Advances in genomic medicine have lead to debate about the potential inclusion of genetic tests for susceptibility to common complex disorders in newborn screening programmes. Empirical evidence concerning psychosocial reactions to genetic testing is a crucial component of both ethical debate and policy development, but while there has been much speculation concerning the possible psychosocial impact of screening newborns for genetic susceptibilities, there remains a paucity of data. The aim of the study reported here is to provide (...) some of this missing empirical evidence, using type 1 diabetes as an example of a common disorder with multiple significant genetic contributors to its aetiology. Semi-structured interviews were conducted with 11 parents of babies who had received increased risk results in a study that involved newborn screening for genetic susceptibility to type 1 diabetes. Interpretative phenomenological analysis was used to evaluate the data. The interview data suggest that the probabilistic nature of results of genetic susceptibility tests impacts upon all aspects of parents' psychosocial reactions, resulting in a complex and dynamic process quite different to that described in relation to current newborn screening programmes. While parents generally reported fairly minor levels of concern in response to news of their child's increased genetic risk, these worries frequently recurred, and perception of risk also varied and fluctuated over time. Both individual and contextual factors appeared to interact with the inherent uncertainty of the test result to contribute to the dynamic nature of parental reactions, and their behavioural responses. The implications of these findings for future research and for the debate concerning potential expansion of newborn screening are discussed. (shrink)

This chapter contains sections titled: Information Management: Confidentiality, Autonomy and Non‐Directiveness Predictive Genetic Testing Childhood Genetic Testing Genetic Screening Informed Consent to Screening Newborn Screening Carrier Screening Prenatal Screening Susceptibility Screening Further Information Management Goals of Genetic Screening: Public Health vs Individual Choice Conclusion References Further reading.

This article argues that a new diagram is emerging in the criminal justice system as it encounters developments in the neurosciences. This does not take the form that concerns many ‘neuroethicists’ — it does not entail a challenge to doctrines of free will and the notion of the autonomous legal subject — but is developing around the themes of susceptibility, risk, pre-emption and precaution. I term this diagram ‘screen and intervene’ and in this article I attempt to trace out (...) this new configuration and consider some of the consequences. (shrink)

