Health care is transitioning from genetics to genomics, in which single-gene testing for diagnosis is being replaced by multi-gene panels, genome-wide sequencing, and other multi-genic tests for disease diagnosis, prediction, prognosis, and treatment. This health care transition is spurring a new set of increased or novel liability risks for health care providers and test laboratories. This article describes this transition in both medical care and liability, and addresses 11 areas of potential increased or novel liability risk, offering recommendations to both (...) health care and legal actors to address and manage those liability risks. (shrink)

table ronde du Centre national de la recherche scientifique, Paris, 27-29 mars 1979. Huygens et la France (Paris, Vrin, 1981, p. 99-114) CHRISTIAAN HUYGENS VU PAR LEIBNIZ par Albert HEINEKAMP (*) (Leibniz-Archiv, Hannover) Les ...

No consensus yet exists on how to handle incidental fnd-ings in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are fndings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research. We conclude that researchers (...) have an obligation to address the possibility of discovering IFs in their protocol and communications with the IRB, and in their consent forms and communications with research participants. Researchers should establish a pathway for handling IFs and communicate that to the IRB and research participants. We recommend a pathway and categorize IFs into those that must be disclosed to research participants, those that may be disclosed, and those that should not be disclosed. (shrink)

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

The negative emotions generated following stressful life events can increase one’s risk of depressive symptoms and promote higher levels of perceived stress. The process model of emotion regulation can help distinguish between adaptive and maladaptive emotion regulation strategies to determine who may be at the greatest risk of worse psychological health across the lifespan. Heart rate variability may affect these relationships as it indexes aspects of self-regulation, including emotion and behavioral regulation, that enable an individual to dynamically adapt to the (...) changing demands of both internal and external environments. In this study, we expected individual differences in resting vagally mediated HRV to moderate the influence of emotion regulatory strategies among our sample of 267 adults. We found support for the hypothesis that higher vagally mediated HRV buffers against the typical adverse effects of expressive suppression when evaluating depressive symptoms and found weak support when considering perceived stress. There was no evidence for an interaction between cognitive reappraisal and vagally mediated HRV but there was a significant, negative association between cognitive reappraisal and depressive symptoms and perceived stress. Future work may determine if intervening on either emotion regulation strategies or HRV may change these within-persons over time. (shrink)

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

The selections contained in these volumes from the papers and letters of Leibniz are intended to serve the student in two ways: first, by providing a more adequate and balanced conception of the full range and penetration of Leibniz's creative intellectual powers; second, by inviting a fresher approach to his intellectual growth and a clearer perception of the internal strains in his thinking, through a chronological arrangement. Much confusion has arisen in the past through a neglect of the develop ment (...) of Leibniz's ideas, and Couturat's impressive plea, in his edition of the Opuscu/es et fragments (p. xii), for such an arrangement is valid even for incomplete editions. The beginning student will do well, however, to read the maturer writings of Parts II, III, and IV first, leaving Part I, from a period too largely neglected by Leibniz criticism, for a later study of the still obscure sources and motives of his thought. The Introduction aims primarily to provide cultural orientation and an exposition of the structure and the underlying assumptions of the philosophical system rather than a critical evaluation. I hope that together with the notes and the Index, it will provide those aids to the understanding which the originality of Leibniz's scientific, ethical, and metaphysical efforts deserve. (shrink)

Le rôle de David Hume dans la philosophie moderne, par A. L. Leroy.--The enlightenment of David Hume, by E. C. Mossner.--Hume and Jurieu: possible Calvinist origins of Hume's theory of belief, by R. H. Popkin.--Hume: philosopher or psychologist? A problem of exegesis, by T. E. Jessop.--L'astrazione nella filosofia di Hume, di M. Dal Pra.--Infinite divisibility in Hume's "Treatise," by A. Flew.--Note a "La rgola del gusto," di E. Migliorini.--Kant, Hamann-Jacobi and Schelling on Hume, by P. Merlan.--Bibliografia humiana dal 1937 (...) al 1966, di E. Ronchetti. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:136 HISTORY OF PHILOSOPHY man felt two needs :"the theoretical need for guaranteeing a priori the subsistence of an ethical sphere against the Enlightenment's emphasis on happiness, and the political and practical need for guaranteeing individual freedom against an enlightened absolutism" (p. 71). Owing to this double need, Kant seems to be against himself and consequently the most critical and dialectical interpretation of Kant's thought is opposed to the (...) formalistic absolutism used by the Kantian jurists, who reject the most vital and profound critical philosophy for a metaphysical framework which confuses everything as though all were homogeneous. In fact, what appears more valid in Kant's philosophy is the continuous tension between formalism and dialectics, a tension which, even though it is never definitively overcome in a dialectical sense by Kant himself, nevertheless reveals the need for a legal dialectic rather than a formalism. It shows "the destiny of legal right to cease being a coercive apparatus, and of being transformed into rules for human society taken from civil society" (p. 390). Of course, this dialectical perspective suggests new horizons and also new problems and a wide plan of work. However, I agree with the author that the uncertainties which will inevitably emerge in this work must be met urgently and radically. For we know that "on the other scale-pan there are in fact the raw metaphysics of legal positivism, the conservatism of the jurists, and at best the formalistic, paralyzing ascetics" (p. 390). The merit of Negri's book seems to me to lie above all in the lively problematical tension with which he examines the Kantian thought. Following in the paths of G. Gurwitch, Metzger and Goldmann, as well as of Luk~s' History and Class Consciousness, he appreciates and understands the interpenetration of ethical motivations with the social and cultural environment. This historical and philosophical awareness of problems is particularly lively in the pages where the author notices the begging of principle in Kantian thought; a begging of principle consisting in the fact that "the definition of limit presupposes a limit to the principle itself, but the examination of this presupposition is neglected" (p. 77 ft.). Because of this critical and historical tension, Negri's book can be of great interest to the jurist, the philosopher and the historian. And if this ensues, it is because the conception of legal right which the author seeks to assert throughout his theoretical tension is deep-rooted humanly, dialectically, concretely. It is most needed by those who really want to make of law and right not a formal science but a human science. ANTONELLA GUARALDI Bari, Italy The Narrow Pass: Kierkegaard's Concept of Man. By George Price. (New York, Toronto, London: McGraw-Hill Book Co., 1963. Pp. 5-218.) Selon hombre de ses commentateurs, Kierkegaard seralt un ehrdtien passionnd; pour d'autres, il serait une sorte d'incroyant; pour George Price, nous devrions lui accorder une unitd complexe, unitd de production, qui s'exprime directement par la suite de ses oeuvres, unitd d'intention, une vue religicuse qui repose sur une certaine conception de l'homme, un th~me fondamental aussi qui est au centre des diverses discussions sur le pdchd, la foi, la raison, la morale, la subjectivitd et le "paradoxe", tous ces probl~mes qui paraissent se poser et se reposer sans cesse pour Kierkegaard, toujours de mani~re assez nouvelle. L'homme est i~la fois une synth~se de son corps et de son moi, des causes qui ont d'abord faeonnd son ~tre, et de qu'il y a en lui d'original et qui ne sera jamais rdpdtd, ce que son esprit a fait par un effort crdateur. Et d'abord une premiere remarque pour simplifier les vues de Kierkegaard. II n'y a pas ici de substances conjointes, il n'y a que des dvdnements corporels et spirituels. L'influence de Fichte apparait par l'importance accordde au devenir, un devenir qui se poursuit selon un module et qui reste fragile, si la volontd de se rdaliser ne se maintient pas. L'homme dolt se passionner pour son existence, it dolt devenir lui-m~me. La chute de l... (shrink)