Hastings Center Report, Volume 52, Issue 2, Page 49-57, March‐April 2022.

Newborn bloodspot screening programs are some of the longest running population screening programs internationally. Debate continues regarding the need for parents to give consent to having their child screened. Little attention has been paid to how meanings of consent-related terminology vary among stakeholders and the implications of this for practice. We undertook semi-structured interviews with parents, healthcare professionals and policy decision makers in two Canadian provinces. Conceptions of consent-related terms revolved around seven factors within two broad domains, decision-making and information (...) attainment. Decision-making comprised: parent decision authority; voluntariness; parent engagement with decision-making; and the process of enacting choice. Information ascertainment comprised: professional responsibilities ; parent responsibilities; and the need for discussion and understanding prior to a decision. Our findings indicate that consent-related terms are variously understood, with substantive implications for practice. We suggest that consent procedures should be explained descriptively, regardless of approach, so there are clear indications of what is expected of parents and healthcare professionals. Support systems are required both to meet the educational needs of parents and families and to support healthcare professionals in delivering information in a manner in keeping with parent needs. (shrink)

Background: Expanded newborn screening generates incidental results, notably carrier results. Yet newborn screening programmes typically restrict parental choice regarding receipt of this non-health serving genetic information. Healthcare providers play a key role in educating families or caring for screened infants and have strong beliefs about the management of incidental results. Methods: To inform policy on disclosure of infant sickle cell disorder (SCD) carrier results, a mixed-methods study of healthcare providers was conducted in Ontario, Canada, to understand attitudes regarding result management (...) using a cross-sectional survey (N = 1615) and semistructured interviews (N = 42). Results: Agreement to reasons favouring disclosure of SCD carrier results was high (65.1%–92.7%) and to reasons opposing disclosure was low (4.1%–18.1%). Genetics professionals expressed less support for arguments favouring disclosure (35.3%–78.8%), and more agreement with arguments opposing disclosure (15.7%–51.9%). A slim majority of genetics professionals (51.9%) agreed that a reason to avoid disclosure was the importance of allowing the child to decide to receive results. Qualitatively, there was a perceived “duty” to disclose, that if the clinician possessed the information, the clinician could not withhold it. Discussion: While a majority of respondents perceived a duty to disclose the incidental results of newborn screening, the policy implications of these attitudes are not obvious. In particular, policy must balance descriptive ethics (ie, what providers believe) and normative ethics (ie, what duty-based principles oblige), address dissenting opinion and consider the relevance of moral principles grounded in clinical obligations for public health initiatives. (shrink)

Background It has been suggested that researchers are obliged to offer summary findings to research participants to demonstrate respect for persons, and that this may increase public trust in, and awareness of, the research enterprise. Yet little research explores researchers' attitudes and practices regarding the range of initiatives that might serve these ends. Methods Results of an international survey of 785 eligible authors of genetics research studies in autism or cystic fibrosis are reported. Results Of 343 researchers who completed the (...) survey (44% response rate), the majority agreed that their team should (i) inform participants of summary findings (90.7%) and (ii) ensure they gain an awareness of developments in the field (86.9%). Additionally, the majority reported that in practice, their team (i) informs participants of summary findings (69.4%) and (ii) provides other types of relevant non-results information (eg, state of science in the field, opportunities for research participation) (67.9%). Conclusion Researchers endorsed the obligation of communicating with research participants by providing summary findings and other research-related information in equal measure. In light of these findings, it is suggested that while the provision of summary results may contribute to efforts to discharge the obligation of respect for persons, it may be neither a necessary nor a sufficient means to this end. (shrink)

The use of traditional ethical methodologies is inadequate in addressing a constructed maternal–fetal rights conflict in a multicultural obstetrical setting. The use of caring ethics and a relational approach is better suited to address multicultural conceptualizations of autonomy and moral distress. The way power differentials, authoritative knowledge, and informed consent are intertwined in this dilemma will be illuminated by contrasting traditional bioethics and a caring ethics approach. Cultural safety is suggested as a way to develop a relational ontology. Using caring (...) ethics and a relational approach can alleviate moral distress in health-care providers, while promoting collaboration and trust between providers and their patients and ultimately decreasing reproductive disparities. This article examines how a relational approach can be applied to a cross-cultural reproductive dilemma. (shrink)

