Recent studies of early development in a number of ivertebrate and vertebrate species have suggested that growth factors and their receptors may play important roles in differentiation as well as cell proliferation. In the mouse embryo, the expression of the receptors for insulin and insulin‐like growth factors I and II (IGF‐I and ‐II) are temporally regulated. The ontogeny of receptor and ligand expression within the insulin and IGF gene family suggests that the very earliest stages of mammalian embryogenesis may be (...) subject to regulation by autocrine and paracrine factors from maternal and embryonic sources. (shrink)

Violence and the Remaking of a Self Susan J. Brison. Political activism (including lobbying for new legislation, speaking out, educating others, helping survivors) can also help to undo the double bind of self-blame versus helplessness.

____The Rejected Body__ argues that feminist theorizing has been skewed toward non-disabled experience, and that the knowledge of people with disabilities must be integrated into feminist ethics, discussions of bodily life, and criticism of the cognitive and social authority of medicine. Among the topics it addresses are who should be identified as disabled; whether disability is biomedical, social or both; what causes disability and what could 'cure' it; and whether scientific efforts to eliminate disabling physical conditions are morally justified. Wendell (...) provides a remarkable look at how cultural attitudes towards the body contribute to the stigma of disability and to widespread unwillingness to accept and provide for the body's inevitable weakness. (shrink)

Rural landscapes are facing a loss of biodiversity. To deal with this challenge, landscape governance is seen as an alternative and addition to sectoral policies and a potential way of realizing transformative change for biodiversity. To study transformative change in the Bulb Region, the Netherlands, this study uses a discursive-institutional perspective. A mixed methods approach was used including 50 interviews, participant observation and document analysis. The structuration and institutionalization of three competing landscape discourses were analyzed: a hegemonic discourse rejecting any (...) changes in bulb farming; an emerging discourse aiming to enhance sustainability through innovation; and an unstructured discourse questioning the sustainability of bulb farming. The paper shows that the emerging sustainability discourse strengthens the hegemonic discourse by providing an action repertoire for farmers to deal with changing societal demands, while not questioning the hegemonic view on the landscape. Moreover, an institutionalized landscape discourse can be very stable if discursive (relation between naturalized landscape perspectives, identity and the articulated economic interests) and non-discursive factors (natural-spatial conditions, structure of agricultural sector, embeddedness in international trade) are strongly intertwined, leaving little room for alternative discourses. The sustainability discourse was induced by changes outside the Bulb Region (e.g., legislation), thus raising the question whether landscapes are the appropriate level to expect the initiation of transformative change. For rural transformations to come about, solely relying on policies on the landscape level is not sensible. A mix of policies at both the landscape and higher levels offers more perspective for transformative change. (shrink)

The deliberative turn in political philosophy sees theorists attempting to ground democratic legitimacy in free, rational, and public deliberation among citizens. However, feminist theorists have criticized prominent accounts of deliberative democracy, and of the public sphere that is its site, for being too exclusionary. Iris Marion Young, Nancy Fraser, and Seyla Benhabib show that deliberative democrats generally fail to attend to substantive inclusion in their conceptions of deliberative space, even though they endorse formal inclusion. If we take these criticisms seriously, (...) we are tasked with articulating a substantively inclusive account of deliberation. I argue in this article that enriching existing theories of deliberative democracy with Fricker's conception of epistemic in/justice yields two specific benefits. First, it enables us to detect instances of epistemic injustice, and therefore failures of inclusion, within deliberative spaces. Second, it can act as a model for constructing deliberative spaces that are more inclusive and therefore better able to ground democratic legitimacy. (shrink)

