This paper contends that eating shapes the self; that is, our practices and understandings of eating can cultivate, reinforce, or diminish important aspects of the self, including agency, values, capacities, affects, and self-understandings. I argue that these self-shaping effects should be included in our ethical analyses and evaluations of eating. I make a case for this claim through an analysis and critique of the hypothesis that young women’s vegetarianism is a risk, sign, or “cover” for eating disorders or disordered eating. (...) After outlining the relevant empirical literature, I suggest that the evidence for this hypothesis is inconclusive. Given this uncertainty, we should consider the risks of making a mistake when accepting or rejecting this understanding of young women’s eating. I argue that these risks importantly include negative effects on the self, such as damage to moral and epistemic agency. Along with other potential consequences of mistakenly accepting the hypothesis, these effects give us reason to reject it pending more conclusive research. Overall, this paper offers a philosophical intervention into the debate over the relationship between vegetarianism and eating disorders while illustrating the ethical importance and relevance of eating as a self-shaping activity. (shrink)

In an effort to address healthcare disparities in lesbian, gay, bisexual, transgender, and queer populations, many hospitals and clinics institute diversity training meant to increase providers’ awareness of and sensitivity to this patient population. Despite these efforts, many healthcare spaces remain inhospitable to LGBTQ patients and their loved ones. Even in the absence of overt forms of discrimination, LGBTQ patients report feeling anxious, unwelcome, ashamed, and distrustful in healthcare encounters. We argue that these negative experiences are produced by a variety (...) of subtle, ostensibly insignificant features of healthcare spaces and interpersonal interactions called microaggressions. Healthcare spaces and providers often convey heteronormative microaggressions, which communicate to LGBTQ—and, we suggest, intersex and asexual —people that their identities, experiences, and relationships are abnormal, pathological, unexpected, unwelcome, or shameful. We identify heteronormative microaggressions common to healthcare settings and specify how they negatively impact LGBTQIA patients. We argue that standard diversity training cannot sufficiently address heteronormative microaggressions. Despite these challenges, healthcare institutions and providers must take responsibility for heteronormative microaggressions and take steps to reduce their frequency and mitigate their effects on LGBTQIA care. We conclude by offering strategies for problem-solving at the level of medical education, institutional culture and policy, and individual awareness. (shrink)

This paper offers a defense of the practice of mindless eating. Popular accounts of the practice suggest that it is non-autonomous and to blame for many of society’s food related problems, including the so-called obesity epidemic and the prevalence of diet related illnesses like diabetes. I use Maureen Sie’s “traffic participation” account of agency to argue that some mindless eating is autonomous, or more specifically, agential. Insofar as we value autonomous eating, then, it should be valued. I also argue that (...) mindless eating can be substantively good: it can help us achieve valuable ends, like creating and maintaining community. Acknowledging the agency and value in mindless eating has both practical and ethical benefits. I contend that it can help us preserve the value in mindless eating while suggesting more effective ways to change it, and, by offering a new narrative about mindless eaters, may be less damaging to agency than popular narratives. (shrink)

Although “you are what you eat” is a well-worn cliché, personal identity does not figure prominently in many debates about the ethics of eating interventions. This paper contributes to a growing philosophical literature theorizing the connection between eating and identity and exploring its implications for eating interventions. I explore how “identity-policing,” a key mechanism for the social constitution and maintenance of identity, applies to eating and trace its ethical implications for eating interventions. I argue that identity policing can be harmful (...) and that eating interventions can subject people to these harms by invoking identity policing qua intervention strategy or by encouraging people to eat in ways that subject them to policing from others. While these harms may be outweighed by the benefits of the intervention being promoted, they should nonetheless be acknowledged and accounted for. To aid in these evaluations, I consider factors that modulate the presence and severity of identity-policing and discuss strategies for developing less harmful eating interventions. I conclude by considering the relationship between identity-policing and identity loss caused by long-term diet change. This paper contributes to the centering of identity in food ethics and to a more comprehensive picture of identity’s ethical importance for eating interventions. (shrink)