Scientific and technological advances are lending pressure to expand the scope of newborn screening. Whereas this has great potential for improving child health, it also challenges our current perception of such programmes. Standard newborn screening programmes are clearly justified by the fact that early detection and treatment of affected individuals avoids significant morbidity and mortality. However, proposals to expand the scope and complexity of such testing are not all supported by a similar level of evidence for unequivocal benefit. (...) We argue that screening for genetic susceptibility to complex disorders is inherently different from standard screening and, while of potential value, must be considered separately from conventional testing. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Genetic Testing and Genetic ScreeningPat Milmoe McCarrick (bio)In recent years there has been an enormous expansion in the knowledge that may be gleaned from the testing of an individual's genetic material to predict present or future disability or disease either for oneself or one's offspring. The Human Genome Project, which is currently mapping the entire human gene system, is identifying progressively more genetic sequencing information (see Scope Note 17, (...) The Human Genome Project). Information obtained from genetic testing raises ethical and legal questions about its uses by society. The ethical dilemmas were foreseen two decades ago by bioethicists who asked whether questionable applications could stop "legitimate pursuits" (IV, Gaylin 1972) and whether genetic disease might come to be viewed as "transmissible" in the sense of being contagious (IV, Veatch 1974).Not only has knowledge expanded, but the practice of genetic testing and screening has greatly increased as well. For example, in the case of testing for cystic fibrosis (CF), the U.S. Congress' Office of Technology Assessment (OTA) estimates that instances of screening jumped from 9310 tests in 1991 to 63,000 tests in 1992 (I, OTA [Cystic Fibrosis] 1992). In addition, the OTA estimates that within the next few years, the six million women who become pregnant each year routinely will be informed of available CF carrier tests (I, OTA [Cystic Fibrosis] 1992).Following the recent identification of a gene linked to breast cancer, Dr. Francis Sellers Collins, director of the National Center for Human Genome Research, said that "it is not inconceivable that every woman in America may want to be screened for this gene. The economic, ethical, and counseling issues will be very daunting." Dr. Collins opines that in the near future physical examinations for 18-year-olds will include DNA testing for diseases with genetic components and that physicians, in the interests of preventive medicine, will make risk-based recommendations for a healthy life-style (IV, Breo 1993). The U.S. President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research predicted as early as 1983 that before the end of the century genetic screening and counseling would become major components of both public health and individual medical care (I, U.S. President's Commission 1983). [End Page 333]The OTA defines genetic testing as "the use of specific assays to determine the genetic status of individuals already suspected to be at high risk for a particular inherited condition. The terms genetic test, genetic assay, and genetic analysis are used interchangeably to mean the actual laboratory examination of samples." In contrast, genetic screening usually uses the same assays employed for genetic testing but is distinguished from genetic testing by its target population (I, OTA [Genetic Monitoring] 1990). The National Academy of Sciences (NAS) defines screening as the systematic search of populations for persons with latent, early, or asymptomatic disease (III, NAS 1975). Some of the literature annotated for this Scope Note appears to use the terms "testing" and "screening" interchangeably.Philip Boyle of the Hastings Center points out that the language used to describe genetic variation is important and asks what words should be used: "Defects, flaws, deleterious genes, disorders, or the more neutral conditions? Using words such as normal—and its corollary, abnormal—is likely to foster stigmatization and discrimination" (III, Genetic Grammar, Boyle 1992).Areas of focus in genetic testing include: prenatal diagnosis, newborn screening, carrier screening, forensic screening, and susceptibility screening.Prenatal diagnosis discerns whether a fetus is at risk for various identifiable genetic diseases or traits. Prenatal diagnosis is made using amniotic fluid, fetal cells, and fetal or maternal blood cells obtained during amniocentesis testing; alpha fetoprotein assays or chorionic villus sampling; or ultrasound tomography, which creates fetal images on a screen. Another method, known as fetoscopy, uses a camera on a needle inserted in the uterus to view the fetus. Since prenatal screening began in 1966 (I, U.S. President's Commission 1983), the number of metabolic defects and genetic disorders that can be diagnosed prenatally has expanded greatly. There is also discussion of requiring testing for parents who are participating in an in vitro fertilization program and are at genetic... (shrink)

Debates about expanding newborn screening with whole genome sequencing are fueled by data about public perception, public opinion, and the positions taken by public advocates and advocacy groups. One form of evidence that merits attention as we consider possible uses of whole‐genome sequencing during the newborn period is parents’ (and children's) diverse experiences with existing expanded screening protocols. What do we know about this experience base? And what implications might these data have for decisions about how we use (...) whole genome sequencing and how we assess its impact in the future? Although the broader literature on genetic susceptibility testing suggests that testing usually does not have adverse effects on children's psychosocial well‐being, certain newborn screening results have been demonstrated to cause distress, alter behavior, and even to influence the formation of new parental and family identities. (shrink)

This paper clarifies the nature of genetic screening and morally evaluates using it to deny people employment. Four sets of variables determine screening’s ability to forecast disorder. The first two concern epistemological limitations: whether the gene itself has been located; whether knowledge of other family members is necessary. The latter two refer to genetic causality: whether other genes are needed; whether the gene causes the disorder or just a susceptibility to it.Considerations of privacy and justice warrant restricting (...) screening to job-specific disorders, without prejudice to the worker. Screening is more of an invasion of privacy than most “searches” because our very selves are disclosed; serious stigmatizing can result. It is unjust to penalize someone for a susceptibility to a disorder. It is also unjust to use the genetic knowledge and technology, developed with public monies allocated for public good, against members of the public. (shrink)