While information technologies present organizations with opportunities to become more competitive, unsettled social norms and lagging legislation guiding the use of these technologies present organizations and individuals with ethical dilemmas. This paper presents two studies investigating the relationship between intellectual property and privacy attitudes, Machiavellianism and Ethical Ideology, and working in R&D and computer literacy in the form of programming experience. In Study 1, Machiavellians believed it was more acceptable to ignore the intellectual property and privacy rights of others. Programmers (...) and R&D workers considered violating intellectual property rights more acceptable. Programmers did not consider violating privacy rights more acceptable, but R&D workers did. Finally, there was an interaction between Machiavellianism, programming and R&D. Machiavellians who also had programming experience or worked in R&D found violations of intellectual property much more acceptable. The effect of Machiavellianism on attitudes toward violations of privacy was enhanced by working in R&D, but not by programming experience. In Study 2, idealists believed it was less acceptable to ignore the intellectual property and privacy rights of others. Relativists found it more acceptable to violate intellectual property rights, though they did not consider it more acceptable to violate privacy rights. Those with programming experience were more accepting of intellectual property rights violations, but not of privacy violations. Finally, programming experience moderated the relationship between idealism, relativism and attitudes toward these unethical information practices. Implications for diminishing unethical behavior among Machiavellians, Relativists, programmers and those in R&D are discussed. (shrink)

We recognize a paradox of power and promise in the context of legislative and organizational changes in nurse regulation which poses constraints on nursing's capacity to bring voice and influence to pressing matters of healthcare and public policy. The profession is at an important crossroads wherein leaders must be well informed in political, economic and legislative trends to harness the profession's power while also navigating forces that may put at risk its central mission to serve society. We present a critical (...) policy analysis of the impact of recent regulatory trends on what the International Council of Nurses considers nursing's three ‘pillars’ – the profession of nursing, socioeconomic welfare of nurses and nurse regulation. Themes surfacing from this analysis include regulatory discontinuity, a tightening of regulatory control, and an increasingly managerial governance culture. These themes illuminate insights and strategies required to renew and revitalize the social mandate of our profession amidst a climate of urgency in the questioning of nurse scholars with respect to the future of the profession. At this historic juncture, nurses must clearly understand the implications of legislative and organizational regulatory changes to ensure the profession contributes to full capacity in achieving health and health equity globally. (shrink)

Many philosophers have been persuaded that if we don’t create our own characters, we cannot be responsible for acts that flow from our characters; they also raise doubts about whether acts that do not flow from our characters can fairly be attributed to us. Both these concerns, however, reflect a simplistic and implausible conception of character and of its relation to our actions and our selves. I suggest a different relationship between character and responsibility: We can be responsible for acts (...) that are in character and also for acts that are out of character, but to be capable of being responsible at all is closely related to the capacity to have a character. I relate this capacity to the exercise of active intelligence—a capacity that is manifested in actions in or out of character, but not in the display of many psychological conditions or disorders. (shrink)

Background Dynamic consent has been proposed as a process through which participants and patients can gain more control over how their data and samples, donated for biomedical research, are used, resulting in greater trust in researchers. It is also a way to respond to evolving data protection frameworks and new legislation. Others argue that the broad consent currently used in biobank research is ethically robust. Little empirical research with cohort study participants has been published. This research investigated the participants’ opinions (...) of adding a dynamic consent interface to their existing study. Methods Adult participants in the Extended Cohort for E-health, Environment and DNA longitudinal cohort study who are members of the EXCEED Public and Participant Engagement Group were recruited. Four focus groups were conducted and analysed for thematic content. Discussion topics were derived from a review of the current literature on dynamic consent. Results Participants were in favour of many aspects of a dynamic consent interface, such as being able to update their information, add additional data to their records and choose withdrawal options. They were supportive provided it was simple to use and not intrusive. Participants expressed a markedly high level of trust in the study and its investigators and were unanimously happy with their current participation. No strong support was found for adding a dynamic consent interface to EXCEED. Conclusions Trust in the study researchers was the strongest theme found. Openness and good data security were needed to retain their trust. While happy to discuss dynamic consent, participants were satisfied with the current study arrangements. There were indications that changing the study might unnecessarily disturb their trust. This raised the question of whether there are contexts where dynamic consent is more appropriate than others. This study was limited by the small number of participants who were committed to the study and biased towards it. More research is needed to fully understand the potential impact of adding a dynamic consent interface to an existing cohort study. (shrink)

Pragmatism and Justice is an interdisciplinary volume of new and seminal essays by political philosophers, social theorists, and scholars of pragmatism which provides a comprehensive introduction and lasting resource for scholars of pragmatist thought and questions of justice.