I am a feminist bioethicist whose work focuses on the ethics of eating. Though COVID-19 is not a foodborne illness, it has had significant impacts on eating around the world, including increases in food insecurity, dining restrictions and closures of restaurants, interruptions in supply chains, and rising food prices. Many people have been eating at home more often—some alone, others with members of their households—and emotional or stress eating is on the rise.A feminist perspective is indispensable for understanding and responding (...) appropriately to these changes. The costs of these changes have not been distributed equally, and drawing attention to how disproportionate harm tracks gendered and intersectional... (shrink)

It is a common practice for family members to bring food to hospitalized loved ones. However, in some cases, this food contravenes a patient's dietary plan. Such situations can create significant tension and distrust between health care professionals and families and may lead the former to doubt a family's willingness or ability to support patient recovery. This case‐study essay offers an ethical analysis of these situations. We draw on Hilde Lindemann's work to argue that providing food to family members is (...) an important way that families discharge their moral functions of caring for their members and holding them in their identities. When family members are hospitalized, other means of performing these functions are limited. Acknowledging the ethical importance of feeding family members alongside the medical need for dietary restrictions, we offer strategies for creative problem‐solving that center diet as a subject for shared decision‐making and regular, ongoing communication among health care professionals, patients, and families. (shrink)

Drawing on the relation between disciplinary power and aesthetics, Honi Fern Haber argues that the muscled woman’s “revolting” body undermines patriarchy and empowers women. Consequently, female bodybuilding can be a Foucauldian and feminist practice of resistance. I will argue that Haber’s insistence on the visibility of embodied resistance is flawed. By positing a static goal and failing to sufficiently consider non-visible aspects of normalization, namely pleasure and pain, Haber risks reinscribing the muscled woman into yet another normalizing scheme. In the (...) light of recent work on Foucault's ethics and embodied resistance, I suggest that weight lifting may be more successfully recommended as a practice of resistance when undertaken to increase capacities and for the pleasure of the activity itself. (shrink)

As philosophers, we may be accustomed to asking ourselves—or at least having to explain to others—why we do philosophy. In Categories We Live By: The Construction of Sex, Gender, Race, and Other So...

This paper argues that common social narratives about unhealthy eaters can cause significant damage to agency. I identify and analyze a narrative that combines a “control model” of eating agency with the healthist assumption that health is the ultimate end of eating. I argue that this narrative produces and enables four types of damage to the agency of those identified as unhealthy eaters. Due to uncertainty about what counts as healthy eating and various forms of prejudice, the unhealthy eater label (...) and its harms to agency are more likely to stick to some people than others and may reinforce patterns of oppression. I argue that fat people are especially vulnerable to this identification and the damage it can do. I then consider possible “counterstories” about unhealthy eaters, alternative narratives that might be less damaging to agency than the control narrative. I identify one promising counterstory but suggest that it may be limited when it comes to repairing damage to the agency of fat people. Overall, this paper illustrates some of the complex ways that healthism about eating affects agency, and emphasizes the ethical importance of the ways we think about and discuss eating and eaters. (shrink)

Based on the poem by Saint Augustine "The Beauty of Creation Bears Witness to God," this is a story about how the author's son, Nick, sees the wonderful presence of God in nature, and how the wonder of Nick himself shines through the story of his wonder watching.

We likely do not need to convince readers of this journal that “obesity” is a topic of great contemporary importance.1 Claims about the “rapidly growing” prevalence of overweight and obese people worldwide (World Health Organization (WHO) Consultation on Obesity 2000), the threat that obesity poses to individuals’ and especially children’s health (Mauro et al. 2008, 173; Centers for Disease Control and Prevention 2014a; World Health Organization (WHO) Consultation on Obesity 2000; World Health Organization 2014; Centers for Disease Control and Prevention (...) 2014c), and the “enormous economic burden” that overweight and obese people place on healthcare systems and governments (Mauro et al. 2008, 173; Centers for .. (shrink)