Niniejszy esej stanowi zbiór podstawowych poglądów brytyjskiego filozofa Robina George’a Collingwooda na cele i zadania nauk historycznych. Zawiera krytykę ujmowania historii jako dyscypliny dążącej do ustanowienia ogólnych, rządzących biegiem dziejów, praw oraz jako dyscypliny zmierzającej do odkrycia, realizowanego w dziejach, boskiego planu. Jest on próbą wykazania różnic między historią a filozofią historii, sztuką i nauką. Wyraża pogląd, że nie istnieje coś takiego jak czysty fakt historyczny, że nie jesteśmy w stanie, w sposób absolutny, poznać jakiegokolwiek faktu historycznego, mimo że wiedza (...) o nim zwiększa się, oraz że myślenie historyczne bazuje na percepcji.Konkluzją esejujest myśl, że każdy historyk patrzy na przeszłość z własnego punktu widzenia, a więc źródła, zjakich korzysta, i wnioski, do jakich dochodzi, będą się znacząco różniły od źródeł i wniosków innych historyków, oraz myśl, że każde wydarzenie historyczne jest niewy- czerpalne w tym sensie, że w rękach każdego nowego historyka przybiera inny kształt. (shrink)

Die folgenden miteinander zusammenhängenden Themen werden erörtert : der Essentialismus, die Trans-Welt-Identität, der ontologische Gottesbeweis und der Glaube, Gott könne jede beliebige Welt erschaffen. Plantingas Einschätzung der De-re-Modalität stellt sich als fehlerhaft heraus, wenn seine Überzeugung, Menschen dürften nicht mit ihren Körpern gleichgesetzt werden, auch überzeugender ist. Leibniz würde jedoch mit guten Gründen der Behauptung Plantingas nicht vorbehaltlos zustimmen, daß Menschen ihrem Wesen nach immateriell sind. Plantinga hat Recht, wenn er — z. B. im Gegensatz zu Leibniz — die Auffassung (...) vertritt, daß dasselbe Individuum in mehr als einer möglichen Welt existieren kann und daß — trotz Tooley — die Rede von möglichen Welten kohärent ist. Van Invagen hat gezeigt, daß Plantingas Version des ontologischen Gottesbeweises nicht sicherer ist als die von Leibniz und daß sie verwundbar bleibt durch eine Kritik Jerome Shaffers. Aber Plantinga hat Recht, wenn er Leibniz' Ansicht, Gott könne jede beliebige Welt schaffen, zurückweist und als „Leibniz' Fehler" abstempelt. (shrink)

The comorbidity of chronic pain and opioid addiction is a serious problem that has been growing with the practice of prescribing opioids for chronic pain. Neuroimaging research has shown that chronic pain and opioid dependence both affect brain structure and function, but this is the first study to evaluate the neurophysiological alterations in patients with comorbid chronic pain and addiction. Eighteen participants with chronic low back pain and opioid addiction were compared with eighteen age- and sex-matched healthy individuals in a (...) pain-induction fMRI task. Unified structural equation modeling (SEM) with Lagrange multiplier (LM) testing yielded a network model of pain processing for patient and control groups based on 19 a priori defined regions. Tests of differences between groups on specific regression parameters were determined on a path-by-path basis using z-tests corrected for the number of comparisons. Patients with the chronic pain and addiction comorbidity had increased connection strengths; many of these connections were interhemispheric and spanned regions involved in sensory, affective, and cognitive processes. The affected regions included those that are commonly altered in chronic pain or addiction alone, indicating that this comorbidity manifests with neurological symptoms of both disorders. Understanding the neural mechanisms involved in the comorbidity is crucial to finding a comprehensive treatment, rather than treating the symptoms individually. (shrink)

Institutional discrimination matters. The purpose of this longitudinal community‐based participatory research study was to examine institutional procedural discrimination, institutional racism, and other institutional discrimination, and their relationships with participants' health during a maternal and child health program in a municipal initiative. Twenty participants from nine multilingual, multicultural community‐based organizations were included. Overall reported incidences of institutional procedural discrimination decreased from April 2019 (18.6%) to November 2019 (11.8%) although changes were not statistically significant and participants reporting incidences remained high (n = (...) 15 in April and n = 14 in November). Participants reported experiencing significantly less “[when] different cultural ways of doing things were shared, the project did not support my way” from April 2019 (23.5%, n = 4) to November 2019 (0%, n = 0), Wilcoxon signed‐rank test Z = −2.00, p < 0.05. Some participants reported experiencing institutional racism (29.4%, n = 5) and other institutional discrimination (5.9%, n = 1). Participants experiencing institutional racism, compared to those who did not, reported a higher impact of the Initiative's program on their quality of life (t = 3.62, p < 0.01). Participatory survey designs enable nurse researchers to identify hidden pathways of institutional procedural discrimination, describe the impacts experienced, and examine types of institutional discrimination in health systems. (shrink)

Robin McKenna argues that we need to make space for an approach to epistemology that avoids the idealizations typical of the field. He applies this approach to topics in applied and social epistemology, such as what to do about science denial, whether we should try to be intellectually autonomous, and what our obligations are to other inquirers.