Health care reform proposals threaten to exacerbate tensions physicians already face in trying to balance traditional duties to individual patients against increasing pressure to serve broader societal and institutional goals. To cope with reform, medical ethics must clarify physicians' moral obligations, change existing ethical codes, and develop an ethics of institutions.

This work examines the evolution of law and legal method, and challenges the law's claim to neutrality by examining its role in creating and reproducing inequality between the sexes. It considers many of the current debates, and in each, the law is stated with reference to recent developments in statute and judicial decisions in the UK and other jurisdictions. The author illustrates how each issue is shaped by the current political climate and, where relevant, by the European Court. Reference is (...) also made to US and Australian case law. The book should be of interest to students studying women and the law, family law, criminal law and jurisprudcence, as well as those on criminology and sociology courses. It should also be useful to family and criminal practitioners. (shrink)

We examined the effects of three different training conditions, all of which involve the motor system, on kindergarteners’ mental transformation skill. We focused on three main questions. First, we asked whether training that involves making a motor movement that is relevant to the mental transformation—either concretely through action or more abstractly through gestural movements that represent the action —resulted in greater gains than training using motor movements irrelevant to the mental transformation. We tested children prior to training, immediately after training, (...) and 1 week after training, and we found greater improvement in mental transformation skill in both the action and move-gesture training conditions than in the point-gesture condition, at both posttest and retest. Second, we asked whether the total gain made by retest differed depending on the abstractness of the movement-relevant training, and we found that it did not. Finally, we asked whether the time course of improvement differed for the two movement-relevant conditions, and we found that it did—gains in the action condition were realized immediately at posttest, with no further gains at retest; gains in the move-gesture condition were realized throughout, with comparable gains from pretest-to-posttest and from posttest-to-retest. Training that involves movement, whether concrete or abstract, can thus benefit children's mental transformation skill. However, the benefits unfold differently over time—the benefits of concrete training unfold immediately after training ; the benefits of more abstract training unfold in equal steps immediately after training and during the intervening week with no additional training. These findings have implications for the kinds of instruction that can best support spatial learning. (shrink)

Quine and Putnam argued for mathematical realism on the basis of the indispensability of mathematics to science. They claimed that the mathematics that is used in physical theories is confirmed along with those theories and that scientific realism entails mathematical realism. I argue here that current theories of confirmation suggest that mathematics does not receive empirical support simply in virtue of being a part of well confirmed scientific theories and that the reasons for adopting a realist view of scientific theories (...) do not support realism about mathematical entities, despite the use of mathematics in formulating scientific theory. (shrink)

To reassure those concerned about wholesale discontinuity between human existence and posthumanity, transhumanists assert shared ground with antiquity on vital challenges and aspirations. Because their claims reflect key misconceptions, there is no shared vision for transhumanists to invoke. Having exposed their misuses of Prometheus, Plato, and Aristotle, I show that not only do transhumanists and antiquity crucially diverge on our relation to ideals, contrast-dependent aspiration, and worthy endeavors but that illumining this divide exposes central weaknesses in transhumanist argumentation. What is (...) more, antiquity’s handling of these topics suggests a way through the impasse in current enhancement debates about human “nature” and helps to resolve a tension within transhumanists’ accounts of what our best moments signify about the ontological requirements for real flourishing. (shrink)

