Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

The U.S. Food and Drug Administration's rationale for supporting the development and approval of BiDil for heart failure specifically in black patients was based on under-powered, post hoc subgroup analyses of two relatively old trials , which were further complicated by substantial covariate imbalances between racial groups. Indeed, the only statistically significant difference observed between black and white patients was found without any adjustment for potential confounders in samples that were unlikely to have been adequately randomized. Meanwhile, because the accepted (...) baseline therapy for heart failure has substantially improved since these trials took place, their results cannot be combined with data from the more recent trial amongst black patients alone. There is therefore little scientific evidence to support the approval of BiDil only for use in black patients, and the FDA's rationale fails to consider the ethical consequences of recognizing racial categories as valid markers of innate biological difference, and permitting the development of group-specific therapies that are subject to commercial incentives rather than scientific evidence or therapeutic imperatives. This paper reviews the limitations in the scientific evidence used to support the approval of BiDil only for use in black patients; calls for further analysis of the V-HeFT I and II data which might clarify whether responses to H-I vary by race; and evaluates the consequences of commercial incentives to develop racialized medicines. We recommend that the FDA revise the procedures they use to examine applications for race-based therapies to ensure that these are based on robust scientific claims and do not undermine the aims of the 1992 Revitalization Act. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Mystery of Sacramentality:Christ, the Church, and the Seven SacramentsCharles JournetTranslated by Aaron D. Henderson, with Introduction and NoteOriginally: Charles Journet, "Le Mystère de la sacramentalité: Le Christ, l'Église, les sept sacrements," Nova et Vetera 49 (1974): 161–214.Translator's IntroductionThe thought of Charles Cardinal Journet, venerable founder of the present journal and unparalleled twentieth-century master of Thomistic ecclesiology, merits a wider reception and a more ardent love.1 Not (...) a few have recognized this of late, producing articles and books dedicated to explicating his teaching.2 Nevertheless, much remains to be done to ensure that English speakers have fuller access to Journet's corpus. For instance, only the first [End Page 611] volume of L'Église du Verbe incarné,3 his magnum opus, has been translated into English.4 It is with this in mind that we set out to translate the article below. And it is no meager article that is reproduced below (though such a work is foreign to Journet), but one of considerable substance and importance. After all, it is a wonderful (and wonderfully extensive) expression of his post-conciliar Christology, ecclesiology, and sacramental theology. Indeed, written in 1974, but one year before his death, this article represents the mature fruit of many years of contemplation and prayer.With respect to his ecclesiology, Journet was influenced by the Second Vatican Council, in which he participated after his elevation to the episcopacy and cardinalate. As an example of this influence, an influence evident in the article below, the conciliar documents speak in several places of the sacramentality of the Church.5 The Church is, in Christ, a sacrament, "a sign and instrument both of a very closely knit union with God and of the [End Page 612] unity of the whole human race."6 Describing the Church as a sacrament is part of the Council's effort to unfold for the Catholic faithful and for the whole world the Church's inner nature and universal mission. Following the teaching of the Council, therefore, Journet includes the Church herself, in her being and action, in "the mystery of sacramentality."7But the mystery of sacramentality includes more than the Church. Indeed, there is a respect in which the entire economy of salvation is sacramental. Furthermore, the Church is a sacrament (a sign and instrument) only in a derived sense, in a way wholly dependent on her divine Spouse and Head. It is for this reason that Journet refers to Christ as "the sacrament of the divine life in its source" and to the Church as "the sacrament of the divine life communicated." Both Christ and the Church, then, are sacraments, but not in precisely the same manner. As Journet puts it, "Now, to which of these two is the Second Vatican Council's definition, 'universal sacrament of salvation,' suited? To Christ and to his Church respectively, though proportionally (that is, analogically)."8Journet's systematic ordering (first Christ, then the Church, and finally the sacraments) is intelligible and consonant with others who suggest that, had St. Thomas written an ecclesiological treatise in the Summa theologiae, it would be situated between the questions on Christ (ST III, qq. 1–59) and the questions on the sacraments (ST III, qq. 60–90).9 Journet begins [End Page 613] his work, however, with a reality that he refuses to call a sacrament, namely, the Most Holy Trinity. The Trinitarian mystery stands at the heart of the Christian faith; it is the source of the mystery of sacramentality. We see the splendor of the entire economy of salvation, and of the New Law especially, in the mystery of the Trinitarian indwelling and missions of the Son and Spirit. The Word became flesh, became human, so that he might rescue our sin-ravaged world. Jesus is, in his sacred humanity, the sacrament of the Trinity, the sacrament of the divine life in its source, to employ again Journet's language.Journet describes the Word as seizing or taking hold of the depths of his sacred humanity in his being and in his action. The Gospels bear authoritative witness to this, but they... (shrink)