ABSTRACT:This paper offers a novel argument for the claim that "environmental" explanations of obesity meant to help address racial health disparities may actually reinforce racism. While some contend that these explanations reinforce racist and sizeist interracial dynamics, we argue that environmental explanations can bolster intraracial hierarchies of whiteness that reinforce white supremacy. Deployments of environmental accounts in contexts like the U.S. invoke and intertwine two damaging dichotomies: the "good fatty/bad fatty" and the "good white person/bad white person." This supports a (...) cultural system that oppresses people of color and enables thin, white proponents to position themselves as "good white people" against those who deploy racist, moralizing accounts of obesity, and against fat white people, who are implicitly framed as morally inferior. This analysis furthers our understanding of racist and sizeist discourse about fatness and the insidious ways that attempts to address racism can reinforce it. (shrink)

Lack of time is a commonly reported barrier to healthy eating, but a literal lack of time is only one way that time may compromise eating well. This article explores how the first-personal lived experience of time shapes and is shaped by eating. I draw upon phenomenology and feminist theory to argue that the dynamic relationship between eating and temporality matters for food ethics. Specifically, temporalities and related ways of eating can be better or worse vis-à-vis key ethical concerns. I (...) highlight the possibility of altering temporalities through strategic eating and consider implications for individual food choice and structural change. (shrink)

The covert administration of medication occurs with incapacitated patients without their knowledge, involving some form of deliberate deception in disguising or hiding the medication. Covert medication in food is a relatively common practice globally, including in institutional and homecare contexts. Until recently, it has received little attention in the bioethics literature, and there are few laws or rules governing the practice. In this paper, we discuss significant, but often overlooked, ethical issues related to covert medication in food. We emphasise the (...) variety of ways in which eating has ethical importance, highlighting what is at risk if covert administration of medication in food is discovered. For example, losing trust in feeders and food due to covert medication may risk important opportunities for identity maintenance in contexts where identity is already unstable. Since therapeutic relationships may be jeopardised by a patient’s discovery that caregivers had secretly put medications in their food, this practice can result in an ongoing deception loop. While there may be circumstances in which covert medication is ethically justified, given a lack of suitable alternatives, we argue that in any particular case this practice should be continually re-evaluated in light of the building moral costs to the relational agent over time. (shrink)

As members of the fetal surgery advisory board at a large tertiary care center, we read with great interest Hendriks’ et al. target article proposing a new ethical framework for fetal therap...

We were interested to read the current target article, given our admiration for the senior author’s comprehensive coverage of these same topics a decade ago (Donley, Hul...

This book brings together an international collection of experts in reproductive ethics, law, disability studies, and medicine to explore the challenging future of reproduction and children. From the medical to the social and from the financial to the legal, the authors explore the expanding impact of reproductive genetics on our society. New advances in genetic technologies are revolutionizing the practice of reproductive medicine. We have expanded our ability to detect genetic changes in embryos and fetuses in ways that potentially allow (...) to identify, treat, or prevent a growing range of diseases. The development of gene-editing technologies raises questions about the possibility of removing disease-causing variants from embryos before pregnancy implantation. The growing sophistication of prenatal genomic sequencing offers us glimpses into the whole genome of the developing fetus. And, the increasingly sophisticated science of 'gene matching' allows us greater and greater foreknowledge of how the genomes of two individuals will combine in a future child. This is an indispensable book on the newest developments in bioethics caused by the sciences. Chapter 5 is available open access under a Creative Commons Attribution 4.0 International License via link.springer.com. (shrink)

In their target article, Conley et al. (2023) appropriately highlight the ongoing conceptual and practical opacity of public engagement (PE) in the translation of human gene editing (HGE) (Conley e...

As next‐generation genomic sequencing, including whole‐genome sequencing information, becomes more common in research, clinical, and public health contexts, there is a need for comprehensive communication strategies and education approaches to prepare patients and clinicians to manage this information and make informed decisions about its use, and nowhere is that imperative more pronounced than when genomic sequencing is applied to newborns. Unfortunately, in‐person counseling is unlikely to be applicable or cost‐effective when parents obtain genomic risk information directly via the Internet. As (...) a rule, communication strategies should match how people are accessing health information. Today, many people can obtain health information in a variety of settings, including through direct‐to‐consumer services, via websites, and through other digital channels or settings. In response to these changes, new communication strategies need to be considered. Adopting a comprehensive communication model means understanding the multiple levels of influence experienced by parents and the clinicians who serve them. In addition, applying communication‐science principles can help in addressing some key challenges to effectively communicating genomic information to parents. (shrink)

We are grateful to Friesen and colleagues for drawing attention to the tension between the protection of populations that may experience vulnerability with their inclusion in research (Friesen et a...