Science is not a great way to make money, or these days, even a job. But there are great riches in it, and in this book too. Tim Bradford, 'New Scientist'.

A model for the ideal state includes discussion of the nature and application of justice, the role of the philosopher in society, the goals of education, and the effects of art upon character.

In spite of advances in medicine and public health, malaria and other mosquito‐borne diseases are on the rise worldwide. Although vaccines, genetically modified mosquitoes and safer insecticides are under development, herein we examine a promising new approach to malaria control through better repellents. Current repellents, usually based on DEET, inhibit host finding by impeding insect olfaction, but have significant drawbacks. We discuss how comparative genomics, using data from the Anopheles genome project, allows the rapid identification of members of three protein (...) classes critical to insect olfaction: odorant‐binding proteins, G‐protein‐coupled receptors, and odorant‐degrading enzymes. A rational design approach similar to that used by the pharmaceutical industry for drug development can then be applied to the development of products that interfere with mosquito olfaction. Such products have the potential to provide more complete, safer and longer lasting protection than conventional repellents, preventing disease transmission by interrupting the parasite life cycle. BioEssays 25:1011–1020, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

Many of us hold false beliefs about matters that are relevant to public policy such as climate change and the safety of vaccines. What can be done to rectify this situation? This question can be read in two ways. According to the descriptive reading, it concerns which methods will be effective in persuading people that their beliefs are false. According to the normative reading, it concerns which methods we are permitted to use in the service of persuading people. Some effective (...) methods—a programme of brainwashing, say—would not be permissible. In this paper I compare “methods of rational persuasion” with what you might call “marketing methods” such as how one frames the problem of climate change. My aim is to show that “marketing methods” are preferable to “methods of rational persuasion”. My argument has two parts. First, I argue that the evidence suggests that “marketing methods” are more effective in persuading people to change their minds. Second, I argue that “marketing methods” are an acceptable response to the normative question. (shrink)

A translation of Plato's dialogue on the nature of pleasure and its relation to thought and knowledge. It includes a cogent introduction, notes, and comprehensive bibliography.

This text examines the intellectual partnership of Friedrich Nietzsche (1844-1900) and Paul Rée (1849-1901), combining biography with philosophy to give an account of a friendship that made major contributions to modern thought"--Provided by publisher.

In this paper I develop a version of contextualism that I call interests contextualism. Interests contextualism is the view that the truth-conditions of knowledge ascribing and denying sentences are partly determined by the ascriber’s interests and purposes. It therefore stands in opposition to the usual view on which the truth-conditions are partly determined by the ascriber’s conversational context. I give an argument against one particular implementation of the usual view, differentiate interests contextualism from other prominent versions of contextualism and argue (...) that, unlike those versions, interests contextualism can mitigate against the epistemic descent objection put forward by Duncan Pritchard in his ‘Contextualism, Scepticism, and the Problem of Epistemic Descent’ (the objection is that, on the contextualist view, an ascriber of knowledge cannot, for some subject S and proposition p, properly ascribe knowledge that p to S if that ascriber has previously retracted an earlier ascription of knowledge that p to S). (shrink)

