (shrink)

Genetic research into ageing, longevity and late-onset disease is becoming increasingly common. Yet, there is a paucity of knowledge related to clinical actionability and the return of pathogenic variants to otherwise healthy elderly individuals. Whether or not genetic research in the elderly should be managed differently from standard practices adapted for younger populations has not yet been defined. In this article, we provide an overview of ethical and practical challenges in preparing for a genetic study of over 14 000 healthy (...) Australians aged 70 years or older enrolled in the ASPirin in Reducing Events in the Elderly Healthy Ageing Biobank. At the time of consent, all participants in this study were free of life-threatening illness, cardiovascular disease or cognitive impairment. ASPREE is thus a cohort of healthy elderly individuals with seemingly minimal burden of genetic disease recruited without ascertainment bias. The cohort presents a unique opportunity to address the penetrance of known pathogenic variants in a population without disease symptoms; however, it also raises a number of ethical concerns regarding the interpretation and disclosure of variants with known clinical actionability. Some of the challenges include how to manage the interpretation, disclosure and actioning of pathogenic variants found in otherwise healthy elderly adults without disease symptoms, whether or not to disclose findings for the benefit of family members rather than elderly consented donors themselves, how to manage the return of genetic findings to the elderly individuals who are now in severe cognitive decline or terminal illness, how to ensure quality of information and clinical service upon disclosure of results to this demographic and how to prepare for the insurance implications of disclosing genetic information under Australian law. We discuss these and other dilemmas and propose a defensible plan of management. Trial registration number ISRCTN83772183. (shrink)

The overarching issue with this case study is poor regulation and quality control over direct-to-consumer genetic testing, delivered in the absence of any medical oversight.

The present volume focuses on this wisdom of humility that characterizes Westphals thought and explores how that wisdom, expressed through the redemptive ...

Le présent article s’appuie sur une recherche clinique référée à la théorie psychanalytique et menée à partir de trente entretiens semi-directifs réalisés auprès d’adultes homosexuels engagés dans la parentalité. L’auteur présente deux études de cas qui concernent des sujets ayant choisi la configuration de la coparentalité à quatre. Les hypothèses suivantes sont soumises à l’analyse du discours : d’une part, dans ce genre de configuration, on retrouve une permanence des processus psychiques liés au devenir parent (réactualisation des enjeux œdipiens, deuil (...) développemental, permutation symbolique des places); d’autre part ce genre de configuration met en évidence que ces processus peuvent trouver un étayage sur le lien amoureux entre personnes de même sexe ainsi que sur les liens qui se créent entre les membres du « quatuor » et dans lesquels les fantaisies hétérosexuelles jouent un rôle non négligeable. (shrink)

O texto apresenta debates referentes a uma pesquisa bibliográfica que analisou produções escritas sobre o tema do abrigamento de crianças e jovens. Tal pesquisa visou cartografar as narrativas escritas sobre abrigos e convivência familiar a partir do ano 2000, quando, após dez anos da promulgação do..

)L’auteur propose un retour sur certains travaux de sciences humaines à propos des familles homoparentales, son objectif étant d’interroger les notions qui nous permettent de rendre compte des changements dont ces familles sont porteuses. Il examine notamment deux notions souvent rencontrées dans les travaux sur les nouvelles formes de familles : la désinstitutionnalisation et la désexualisation. La première, spécifiquement sociologique, semble échouer à décrire le travail complexe de réinstitution de la famille qui est à l’œuvre tant dans le droit que (...) dans les familles homoparentales elles-mêmes. La seconde montre sa pertinence dans le champ socio-anthropologique mais pose question si l’on s’appuie sur les recherches d’orientation psychanalytique auprès de ces configurations familiales. En effet, si, du point de vue anthropologique, l’instauration de la disjonction entre sexualité et reproduction ne fait pas de doute, il en va tout autrement du point de vue des processus psychiques inconscients qui accompagnent le devenir parent en appui sur la représentation d’une scène primitive et sur des fantasmes de bisexualité psychique. (shrink)

This book offers an introduction to the Sophists of fifth-century Athens and a new overall interpretation of their thought. Since Plato first animadverted on their activities, the Sophists have commonly been presented as little better than intellectual mountebanks - a picture which Professor Kerferd forcefully challenges here. Interpreting the evidence with care, he shows them to have been part of an exciting and historically crucial intellectual movement. At the centre of their teaching was a form of relativism, most famously expressed (...) by Protagoras as 'Man is the measure of all things', and which they developed in a wide range of views - on knowledge and argument, virtue, government, society, and the gods. On all these subjects the Sophists did far more than simply provoke Plato to thought. Their contributions were substantial and serious; they inaugurated the debate on many central philosophical questions and decisively shifted the focus of philosophical attention from the cosmos to man. (shrink)

Institutional explanations have been, and continue to be, one of the most important means of understanding the choices made by governments and other actors in society. This four volume set brings together a collection of the key readings in institutional theory and its applications to political phenomena. Although the principal focus of these readings is on institutional theory based in political science, articles from other disciplines that have been central to the development of theory in this discipline, or that have (...) substantial relevance for political phenomena, have also been included. Forming part of the SAGE Library of Political Science, this set contains a substantial overall introduction and conclusion as well as shorter introductions to each Part. It is an essential purchase for social science libraries around the world. (shrink)

À partir de certains écrits sur la médiation familiale, l’auteur propose une réflexion critique, destinée à mettre en évidence les limites d’une théorisation de cette pratique fondée sur la seule référence à la mythologie actuelle de l’individu souverain et autonome. En un premier temps, des métaphores récurrentes sous la plume des médiateurs familiaux sont analysées et rapportées à cette mythologie contemporaine. En un deuxième temps, l’auteur propose un cadre théorique susceptible de permettre de penser différemment la médiation familiale. Une conception (...) anthropologico-psychanalytique des liens de filiation et de parentalité est envisagée, comme pouvant fonder une pratique de la médiation familiale qui prendrait en compte la spécificité des liens familiaux. (shrink)

"First published by Oxford University Press, 1916."--Title page verso.

Various U.S. laws, such as the Clean Air Act and the Food Quality Protection Act, require additional protections for susceptible subpopulations who face greater environmental health risks. The main ethical rationale for providing these protections is to ensure that environmental health risks are distributed fairly. In this article, we (1) consider how several influential theories of justice deal with issues related to the distribution of environmental health risks; (2) show that these theories often fail to provide specific guidance concerning policy (...) choices; and (3) argue that an approach to public decision making known as accountability for reasonableness can complement theories of justice in establishing acceptable environmental health risks for the general population and susceptible subpopulations. Since accountability for reasonableness focuses on the fairness of the decision-making process, not the outcome, it does not guarantee that susceptible subpopulations will receive a maximum level of protection, regardless of costs or other morally relevant considerations. (shrink)