Given the prevalence of social media, a nascent but important area of research is the effect of social media posting on one’s own self. It is possible that an individual’s social media posts may have predictive capacity, especially in relation to health behavior. Researchers have long used concepts from the theory of reasoned action to predict health behaviors. The theory does not account for social media, which may influence or predict health behaviors. The purpose of this study was to test (...) a model including Facebook alcohol displays and constructs from the theory of reasoned action to predict binge drinking. Incoming college freshmen from two schools (312 participants between 18 and 19 years old) were interviewed prior to (T1) and 1 year into college (T2), and their Facebook profiles were evaluated for displayed alcohol content. Path modeling was used to evaluate direct and indirect paths predicting binge drinking. Path analysis suggested that Facebook alcohol displays at T1 directly predict binge drinking at T2, while alcohol attitude both directly and indirectly predicts binge drinking. Based on these results, a preliminary model of social media presentation and action is discussed. (shrink)

Philosophers analyze the last of the great rock stars.

Having a confirmation bias sometimes leads us to hold inaccurate beliefs. So, the puzzle goes: why do we have it? According to the influential argumentative theory of reasoning, confirmation bias emerges because the primary function of reason is not to form accurate beliefs, but to convince others that we’re right. A crucial prediction of the theory, then, is that confirmation bias should be found only in the reasoning domain. In this article, we argue that there is evidence that confirmation bias (...) does exist outside the reasoning domain. This undermines the main evidential basis for the argumentative theory of reasoning. In presenting the relevant evidence, we explore why having such confirmation bias may not be maladaptive. (shrink)

While the 2022 Supreme Court of the United States decision in Dobbs v Jackson Women’s Health Organization may bring the contingent rights of pregnant people to refuse interventions into sharper foc...

There are complex considerations when planning to disclose an attenuated psychosis syndrome diagnosis. In this review, we evaluate ethical, legal, and clinical perspectives as well as caveats related to full, non- and partial disclosure strategies, discuss societal implications, and provide clinical suggestions. Each of the disclosure strategies is associated with benefits as well as costs/considerations. Full disclosure promotes autonomy, allows for the clearest psychoeducation about additional risk factors, helps to clarify and/or correct previous diagnoses/treatments, facilitates early intervention and bolsters communication (...) between providers but there are important considerations involving heritability, comorbidity, culture, and stigma. Non-disclosure advances nonmaleficence by limiting stigma and stress, and confusion in a sensitive developmental period but is complicated by varying patient preferences and the possibility that, as new treatments without adverse effects become available, the risk with false positives no longer justifies the accompanying loss of autonomy. Partial disclosure balances ethical considerations by focusing on symptoms instead of labels, but evidence that laypersons may interpret this information as a pseudo-diagnosis and that symptoms alone also contribute to stigma limits the efficacy of this approach. In addition, there are notable societal considerations relating to disclosure involving conservatorship, the reach of insurance companies, and discrimination. We advocate a hybrid approach to disclosure and recommend future research aimed at understanding the effects of stigma on clinical course and a renewed focus on those help-seeking cases that do not transition but remain clinically relevant. (shrink)

Which systems/organisms are conscious? New tests for consciousness (‘C-tests’) are urgently needed. There is persisting uncertainty about when consciousness arises in human development, when it is lost due to neurological disorders and brain injury, and how it is distributed in nonhuman species. This need is amplified by recent and rapid developments in artificial intelligence (AI), neural organoids, and xenobot technology. Although a number of C-tests have been proposed in recent years, most are of limited use, and currently we have no (...) C-tests for many of the populations for which they are most critical. Here, we identify challenges facing any attempt to develop C-tests, propose a multidimensional classification of such tests, and identify strategies that might be used to validate them. (shrink)