I develop and argue for a version of epistemic contextualism - the view that the truth-values of ‘knowledge’ ascriptions depend upon and vary with the context in which they are uttered - that emphasises the roles played by both the practical interests of those in the context and the epistemic practices of the community of which they are part in determining the truth-values of their ‘knowledge’ ascriptions. My favoured way of putting it is that the truth of a ‘knowledge’ ascription (...) of the form ‘S knows that p’ requires that the subject of the ascription can rule out the relevant alternatives in which not-p, where the relevant alternatives are the ones that those in the ascriber’s context have a reason to consider. What alternatives those in the context have a reason to consider depends on their practical situation and on what alternatives are generally considered relevant within their community. I call this ‘interests contextualism’. The thesis splits into three parts. First, I deal with what I call ‘linguistic objections’, which purport to show that there’s no linguistic evidence that the expression ‘knows’ is context-sensitive, and objections concerning the way ‘knows’ behaves in intra- and inter-contextual disagreement reports. I argue that there are a number of ways in which contextualists can deal with these objections. Consequently, they provide no reason to reject contextualism. Second, there are a number of ways of going beyond the basic contextualist thesis, and I argue that the best way is along the lines indicated above, viz. interests contextualism. In the process I articulate a number of desiderata for a contextualist account of the features of context that are responsible for contextual variation in the truth-values of ‘knowledge’ ascriptions. I argue that, unlike its main rival - which I call ‘conversational contextualism’ - interests contextualism can satisfy all of the desiderata. Consequently, interests contextualism is preferable to conversational contextualism. Third, I argue that there is good reason to prefer interests contextualism to its noncontextualist rivals, strict invariantism, sensitive invariantism and relativism. The objections dealt with in the first part are meant to provide the main reason to prefer a sort of relativism to interests contextualism. Consequently, the upshot of the first part is that relativism is off the table. The considerations that tell in favour of interests contextualism and against sensitive invariantism are of two types. First, I argue that interests contextualism can deal with a wider range of cases than sensitive invariantism. Second, I argue that the influential account of the function of ‘knowledge’ ascriptions developed in Edward Craig tells against sensitive invariantism and in favour of interests contextualism. I also argue that the second consideration tells against strict invariantism as much as sensitive invariantism. Consequently, I conclude that interests contextualism is preferable to all of its rivals. (shrink)

How can Christian ethics make a significant contribution to health care ethics in today's Western, pluralistic society? Robin Gill examines the 'moral gaps' in secular accounts of health care ethics and the tensions within specifically theological accounts. He explores the healing stories in the Synoptic Gospels, identifying four core virtues present within them - compassion, care, faith and humility - that might bring greater depth to a purely secular interpretation of health care ethics. Each of these virtues is examined (...) in turn, using a range of topical issues including health care rationing, genetics, HIV/AIDS, withholding/withdrawing nutrition from PVS patients, and the empirical evidence which suggests a connection between religion and health. Professor Gill also argues that these four virtues are shared by other major religious and humanistic traditions and that, together with secular principles, they can enrich health care ethics even in a pluralistic society. (shrink)

Atheism has had a strong presence on YouTube since its founding in the mid-2000s, which coincided with the rise of the new atheism movement, and lay atheists were quick to use the platform to spread new atheist ideas. Drawing from a sample of sixty-five atheist YouTube channels located and observed through online ethnographic methods, this article views YouTube videos as educational resources for atheists. It investigates different types of educational videos and ways of thinking about science, philosophy, and religion that (...) atheist content creators utilize and promote. The analysis reveals that they consistently frame these domains of knowledge through the truth claims they make and generally construct them within a hierarchical framework, with scientific knowledge at the top and religious knowledge at the bottom. Overall, their educational content reproduces new atheist discourses around these subjects, revealing the continuing influence of new atheism, two decades after its emergence. Furthermore, the popularity of videos that debunk arguments from religious apologists suggests that the intended audience of these videos includes both atheists, who are expected to need to learn to defend their atheism in debate with religious others, and “potential atheists”, religious believers who can be deconverted using rational arguments. (shrink)

Arrogance is traditionally regarded as among the worst of human vices. Kant’s discussion of one kind of arrogance as a violation of the categorical moral duty to respect other persons gives familiar support for this view. However, I argue that what Kant says about the ways in which another kind of arrogance is opposed to different kinds of self-respect reveals how profoundly vicious arrogance can be. As a failure of self-respect, arrogance is the Ur-Vice that corrupts moral agency and rational (...) judgment. As its contrary, self-respect is thus morally vital: it is the first condition of the possibility of genuine moral agency and judgment. There are also important gender dimensions to arrogance: although women are called haughty, supercilious, disdainful, even imperious or presumptuous, they are rarely called arrogant, perhaps because arrogance is an exercise of power. I consider, then, whether despite the Kantian condemnation of it, something that is properly called "arrogance" might be, in contexts of oppression, a liberatory virtue of self-respect that oppressed peoples ought to cultivate. (shrink)

The authors study opera from the perspective of the theories of psychoanalyst Jacques Lacan, and argue that opera's second death corresponded with the rise of psychoanalysis in the early 20th century. With a preface by Lanfossi and an afterword by Alberto Toscano.

