Background To describe the preferences for disclosure of individual biomarker results among mothers participating in a longitudinal birth cohort. Methods We surveyed 343 mothers that participated in the Health Outcomes and Measures of the Environment Study about their biomarker disclosure preferences. Participants were told that the study was measuring pesticide metabolites in their biological specimens, and that the health effects of these low levels of exposure are unknown. Participants were asked whether they wanted to receive their results and their child's (...) results. In addition, they were asked about their preferred method (letter vs in person) and format (more complex vs less complex) for disclosure of results. Results Almost all of the study participants wanted to receive their individual results (340/343) as well as their child's results (342/343). However, preferences for receiving results differed by education level. Mothers with less than a college degree preferred in-person disclosure of results more often than mothers with some college education or a college degree (34.3% vs 17.4% vs 7.9%, p<0.001). Similarly, mothers with less than a college education preferred a less complex disclosure format than mothers with some college education or a college degree (59.7% vs 79.1% vs 86.3%, p<0.0001). Conclusion While almost all study participants preferred to receive results of their individual biomarker tests, level of education was a key factor in predicting preferences for disclosure of biomarker results. To ensure effective communication of this information, disclosure of biomarker results should be tailored to the education level of the study participants. (shrink)

That brings me to the crux of my disagreement with Hillis Miller. The central contention is not simply that I am sometimes, or always, wrong in my interpretation, but instead that I—like other traditional historians—can never be right in my interpretation. For Miller assents to Nietzsche's challenge of "the concept of 'rightness' in interpretation," and to Nietzsche's assertion that "the same text authorizes innumerable interpretations : there is no 'correct' interpretation."1 Nietzsche's views of interpretation, as Miller says, are relevant to (...) the recent deconstructive theorists, including Jacques Derrida and himself, who have "reinterpreted Nietzsche" or have written "directly or indirectly under his aegis." He goes on to quote a number of statements from Nietzsche's The Will to Power to the effect, as Miller puts it, "that reading is never the objective identifying of a sense but the importation of meaning into a text which had no meaning 'in itself.'" For example: "Ultimately, man finds in things nothing but what he himself has imported into them." "In fact interpretation is itself a means of becoming master of something."2 On the face of it, such sweeping deconstructive claims might suggest those of Lewis Carroll's linguistic philosopher, who asserted that meaning is imported into a text by the interpreter's will to power: "The question is," said Alice, "whether you can make words mean so many different things.""The question is," said Humpty Dumpty, "which is to be master—that's all." But of course I don't believe that such deconstructive claims are, in Humpty Dumpty fashion, simply dogmatic assertions. Instead, they are conclusions which are derived from particular linguistic premises. I want, in the time remaining, to present what I make out to be the elected linguistic premises, first of Jacques Derrida, then of Hillis Miller, in the confidence that if I misinterpret these theories, my errors will soon be challenged and corrected. Let me eliminate suspense by saying at the beginning that I don't think that their radically skeptical conclusions from these premises are wrong. On the contrary, I believe that their conclusions are right—in fact, they are infallibly right, and that's where the trouble lies. · 1. "Tradition and Difference," Diacritics 2 : 8, 12.· 2. Ibid. M. H. Abrams’s contributions to Critical Inquiry include "Rationality and Imagination in Cultural History: A Reply to Wayne Booth" and "Behaviorism and Deconstruction: A Comment on Morse Peckham's 'The Infinitude of Pluralism'". (shrink)

Let us call an integer part of an ordered field any subring such that every element of the field lies at distance less than 1 from a unique element of the ring. We show that every real closed field has an integer part.