The emergence of the “4th Industrial Revolution,” i.e. the convergence of artificial intelligence, the Internet of Things, advanced materials, and bioengineering technologies, could accelerate socioeconomic insecurities and anxieties or provide beneficial alternatives to the status quo. In the post-Covid-19 era, the entities that are best positioned to capitalize on these innovations are large firms, which use digital platforms and big data to orchestrate vast ecosystems of users and extract market share across industry sectors. Nonetheless, these technologies also have the potential (...) to democratize ownership, broaden political-economic participation, and reduce environmental harms. We articulate the potential sociotechnical pathways in this high-stakes crossroads by analyzing cellular agriculture, an exemplary 4th Industrial Revolution technology that synergizes computer science, biopharma, tissue engineering, and food science to grow cultured meat, dairy, and egg products from cultured cells and/or genetically modified yeast. Our exploration of this space involved multi-sited ethnographic research in both the cellular agriculture community and alternative economic organizations devoted to open source licensing, member-owned cooperatives, social financing, and platform business models. Upon discussing how these latter approaches could potentially facilitate alternative sociotechnical pathways in cellular agriculture, we reflect upon the broader implications of this work with respect to the 4th Industrial Revolution and the enduring need for public policy reform. (shrink)

The scientific study of consciousness emerged as an organized field of research only a few decades ago. As empirical results have begun to enhance our understanding of consciousness, it is important to find out whether other factors, such as funding for consciousness research and status of consciousness scientists, provide a suitable environment for the field to grow and develop sustainably. We conducted an online survey on people’s views regarding various aspects of the scientific study of consciousness as a field of (...) research. 249 participants completed the survey, among which 80% were in academia, and around 40% were experts in consciousness research. Topics covered include the progress made by the field, funding for consciousness research, job opportunities for consciousness researchers, and the scientific rigor of the work done by researchers in the field. The majority of respondents (78%) indicated that scientific research on consciousness has been making progress. However, most participants perceived obtaining funding and getting a job in the field of consciousness research as more difficult than in other subfields of neuroscience. Overall, work done in consciousness research was perceived to be less rigorous than other neuroscience subfields, but this perceived lack of rigor was not related to the perceived difficulty in finding jobs and obtaining funding. Lastly, we found that, overall, the global workspace theory was perceived to be the most promising (around 28%), while most non-expert researchers (around 22% of non-experts) found the integrated information theory (IIT) most promising. We believe the survey results provide an interesting picture of current opinions from scientists and researchers about the progresses made and the challenges faced by consciousness research as an independent field. They will inspire collective reflection on the future directions regarding funding and job opportunities for the field. (shrink)

Objective We reviewed human–robot interaction (HRI) participatory design (PD) research with older adults. The goal was to identify methods used, determine their value for design of robots with older adults, and provide guidance for best practices. Background Assistive robots may promote aging-in-place and quality of life for older adults. However, the robots must be designed to meet older adults’ specific needs and preferences. PD and other user-centered methods may be used to engage older adults in the robot development process to (...) accommodate their needs and preferences and to assure usability of emergent assistive robots. Method This targeted review of HRI PD studies with older adults draws on a detailed review of 26 articles. Our assessment focused on the HRI methods and their utility for use with older adults who have a range of needs and capabilities. Results Our review highlighted the importance of using mixed methods and including multiple stakeholders throughout the design process. These approaches can encourage mutual learning (to improve design by developers and to increase acceptance by users). We identified key phases used in HRI PD workshops (e.g., initial interview phase, series of focus groups phase, and presentation phase). These approaches can provide inspiration for future efforts. Conclusion HRI PD strategies can support designers in developing assistive robots that meet older adults’ needs, capabilities, and preferences to promote acceptance. More HRI research is needed to understand potential implications for aging-in-place. PD methods provide a promising approach. (shrink)

Bioethicists in healthcare institutions have the skills and insights and can and must facilitate and promote measures that address deeply ingrained structural issues that exacerbate health inequity...