Medical-legal partnerships connect legal advocates to healthcare providers and settings. Maintaining effectiveness of medical-legal partnerships and consistently identifying opportunities for innovation and adaptation takes intentionality and effort. In this paper, we discuss ways in which our use of data and quality improvement methods have facilitated advocacy at both patient (client) and population levels as we collectively pursue better, more equitable outcomes.

This article documents and provides explanations for levels of and trends in earnings inequality, with a central focus on international differences in these outcomes. It concentrates on OECD countries, which are largely advanced industrialized nations, and typically have similar levels of labour productivity but often very different labour market institutions and changes in the supply of or demand for labour of various skill levels. As a result, one can use international differences to test hypotheses about the role of supply and (...) demand and institutions in influencing levels and trends in earnings inequality. The article first provides an analytical framework for understanding earnings inequality in which labour earnings are distinguished from wage rates. It then places inequality of wage rates in a supply and demand framework, augmented by consideration of labour market institutions. Next, after providing some data on the extent of earnings and wage inequality across countries and over time, it discusses evidence on the determinants of differences and changes in earnings inequality. (shrink)

Public health ethics, like the field of public health it addresses, traditionally has focused more on practice and particular cases than on theory, with the result that some concepts, methods, and boundaries remain largely undefined. This paper attempts to provide a rough conceptual map of the terrain of public health ethics. We begin by briefly defining public health and identifying general features of the field that are particularly relevant for a discussion of public health ethics.Public health is primarily concerned with (...) the health of the entire population, rather than the health of individuals. Its features include an emphasis on the promotion of health and the prevention of disease and disability; the collection and use of epidemiological data, population surveillance, and other forms of empirical quantitative assessment; a recognition of the multidimensional nature of the determinants of health; and a focus on the complex interactions of many factors—biological, behavioral, social, and environmental—in developing effective interventions. (shrink)

The prospect of using cell-based interventions to treat neurological conditions raises several important ethical and policy questions. In this target article, we focus on issues related to the unique constellation of traits that characterize CBIs targeted at the central nervous system. In particular, there is at least a theoretical prospect that these cells will alter the recipients' cognition, mood, and behavior—brain functions that are central to our concept of the self. The potential for such changes, although perhaps remote, is cause (...) for concern and careful ethical analysis. Both to enable better informed consent in the future and as an end in itself, we argue that early human trials of CBIs for neurological conditions must monitor subjects for changes in cognition, mood, and behavior; further, we recommend concrete steps for that monitoring. Such steps will help better characterize the potential risks and benefits of CBIs as they are tested and potentially used for treatment. (shrink)

While the bioethics literature demonstrates that the field has spent substantial time and thought over the last four decades on the goals, methods, and desired outcomes for service and training in bioethics, there has been less progress defining the nature and goals of bioethics research and scholarship. This gap makes it difficult both to describe the breadth and depth of these areas of bioethics and, importantly, to gauge their success. However, the gap also presents us with an opportunity to define (...) this scope of work for ourselves and to help shape the broader conversation about the impact of academic research. Because of growing constraints on academic funding, researchers and scholars in many fields are being asked to demonstrate and also forecast the value and impact of their work. To do that, and also to satisfy ourselves that our work has meaningful effect, we must understand how our work can motivate change and how that change can be meaningfully measured. In a field as diverse as bioethics, the pathways to and metrics of change will likewise be diverse. It is therefore critical that any assessment of the impact of bioethics research and scholarship be informed by an understanding of the nature of the work, its goals, and how those goals can and ought to be furthered. In this paper, we propose a conceptual model that connects individual bioethics projects to the broader goals of scholarship, describing the translation of research and scholarly output into changes in thinking, practice, and policy. One of the key implications of the model is that impact in bioethics is generally the result of a collection of projects rather than of any single piece of research or scholarship. Our goal is to lay the groundwork for a thoroughgoing conversation about bioethics research and scholarship that will advance and shape the important conversation about their impact. (shrink)