The concept of yinyang lies at the heart of Chinese thought and culture. The relationship between these two opposing, yet mutually dependent, forces is symbolized in the familiar black and white symbol that has become an icon in popular culture across the world. The real significance of yinyang is, however, more complex and subtle. This brilliant and comprehensive analysis by one of the leading authorities in the field captures the richness and multiplicity of the meanings and applications of yinyang, including (...) its visual presentations. Through a vast range of historical and textual sources, the book examines the scope and role of yinyang, the philosophical significance of its various layers of meanings and its relation to numerous schools and traditions within Chinese philosophy. By putting yinyang on a secure and clear philosophical footing, the book roots the concept in the original Chinese idiom, distancing it from Western assumptions, frameworks and terms, yet also seeking to connect its analysis to shared cross-cultural philosophical concerns. (shrink)

In Less Than Nothing, the pinnacle publication of a distinguished career, Slavoj i ek argues that it is imperative that we not simply return to Hegel but that we repeat and exceed his triumphs, overcoming his limitations by being even more ...

It is natural to think of remembering in terms of causation: I can recall a recent dinner with a friend because I experienced that dinner. Some fifty years ago, Martin and Deutscher (1966) turned this basic thought into a full-fledged theory of memory, a theory that came to dominate the landscape in the philosophy of memory. Remembering, Martin and Deutscher argue, requires the existence of a specific sort of causal connection between the rememberer's original experience of an event and his (...) later representation of that event: a causal connection sustained by a memory trace. In recent years, it has become apparent that this reference to memory traces may be out of step with memory science. Contemporary proponents of the causal theory are thus confronted with the question: is it possible to develop an empirically adequate version of the theory, or is it time to move beyond it? This chapter traces the recent history of the causal theory, showing how increased awareness of the theory’s problems has led to the development of modified version of the causal theory and ultimately to the emergence of postcausal theories. (shrink)

What responsibility do individuals bear for structural injustice? Iris Marion Young has offered the most fully developed account to date, the Social Connections Model. She argues that we all bear responsibility because we each causally contribute to structural processes that produce injustice. My aim in this article is to motivate and defend an alternative account that improves on Young’s model by addressing five fundamental challenges faced by any such theory. The core idea of what I call the “Role-Ideal Model” is (...) that we are each responsible for structural injustice through and in virtue of our social roles, i.e. our roles as parents, colleagues, employers, citizens, etc., because roles are the site where structure meets agency. In short, the Role-Ideal Model explains how individual action contributes to structural change, justifies demands for action from each particular agent, specifies what kinds of acts should be undertaken, moderates between demanding too much and too little of individual agents, and provides an account of the critical responses appropriate for holding individuals accountable for structural injustice. (shrink)

In this paper, we defend two main claims. The first is a moderate claim: we have a negative duty to not use binary gender-specific pronouns he or she to refer to genderqueer individuals. We defend this with an argument by analogy. It was gravely wrong for Mark Latham to refer to Catherine McGregor, a transgender woman, using the pronoun he; we argue that such cases of misgendering are morally analogous to referring to Angel Haze, who identifies as genderqueer, as he (...) or she. The second is a radical claim: we have a negative duty to not use any gender-specific pronouns to refer to anyone, regardless of their gender identity. We offer three arguments in favor of this claim (which appeal to concerns about inegalitarianism and risk, invasions of privacy, and reinforcing essentialist ideologies). We also show why the radical claim is compatible with the moderate claim. Before concluding, we examine common concerns about incorporating either they or a neologism such as ze as a third-person singular gender-neutral pronoun. These concerns, we argue, do not provide sufficient reason to reject either the moderate or radical claim. (shrink)

Gender classifications often are controversial. These controversies typically focus on whether gender classifications align with facts about gender kind membership: Could someone really be nonbinary? Is Chris Mosier really a man? I think this is a bad approach. Consider the possibility of ontological oppression, which arises when social kinds operating in a context unjustly constrain the behaviors, concepts, or affect of certain groups. Gender kinds operating in dominant contexts, I argue, oppress trans and nonbinary persons in this way: they marginalize (...) trans men and women, and exclude nonbinary persons. As a result, facts about membership in dominant gender kinds should not settle gender classification practices. (shrink)