Health policy is increasingly confronted with the demand for financing genetic testing on inherited susceptibility to disease. Tests on polymorphism/snp associated with multicausal and chronic conditions are already offered in private commercial institutions or in academic hospitals. The increasing pressure on public health services to offer SNP testing leads to first methodological approaches for a generally valid regulatory framework applicable for inclusion or refusal of genetic tests into the public health services. Systematic search in Medline, Embase and the Web (...) for methodological papers or guidelines for the assessment of polymorphism-screening. Since genetic testing has not only clinical and economic effects on health care, but also primarily ethical consequences by profiling our understanding of “health” and “disease”, this paper gives an overview of relevant aspects and background information to consider in the assessment of genetic tests. Although 2–3 million SNPs are identified and the journals are full of reported “significant” associations between disease and mutation, only a few can be replicated unequivocally. The ACCE -framework was developed by the Center of Disease Control for the assessment of genetic testing. This standardised appraisal approach proposes collecting and evaluating: Prevalence, genotype-/phenotype-relation. Clinical presentation: natural history; the different expressions of disease. Performance of the genetic test. Implications for therapy and prevention. Conclusion for clinical applications of risk-profiling of health on their susceptibility to disease and/or for clarification of disease for therapy planning. Since genetic testing is urging its way into the health care system, the actual danger is, that population screening starts before valid evidence from big prospective studies have been carried out and delivered proofs of direct causal associations. Before diffusing into the health care system we are suggesting to take a cautious and standardised approach. (shrink)

Genetic testing in the workplace is a technology both full of promise and fraught with ethical peril. Though not yet common, it is likely to become increasingly so. We survey the key arguments in favour of such testing, along with the most significant ethical worries. We further propose a set of pragmatic criteria, which, if met, would make it permissible for employers to offer (but not to require) workplace genetic testing.

The ability to determine genetic predisposition to cancer represents an opportunity to expand cancer control efforts in a manner that was previously unimaginable. This possibility also forces individual patients, families, health care professionals, and society to confront difficult questions about genetic knowledge. Although genetic testing or screening for cancer risk may hold promise of cancer control benefits, this prospect also raises significant ethical and legal concerns that must inform and shape policy decisions. In “Cancer Genetic Susceptibility Testing,” Benjamin (...) Wilfond and the Cancer Genetic Screening Consortium present a status report and an ambitious agenda for future examination of ethical and policy issues in this embryonic field. The paper provides a provocative and timely discussion of some extremely vexing issues, but it also misses on several critical points. (shrink)

The purpose of this paper is modelling and controlling the spread of COVID-19 disease in Morocco. A nonlinear mathematical model with two subclasses of infectious individuals is proposed. The population is divided into five classes, namely, susceptible, exposed, undiagnosed infectious, diagnosed patients, and removed individuals. To reflect the real dynamic of the COVID-19 transmission in Morocco, the real reported data are used for estimating model parameters. Two controls representing screening effort and limited treatment are considered. Based on viability theory (...) and set-valued analysis, a Lyapunov function is constructed such that both exposed and infected populations are decreased to zero asymptotically. The corresponding controls are derived via a continuous selection of adequately designed feedback map. Numerical simulations are presented with three scenarios. Our results show that when only one control is to be applied, screening is the most effective in decreasing the number of people in the three infected compartments, whereas combining both controls is found to be highly effective and leads to a significant improvement in the epidemiological situation of Morocco. To the best of our knowledge, this work is the first one that applies the set-valued approach to a controlled COVID-19 model which agrees with the observed cases in Morocco. (shrink)

This chapter considers ethical issues involved in genetic testing and screening for susceptibility to various forms of cancer.