Nanomedicine is yielding new and improved treatments and diagnostics for a range of diseases and disorders. Nanomedicine applications incorporate materials and components with nanoscale dimensions where novel physiochemical properties emerge as a result of size-dependent phenomena and high surface-to-mass ratio. Nanotherapeutics and in vivo nanodiagnostics are a subset of nanomedicine products that enter the human body. These include drugs, biological products, implantable medical devices, and combination products that are designed to function in the body in ways unachievable at larger scales. (...) Nanotherapeutics andin vivonanodiagnostics incorporate materials that are engineered at the nanoscale to express novel properties that are medicinally useful. These nanomedicine applications can also contain nanomaterials that are biologically active, producing interactions that depend on biological triggers. Examples include nanoscale formulations of insoluble drugs to improve bioavailability and pharmacokinetics, drugs encapsulated in hollow nanoparticles with the ability to target and cross cellular and tissue membranes and to release their payload at a specific time or location, imaging agents that demonstrate novel optical properties to aid in locating micrometastases, and antimicrobial and drug-eluting components or coatings of implantable medical devices such as stents. (shrink)

Flesh of My Flesh is a collection of articles by today's most respected scientists, philosophers, bioethicists, theologians, and law professors about whether we should allow human cloning. It includes historical pieces to provide background for the current debate. Religious, philosophical, and legal points of view are all represented.

Qu'est-ce que la réalité? Jamais un état de fait. C'est une oeuvre. Une oeuvre d'art qui ne correspond qu'à un moment d'une mise en oeuvre dont nous sommes de plus en plus les maîtres d'oeuvre. C'est à partir de ce constat que l'auteur démontre implacablement l'inanité du réalisme. Ce qu'illustre à ses yeux aussi bien la révolution impressionniste, qui fit exploser le réalisme pictural, que le dépassement nécessaire de la confrontation matérialisme-idéalisme ou que le flamboiement de l'utopisme gaullien de 1940 (...) confronté au réalisme pétainiste. À travers cette thèse singulière et stimulante qui débouche sur une nouvelle approche de la philosophie et de l'histoire de son rapport au réel, Jean-François Kahn incite à de salutaires remises en question qui ne manqueront pas de faire grincer quelques dents. (shrink)

Ces études voudraient inviter le public francophone à la découverte de la philosophie de l'école de Marbourg et de son apport au site pratique de la philosophie. La réflexion morale, juridique et politique s'est trouvée fort enrichie par les écrits de Friedrich Albert Lange, Hermann Cohen et Paul Natorp. Ernst Cassirer a poursuivi la réflexion de ses maîtres en théorie de la connaissance, mais aussi dans le site pratique, ici dominé par un socialisme d'inspiration kantienne.

According to a common caricature of Kant’s ethics, it is synonymous with the Categorical Imperative (CI) and with the sublime and clarion call of duty. But in this paper, I argue that the conjunction of Kant’s concept of duty and his idea of morality as a system of imperatives is unsustainable on the grounds that it commits him to the following two theses: (I) If an agent has a duty to D, then she must be constrained to D, and (II) (...) the Supreme Law of Morality always manifests in the form of duty for humans. I begin by examining (and rejecting) various attempts to defend these two theses. I then explore how this bears on various central aspects of Kant's thought including “ought implies can” (OIC), “ought implies able not to” (OIAN), his system of duties, and the nature of respect. (shrink)

Quels peuvent être les enjeux contemporains d'une philosophie des valeurs dans le contexte éducatif? Quelles sont les valeurs éducatives convoquées dans les discours sur l'éducation aujourd'hui? Sur quels modes le sont-elles? Trois grandes parties structurent cet ouvrage : Philosophie de la valeur, Repenser les valeurs et Focus sur quelques valeurs. [Source : 4e de couv.].