The hopes and fears expressed in the debate on human enhancement are not always based on a realistic assessment of the expected possibilities. Discussions about extreme scenarios may at times obscure the ethical and policy issues that are relevant today. This paper aims to contribute to an adequate and ethically sound societal response to actual current developments. After a brief outline of the ethical debate concerning neuro-enhancement, it describes the current state of the art in psychopharmacological science and current uses (...) of psychopharmacological enhancement, as well as the prospects for the near future. It then identifies ethical issues regarding psychopharmacological enhancements that require attention from policymakers, both on the professional and on the governmental level. These concern enhancement research, the gradual expansion of medical categories, off-label prescription and responsibility of doctors, and accessibility of enhancers on the Internet. It is concluded that further discussion on the advantages and drawbacks of enhancers on a collective social level is still needed. (shrink)

Aldous Huxley’s Brave New World is a famous dystopia, frequently called upon in public discussions about new biotechnology. It is less well known that 30 years later Huxley also wrote a utopian novel, called Island. This paper will discuss both novels focussing especially on the role of psychopharmacological substances. If we see fiction as a way of imagining what the world could look like, then what can we learn from Huxley’s novels about psychopharmacology and how does that relate to the (...) discussion in the ethical and philosophical literature on this subject? The paper argues that in the current ethical discussion the dystopian vision on psychopharmacology is dominant, but that a comparison between Brave New World and Island shows that a more utopian view is possible as well. This is illustrated by a discussion of the issue of psychopharmacology and authenticity. The second part of the paper draws some further conclusions for the ethical debate on psychopharmacology and human enhancement, by comparing the novels not only with each other, but also with our present reality. It is claimed that the debate should not get stuck in an opposition of dystopian and utopian views, but should address important issues that demand attention in our real world: those of evaluation and governance of enhancing psychopharmacological substances in democratic, pluralistic societies. (shrink)

Clinicians' work depends on sincere and complete disclosures from their patients; they honour this candidness by confidentially safeguarding the information received. Breaching confidentiality causes harms that are not commensurable with the possible benefits gained. Limitations or exceptions put on confidentiality would destroy it, for the confider would become suspicious and un-co-operative, the confidant would become untrustworthy and the whole climate of the clinical encounter would suffer irreversible erosion. Excusing breaches of confidence on grounds of superior moral values introduces arbitrariness and (...) ethical unreliability into the medical context. Physicians who breach the agreement of confidentiality are being unfair, thus opening the way for, and becoming vulnerable to, the morally obtuse conduct of others. Confidentiality should not be seen as the cosy but dispensable atmosphere of clinical settings; rather, it constitutes a guarantee of fairness in medical actions. Possible perils that might accrue to society are no greater than those accepted when granting inviolable custody of information to priests, lawyers and bankers. To jeopardize the integrity of confidential medical relationships is too high a price to pay for the hypothetical benefits this might bring to the prevailing social order. (shrink)

L' auteur distingue entre la philosophie comme attitude mentale et la philosophie comme science. La philosophie dans la première acception regarde, plus ou moins, tous les hommes. La philosophie scientifique est la pensée qui scrute méthodiquement le sens de l' Univers. Le mot "philosophie" indique une attitude mentale, mais ce mot n' est pas un nom qui pourrait désigner la science qu' est la philosophie. Jusqu' ici cette science, n' a pas de nom caractéristique. Car ce nom devrait indiquer le (...) sujet de cette science, comme le font p.e. géologie, anthropologie, psychologie. Une simple analogie logique nous incite à appeler la philosophie scientifique du nom de pantologie. Ce nom la défendrait peut-être contre le dilettantisme verbeux et les rêveries nébuleuses qui ne manquent pas dans la philosophie pour autant qu'elle est et qu'elle doit être l' affaire de tout être humain. (shrink)