La distinction de droit pénal entre la conduitemalum in seetmalum prohibitumest vieille de cinq siècles dans les juridictions de common law, et pourtant son sens autant que son utilité continuent d’être débattus. Je me joins à la mêlée, en faisant valoir que les conditions ne peuvent pas être interprétées littéralement, mais que il existe un moyen d’établir la distinction qui est à la fois plausible et utile. Une conduitemala in seest un comportement quidoitêtre interdit dans toute société politique juste, alors (...) que la conduitemala prohibita peutêtre criminalisée, mais nedoitpas absolument l’être. Je sollicite dans mon explication des concepts de la théorie du contrat social. (shrink)

The population of most non-dominant ethnic groups in the USA is growing dramatically. Faculty members are challenged to develop curricula that adequately prepare our future nurses. An increased focus on clinical ethics has resulted from the use of sophisticated technology, changes in health care financing, an increasing elderly population and the shift of care from inpatient to outpatient settings. Nurses frequently face situations demanding resolution of ethical dilemmas involving cultural differences. Nursing curricula must include content on both ethics and cultural (...) sensitivity. Active student participation is an important element providing a foundation for ethical practice. A proposed educational format was introduced with graduating baccalaureate students. In a pilot study, curricular content on cultural sensitivity and ethical practice was taught in separate modules. Students were then asked to identify and problem solve an ethical dilemma involving patients and professional caregivers from vastly different cultures. Course faculty members provided discussion questions to guide the students' thinking. (shrink)

Re-consent in research, the asking for a new consent if there is a change in protocol or to confirm the expectations of participants in case of change, is an under-explored issue. There is little clarity as to what changes should trigger re-consent and what impact a re-consent exercise has on participants and the research project. This article examines applicable policy statements and literature for the prevailing arguments for and against re-consent in relation to longitudinal cohort studies, tissue banks and biobanks. (...) Examples of re-consent exercises are presented, triggers and non-triggers for re-consent discussed and the conflicting attitudes of commentators, participants and researchers highlighted. We acknowledge current practice and argue for a greater emphasis on ‘responsive autonomy,’ that goes beyond a one-time consent and encourages greater communication between the parties involved. A balance is needed between respecting participants' wishes on how they want their data and samples used and enabling effective research to proceed. (shrink)

Developing ethical standards for clinical use of large-scale genome and exome sequencing has proven challenging, in part due to the inevitability of incidental or secondary findings. Policy of the American College of Medical Genetics and Genomics has evolved but remains problematic. In 2013, ACMG issued policy recommending mandatory analysis of 56 extra genes whenever sequencing was ordered for any indication, in order to ascertain positive findings in pathogenic and actionable genes. Widespread objection yielded a 2014 amendment allowing patients to opt-out (...) from analysis of the extra genes. In 2015, ACMG published the amended policy, providing that patients could opt out of the full set of extra genes, but not a subset. In 2016, ACMG enlarged the set and indicated planned expansion of the roster of extra genes to include pharmacogenetic findings. ACMG policy does not protect the respect for patient choice that prevails in other domains of clinical medicine, where informed consent allows patients to opt in to desired testing. By creating an expanding domain of genomic testing that will be routinely conducted unless patients reject the entire set of extra tests, ACMG creates an exceptional domain clinical practice that is not supported by ethics or science. (shrink)

Successful preimplantation genetic diagnosis to avoid creating a child affected by a genetically-based disorder was reported in 1989. Since then PGD has been used to biopsy and analyze embryos created through in viuo fertilization to avoid transferring to the mother’s uterus an embryo affected by a mutation or chromosomal abnormality associated with serious illness. PGD to avoid serious and early-onset illness in the child-to-be is widely accepted. PGD prevents gestation of an affected embryo and reduces the chance that the parents (...) will be faced with a difficult decision of whether to terminate the pregnancy. More controversial have been PGD to select the sex of the child-to-be for “family balancing”, PGD for mere susceptibility to disease and for late-onset disorders such as Alzheimer diseas, and most controversially, PGD to create a donor child who is Human Leukocyte Antigen (HLA-matched with a preexisting sibling in need of stem cell transplant. (shrink)