Dans la Remarque générale sur l'exposition des jugements réfléchissants esthétiques, Kant formule une cinquième et dernière définition du beau, synthèse des quatre premières: „Schön ist das, was in der bloßen Beurtheilung gefällt.” Le texte de cette définition, donnant matière ultérieurement à des développements dans la Déduction des jugements esthétiques purs, doit être corrigé: la parenthèse explicative ne peut se comprendre telle quelle. Une sensation qui aurait lieu d'après un concept irait à l'encontre de l'ensemble des enseignements de la philosophie de (...) Kant. (shrink)

In a somewhat polemical article on ‘Solstices, Equinoxes, and the Presocratics’ D. R. Dicks has recently challenged the usual view that the Presocratics in general, and the Milesians in particular, made significant contributions to the development of scientific astronomy in Greece. According to Dicks, mathematical astronomy begins with the work of Meton and Euctemon about 430 B.C. What passes for astronomy in the earlier period ‘was still in the pre-scientific stage’ of ‘rough-and-ready observations, unsystematically recorded and imperfectly understood, of practical (...) men’ whose chief concern was to fix the seasons for ploughing, seed-time, sailing voyages and religious festivals. Ionian speculation, says Dicks, took very little note of such observation: ‘some of its wilder flights of fancy might have been avoided, if it had taken more’. In this account of the rise of Greek astronomy, the natural philosophers have no part to play. Their theories represent a speculative enterprise without a scientific future, a philosophic sideline with no impact on the development of observational science from Hesiod to Meton or the development of mathematical astronomy from Meton to Ptolemy.I believe that such a dichotomy between early philosophy and early science in Greece is misguided in principle, and that it seriously distorts our picture of the initial phases of each discipline. It also imposes a considerable strain upon our credulity. Take the case of Anaxagoras who, according to Plato and Theophrastus, had given a causal explanation of eclipses of the moon a generation before Meton. (shrink)

Dewi et Eka sont de vraies jumelles nées dans la province sud du Kalimantan, à Bornéo. La première est sauvée d’un effroyable incendie dans lequel tout le monde pense qu’a péri Eka. En fait, cette dernière a été récupérée par une femelle orang-outan qui l’élèvera. Dewi, elle, sera l’une des femmes les plus brillantes de sa génération, et recevra le prix Nobel de physiologie et médecine. Eka, quant à elle, bien que recueillie dans une société humaine à dix ans, restera (...) une enfant sauvage souffrant d’un grave retard mental. Elle mourra misérablement. Les deux soeurs ont pourtant les mêmes gènes. Comment Dewi a-t-elle pu développer les outils d’un brillant épanouissement pleinement humain, quelles en furent les étapes et les conditions? Pourquoi tout cela n’a-t-il pu s’enclencher chez Eka? Axel Kahn utilise la fiction pour introduire la thématique qu’il développe à travers un essai, s’attachant à enrichir, touche après touche, l’observation de ses héroïnes gémellaires dont l’image et l’exemple traversent l’ouvrage. Il rappelle le rôle de l’altérité de l’un et l’autre, comme deux bûches incandescentes qui s’embrasent l’une l’autre, et nous enjoint : «Osons vouloir, alors nous pourrons, peut-être.». (shrink)