Clinical and research practices designed by developed countries are often implemented in host nations of the Third World. In recent years, a number of papers have presented a diversity of arguments to justify these practices which include the defence of research with placebos even though best proven treatments exist; the distribution of drugs unapproved in their country of origin; withholding of existing therapy in order to observe the natural course of infection and disease; redefinition of equipoise to a more bland (...) version, and denial of post-trial benefits to research subjects. These practices have all been prohibited in developed, sponsoring countries, even though they invariably have pockets of poverty where conditions comparable to the Third World prevail. Furthermore, the latest update of the Declaration of Helsinki clearly decries double ethical standards in research protocols. Under these circumstances, it does not seem appropriate that First World scholars should propose and defend research and clinical practices with less stringent ethical standards than those mandatory in their own countries. Recent years have witnessed frequent reports of less stringent ethical standards being applied to both clinical and research medical practices, for the most part in the field of drug trials and drug marketing, initiated by developed countries in poorer nations. Still more unsettling, a number of articles have endorsed the policy of employing ethical norms in these host countries, which would be unacceptable to both the legislations and the moral standards of the sponsor nations. Also, these reformulations often contravene the Declaration of Helsinki or one of its updates. This paper is not so much concerned with the actual practices, which have been subjected to frequent scrutiny and publicly decried when gross misconduct occurred. Rather, my concern relates to the approval and support such practices have found in the literature on bioethics from authors who might be expected to use their energy and scholarship to explore and endorse the universalisability of ethics rather than to develop ad hoc arguments that would allow exceptions and variations from accepted moral standards. To this purpose, issue will be taken with arguments in three fields: medical and pharmaceutical practices, research strategies, and local application of research results. (shrink)

Peckham claims that my "behavior" in dealing with the quotations in Natural Supernaturalism is the same, in methodology and validity, as the interpretative behavior of Booth's waiter. But the great bulk of the utterances in my quotations—and no less, of the utterances constituting Peckham's own essay—do not consist of orders, requests, or commands. Instead, they consist of assertions, descriptions, judgments, exclamations, approbations, condemnations, and many other kinds of speech-acts, the meanings of which are not related to my interpretative behavior, even (...) in the indirect way in which the meaning of Booth's order is related to the future behavior of his waiter. M. H. Abrams, author of Natural Supernaturalism and The Mirror and the Lamp and Class of 1916 Professor of English at Cornell University, responds in this essay to Morse Peckham's "The Infinitude of Pluralism" . Morse Peckham, in his Critical Response, was commenting on issues raised by the forum on "The Limits of Pluralism" , to which M. H. Abrams contributed. Previous contributions to Critical Inquiry are "Rationality and Imagination in Cultural History: A Reply to Wayne Booth" and "The Deconstructive Angel". (shrink)

In retrospect, I think I was right to compose Natural Supernaturalism by relying on taste, tact, and intuition rather than on a controlling method. A book of this kind, which deals with the history of human intellection, feeling, and imagination, employs special vocabularies, procedures, and modes of demonstration which, over many centuries of development, have shown their profitability when applied to matters of this sort. I agree with Booth that these procedures, when valid, are in a broad sense rational, and (...) subject to analysis and some degree of definition. But the rules underlying such a discourse are complex, elusive, unsystematic, and subject to innovative modification; they manifest themselves in the intuitive expertise of the historian; and the specification of these rules should not precede, but follow practice. . . . After the fact, nevertheless, a book like Natural Supernaturalism is subject to close critical inquiry about its methods and rationale. I am grateful to Booth for opening up such an inquiry, and for doing so in a way that is not only disarming, but seems to me to be the most promising of useful results. That is, instead of adopting a prosecutorial stance, demanding: "Justify the rationality and probative force of what you have done; it looks dammed suspicious to me," he has adopted the friendly tactic of saying: "Your book, in my experience of it, has yielded discoveries that I want to call knowledge, by methods, however deviant from standard rubrics of valid reasoning, that it seems irrational to call non-rational. Let's set out to clarify what these methods are, and to see what grounds we can find for the claim that they provide warranted knowledge." M.H. Abrams' contributions to Critical Inquiry are "The Deconstructive Angel" and "Behaviorism and Deconstruction: A Comment on Morse Peckham's 'The Infinitude of Pluralism'". (shrink)

In the first Critique Kant introduced the analytic/synthetic distinction and illustrated it with theoretical propositions. As his main aim in that work was to justify synthetic a priori propositions, Kant was able to bring his central questions into relief and discuss the methodology of their solution by contrasting synthetic propositions, such as: “Every event has a cause” with analytic propositions, such as: “Every effect has a cause.” Consequently, few commentators have any difficulty in stating as propositions the propositions Kant is (...) justifying in the first Critique or in pointing out the difficulty of justifying such propositions. (shrink)