Purpose: The purpose of this mixed-methods study was to determine whether Facebook use affects biological response to stress and to characterize participants’ use of Facebook during a stressful event. Methods: College students completed a modified Trier Social Stress Test including video recording. Participants were randomly assigned to the Facebook group or control group (no preparatory materials). Pulse and salivary cortisol were measured and compared using t tests. Trained coders assessed videos for 13 common Facebook actions and categorized them as purposeful (...) (tool based) or nonpurposeful (distraction); pulse was compared between groups using Fisher’s exact test. Results: Of 41 participants, 14 (36%) were male and 36 (88%) were Caucasian, mean age was 19.6 ± 1.4 years; 19 participants were randomized to the Facebook group. Comparing Time 1 and Time 3, there were no significant differences in cortisol or pulse change between the Facebook group and the control group. However, males in the control group had a mean pulse reduction of −3.5 ± 0.2 bpm between baseline and Time 3; males in the Facebook group had a mean pulse increase of 10 ± 8.6 bmp (p =.01). Overall, 58.8% of videos were categorized as primarily tool based. Participants who primarily demonstrated distracted use of Facebook had higher than average pulse rates at Time 3 (mean 85.1 vs. 73.6 bpm, p =.03). Discussion: Male Facebook users and participants who demonstrated distracted Facebook use showed increased biologic signs of stress during a stressful event. Some college students may find Facebook use detrimental to performance in stressful situations, but this may vary by gender and type of use. (shrink)

Dynamic Consent is both a model and a specific web-based tool that enables clear, granular communication and recording of participant consent choices over time. The DC model enables individuals to know and to decide how personal research information is being used and provides a way in which to exercise legal rights provided in privacy and data protection law. The DC tool is flexible and responsive, enabling legal and ethical requirements in research data sharing to be met and for online health (...) information to be maintained. DC has been used in rare diseases and genomics, to enable people to control and express their preferences regarding their own data. However, DC has never been explored in relationship to historical collections of bioscientific and genetic heritage or to contexts involving Aboriginal and Torres Strait Islander people.In response to the growing interest by First Peoples throughout Australia in genetic and genomic research, and the increasing number of invitations from researchers to participate in community health and wellbeing projects, this article examines the legal and ethical attributes and challenges of DC in these contexts. It also explores opportunities for including First Peoples' cultural perspectives, governance, and leadership as a method for defining DC on cultural terms that engage best practice research and data analysis as well as respect for meaningful and longitudinal individual and family participation. (shrink)

Two experiments are reported that evaluated route learning of youth with DS, youth with Intellectual Disability and not DS (ID), and typically developing children (TD) matched on Mental Age (MA). In both experiments, participants learned routes with eight choice-points presented via computer. Several objects were placed along the route that could be used as landmarks. Participants were shown the correct route once and then were asked retraced the route without assistance. In Experiment 1 we found that the TD children and (...) ID participants performed very similarly. They learned the route in the same number of attempts, committed the same number of errors while learning the route, and recalled approximately the same number of landmarks. The participants with DS performed significantly worse on both measures of navigation (attempts and errors) and also recalled significantly fewer landmarks. In Experiment 2, we attempted to reduce TD and ID vs DS differences by focusing participants’ attention on the landmarks. Half of the participants in each group were instructed to identify the landmarks as they passed them the first time. The participants with DS again committed more errors than the participants in the ID and TD groups in the navigation task. In addition, they recalled fewer landmarks. While landmark identification improved landmark memory for both groups, it did not have a significant impact on navigation. Participants with DS still performed more poorly than did the TD and ID participants. Of additional interest, we observed that the performance of persons with DS correlated with different ability measures than did the performance of the other groups. The results the two experiments point to a problem in navigation for persons with DS that exceeds expectations based solely on intellectual level. (shrink)