Depuis l'aube des religions et de la philosophie, l'homme se penche sur l'essence de la nature humaine. Aux questions " Qu'est-ce que l'homme? " et " Qu'est-ce que la vie? " s'ajoute dorénavant cette interrogation " Que faisons-nous de nos connaissances? ". " Il faudrait être capable d'être à la hauteur de l'aventure humaine... Tel est le véritable enjeu de la révolution biologique. Elle nous contraint de revoir notre système de valeurs et nous oblige à redéfinir le statut de la (...) technique et de la connaissance. " Cet entretien réalisé par Christian Godin, de deux personnalités reconnues pour leurs compétences, l'un comme biologiste, l'autre comme philosophe est un dialogue sur leurs différends : le scientifique demande une définition de normes bioéthiques, le philosophe s'inquiète de règles pouvant entraver la liberté de recherche. Mais l'un et l'autre tentent de répondre à " l'inquiétude sociale se développant autour des sciences " selon l'expression de Dominique Lecourt. (shrink)

" Nous sommes, en tant qu'Homo sapiens, d'une affligeante banalité biologique. Sur le plan génétique, notre proximité avec les grands singes est considérable ; elle atteint 98,7 % avec le chimpanzé, elle est encore de 80 % avec la souris et de 50 % avec la levure. " Pourtant, seuls parmi les êtres vivants, nous nous interrogeons sur notre nature et sur la valeur de nos actes. Ce paradoxe, au cœur du questionnement philosophique depuis des millénaires, est ici revisité à (...) l'aide des données croisées de la théorie de l'évolution, de la génétique et des sciences cognitives, à la recherche du " propre de l'homme ". Avec L'Homme, ce roseau pensant..., Axel Kan clôt la trilogie qui a fait sa renommée littéraire et son succès, entamée avec Et l'homme dans tout ça? suivi de Raisonnable et humain? Comme toujours, il propose une approche pluridisciplinaire, à la fois érudite et accessible à tous les lecteurs. (shrink)

YVES CHARLES ZARKA. — Vous affirmez, au début de votre livre L’homme ce roseau pensant : « Ma réflexion s’intégrera à une vision matérialiste, évolutionniste, darwinienne et moniste, mais non réductionniste. » Comme vous le savez, bon nombre de vos collègues se réclament d’une approche réductionniste,...

This volume is a Festschrift dedicated to Charles Kahn comprised of more than 20 papers presented at the conference "Presocratics and Plato: Festschrift Symposium in Honor of Charles Kahn", 3-7 June 2009. The conference was held at the European Cultural Center of Delphi, Greece, and was organized and sponsored by the HYELE Institute for Comparative Studies and Parmenides Publishing, with endorsement from the International Plato Society, and the Dean of the School of Arts and Sciences, University of Pennsylvania. Contributors: Julia (...) Annas - University of Arizona; Sarah Broadie - University of St. Andrews; Lesley Brown - University of Oxford; Tomás Calvo-Martínez - Universidad Complutense de Madrid; Diskin Clay - Duke University; John M. Dillon - Trinity College, Dublin; Dorothea Frede - Humbolt University, Berlin; Arnold Hermann - HYELE Institute for Comparative Studies; Carl A. Huffman - DePauw University; Enrique Hülsz Piccone - Universidad Nacional Autonoma de Mexico; D.M. Hutchinson - St. Olaf College; Paul Kalligas - National and Kapodistrian University, Athens; Vassilis Karasmanis - National Technical University, Athens; Aryeh Kosman - Haverford College; Anthony A. Long - University of California, Berkeley; Richard McKirahan - Pomona College; Susan Sauvé Meyer - University of Pennsylvania; Alexander P.D. Mourelatos - University of Texas at Austin; Satoshi Ogihara - Tohoku University, Japan; Richard Patterson - Emory University; Christopher J. Rowe - Durham University; David Sedley - University of Cambridge; Richard Sorabji - University of Oxford. (shrink)

We study here the reception by their contemporaries of Antoine de Villon's and étienne de Clave's anti-Aristotelian, almost materialistic and atomistic theses, which they intended to support publicly in Paris in 1624, using chemical experiments to this purpose. After surveying the intellectual context which could have then nourished an atomism based upon chemical experiments, we go on to show how these theses, far from having been perceived as prominently atomistic, were condemned by the contemporaries above all because of the theological (...) implications of their provocative anti-Aristotelism. Alchemy itself was not directly implicated in the case of the theses. On the contrary, the theses were perceived as an alien body within the alchemical tradition. (shrink)