Advocates of cognitive enhancement maintain that technological advances would augment autonomy indirectly by expanding the range of options available to individuals, while, in a recent article in this journal, Schaefer, Kahane, and Savulescu propose that cognitive enhancement would improve it more directly. Here, autonomy, construed in broad procedural terms, is at the fore. In contrast, when lauding the goodness of enhancement expressly, supporters’ line of argument is utilitarian, of an ideal variety. An inherent conflict results, for, within their utilitarian frame, (...) the content of rational, hence autonomous, choices is quite restricted. Further, advocates do not clearly indicate their relative emphasis between the often conflicting goals of maximizing benefit and avoiding harm. In practice, their construction of harms is highly expansive, for disabilities include any constraints that “rational” people would decline if it were technically possible to do so. For advocates, this means that where enhancement measures are available, those constraints become avoidable limitations, and not to remove them is to harm. The centrality of harm-avoidance and their ideal utilitarian frame entail sociopolitical requirements that enhancement defenders disallow when trumpeting autonomy in the vein of individual choice. Advocates have thus not done enough to support the claim that their views are wholly separate from earlier eugenics. (shrink)

This is the second paper in the invited collection. Dieleman provides an overview of the “state-of-the-field” debate between Analytic Social Epistemology, represented by Alvin Goldman, and what Dieleman calls the Sociological Social Epistemology, represented by Steve Fuller. In response to this ongoing debate, this paper has two related and complementary objectives. The first is to show that the debate between analytic and sociological versions of social epistemology is overly simplistic and doesn’t take into account additional positions that are available and, (...) indeed, have been available since social epistemology was introduced in the mid to late 1980s. The second is to uncover and tell a story of how Lorraine Code’s Epistemic Responsibility is one such additional position. Looking to Code's Epistemic Responsibility reveals the artificiality of the debate between analytic and sociological social epistemologists. (shrink)

Where research was once strictly confined to one laboratory or office, investigators now widely share and compare their plans, analyses, and results. With the advent of genomic knowledge, researchers are seeking to understand the genetics and genomics of complex human disease. They are combining their efforts into international consortia in order to take on problems that face individuals around the world, such as cancer and malaria — problems that are too large to solve by one country alone. These consortia bring (...) together diverse research groups from different parts of the world to focus on a common goal. Their projects may all focus on one disease or condition, but examine it from different perspectives and share the newly gained information with each other and the wider scientific community. (shrink)

The most contentious issue in current debates about human enhancement is whether it properly belongs to human aspiration to outstrip our human ceiling in cognition and longevity so radically that the result would not be improved human beings but instead "posthumans." Transhumanists answer strongly in the affirmative and hence vigorously support our directing available and foreseeable technologies to that end. According to Nick Bostrom, transhumanism is "an outgrowth of secular humanism and the Enlightenment." Our "ceasing to be human is [not] (...) in any way problematic" as long as we are "replaced by something better".Of the two main lines of technological approach that... (shrink)

Hobbes's central insight about ethics was that it should not be understood to require that we make ourselves a prey for others. It is this insight that both varieties of contractarianism [Hobbesian and Kantian] respect. Consider a relationship between two human beings that exists for reasons of either love or duty; let us also suppose that it is a relationship that can be instrumentally valuable to both parties. In order for that relationship to receive our full moral endorsement, we must (...) ask whether either party uses the duty or the love connecting them in a way that affects the other party's ability to realize the instrumental value from that relationship. To be sure, good marriages and good friendships ought not to be centrally concerned with the question of justice, but they must also be, at the very least, relationships in which love or duty are not manipulated by either party in order to use the other party to her detriment. (shrink)