Cell line immortalisation is a growing component of African genomics research and biobanking. However, little is known about the factors influencing consent to cell line creation and immortalisation in African research settings. We contribute to addressing this gap by exploring three questions in a sample of Xhosa participants recruited for a South African psychiatric genomics study: First, what proportion of participants consented to cell line storage? Second, what were predictors of this consent? Third, what questions were raised by participants during (...) this consent process? 760 Xhose people with schizophrenia and 760 controls were matched to sex, age, level of education and recruitment region. We used descriptive statistics to determine the proportion of participants who consented to cell line creation and immortalization. Logistic regression methods were used to examine the predictors of consent. Reflections from study recruiters were elicited and discussed to identify key questions raised by participants about consent. Approximately 40% of participants consented to cell line storage. The recruiter who sought consent was a strong predictor of participant’s consent. Participants recruited from the South African Eastern Cape, and older participants, were more likely to consent; both these groups were more likely to hold traditional Xhosa values. Neither illness nor education were significant predictors of consent. Key questions raised by participants included two broad themes: clarification of what cell immortalisation means, and issues around individual and community benefit. These findings provide guidance on the proportion of participants likely to consent to cell line immortalisation in genomics research in Africa, and reinforce the important and influential role that study recruiters play during seeking of this consent. Our results reinforce the cultural and contextual factors underpinning consent choices, particularly around sharing and reciprocity. Finally, these results provide support for the growing literature challenging the stigmatizing perception that people with severe mental illness are overly vulnerable as a target group for heath research and specifically genomics studies. (shrink)

The lymphatic vasculature plays a critical role in the regulation of body fluid volume and immune function. Extensive research into the molecular mechanisms that control blood vessel growth has led to identification of molecules that also regulate development and growth of the lymphatic vessels. This is generating a great deal of interest in the molecular control of the lymphatics in the context of embryogenesis, lymphatic disorders and tumor metastasis. Studies in animal models carried out over the past three years have (...) shown that the soluble protein growth factors, vascular endothelial growth factor (VEGF)‐C and VEGF‐D, and their cognate receptor tyrosine kinase, VEGF receptor‐3 (VEGFR‐3), are critical regulators of lymphangiogenesis. Furthermore, disfunction of VEGFR‐3 has recently been shown to cause lymphedema. The capacity to induce lymphangiogenesis by manipulation of the VEGF‐C/VEGF‐D/VEGFR‐3 signaling pathway offers new opportunities to understand the function of the lymphatic system and to develop novel treatments for lymphatic disorders. BioEssays 24:1030–1040, 2002. © 2002 Wiley‐Periodicals, Inc. (shrink)

BackgroundCommunity engagement within biomedical research is broadly defined as a collaborative relationship between a research team and a group of individuals targeted for research. A Community Advisory Board is one mechanism of engaging the community. Within genomics research CABs may be particularly relevant due to the potential implications of research findings drawn from individual participants on the larger communities they represent. Within such research, CABs seek to meet instrumental goals such as protecting research participants and their community from research-related risks, (...) as well as intrinsic goals such as promoting the respect of participants and their community. However, successful community engagement depends on the degree to which CABs legitimately represent and engage with communities targeted for research. Currently, there is little literature describing the use of CABs in genomics research taking place in developing countries, and even less in the field of genomics research relating to mental illness. The aim of this article is to describe and consider the contributions made by a researcher-driven, population-specific CAB in a genomics of schizophrenia research project taking place in South Africa, from the perspective of the research team.DiscussionFour broad discussion topics emerged during the CAB meetings namely: 1) informed consent procedures, 2) recruitment strategies, 3) patient illness beliefs and stigma experiences, and 4) specific ethical concerns relating to the project. The authors consider these discussions in terms of their contributions to instrumental and intrinsic goals of community engagement.SummaryThe CAB gave valuable input on the consent processes and materials, recruitment strategies and suggested ways of minimizing the potential for stigma and discrimination. All of these contributions were of an instrumental nature, and helped improve the way in which the research took place. In addition, and perhaps more importantly, the CAB made a unique and important contribution relating to intrinsic functions such as promoting the respect and dignity of research participants and their community. This was particularly evident in ensuring sensitivity and respect of the community’s traditional beliefs about schizophrenia and its treatment, and in this way promoting a respectful relationship between the research team and the participants. (shrink)