Medicine seeks to overcome one of the most fundamental fragilities of being human, the fragility of good health. No matter how robust our current state of health, we are inevitably susceptible to future illness and disease, while current disease serves to remind us of various frailties inherent in the human condition. This article examines the relationship between fragility and uncertainty with regard to health, and argues that there are reasons to accept rather than deny at least some forms of uncertainty. (...) In situations of current ill health, both patients and doctors seek to manage this fragility through diagnoses that explain suffering and provide some certainty about prognosis as well as treatment. However, both diagnosis and prognosis are inevitably uncertain to some degree, leading to questions about how much uncertainty health professionals should disclose, and how to manage when diagnosis is elusive, leaving patients in uncertainty. We argue that patients can benefit when they are able to acknowledge, and appropriately accept, some uncertainty. Healthy people may seek to protect the fragility of their good health by undertaking preventative measures including various tests and screenings. However, these attempts to secure oneself against the onset of biological fragility can cause harm by creating rather than eliminating uncertainty. Finally, we argue that there are good reasons for accepting the fragility of health, along with the associated uncertainties. (shrink)

BackgroundVulnerability is a key concept in traditional and contemporary bioethics. In the philosophical literature, vulnerability is understood not only to be an ontological condition of humanity, but also to be a consequence of contingent factors. Within bioethics debates, vulnerable populations are defined in relation to compromised capacity to consent, increased susceptibility to harm, and/or exploitation. Although vulnerability has historically been associated with older adults, to date, no comprehensive or systematic work exists on the meaning of their vulnerability. To fill (...) this gap, we analysed the literature on aged care for the meaning, foundations, and uses of vulnerability as an ethical concept.MethodsUsing PRISMA guidelines, we conducted a systematic review of argument-based ethics literature in four major databases: PubMed, Embase®, Web of Science™, and Philosopher’s Index. These covered biomedical, philosophy, bioethical, and anthropological literature. Titles, abstracts, and full texts of identified papers were screened for relevance. The snowball technique and citation tracking were used to identify relevant publications. Data analysis and synthesis followed the preparatory steps of the coding process detailed in the QUAGOL methodology.ResultsThirty-eight publications met our criteria and were included. Publication dates ranged from 1984 to 2020, with 17 publications appearing between 2015 and 2020. Publications originated from all five major continents, as indicated by the affiliation of the first author. Our analyses revealed that the concept of vulnerability could be distinguished in terms of basic human and situational vulnerability. Six dimensions of older adults’ vulnerability were identified: physical; psychological; relational/interpersonal; moral; sociocultural, political, and economic; and existential/spiritual. This analysis suggested three ways to relate to older adults’ vulnerability: understanding older adults’ vulnerability, taking care of vulnerable older adults, and intervening through socio-political-economic measures.ConclusionsThe way in which vulnerability was conceptualised in the included publications overlaps with distinctions used within contemporary bioethics literature. Dimensions of aged care vulnerability map onto defining features of humans, giving weight to the claim that vulnerability represents an inherent characteristic of humans. Vulnerability is mostly a value-laden concept, endowed with positive and negative connotations. Most publications focused on and promoted aged care, strengthening the idea that care is a defining practice of being human. (shrink)

As human beings age, they become weak, fragile, and feeble. It is a slowly progressing yet complex syndrome in which old age or some disabilities are not prerequisites; neither does loss of human parts lead to frailty among the physically fit older persons. This paper aims to describe the influences of transhumanist perspectives on human‐technology enhancements and replacements in the transcendence of human frailties, including those of older persons, in which technology is projected to deliver solutions toward transcending these frailties. (...) Through technologies including genetic screening and other technological manipulations, intelligent machines and augmented humans improve, maintain, and remedy human‐linked susceptibilities. Furthermore, other technologies replace parts fabricated through inorganic‐mechanical processes such as 3D‐printing. Advancing technologies are reaching the summit of technological sophistication contributing to the transhumanist views of being human in a technological world. Technologies enhance the transcendence of human frailties as essential expressions of the symbiosis between human beings and technology in a transcendental world. (shrink)

Broad genome‐wide testing is increasingly finding its way to the public through the online direct‐to‐consumer marketing of so‐called personal genome tests. Personal genome tests estimate genetic susceptibilities to multiple diseases and other phenotypic traits simultaneously. Providers commonly make use of Terms of Service agreements rather than informed consent procedures. However, to protect consumers from the potential physical, psychological and social harms associated with personal genome testing and to promote autonomous decision‐making with regard to the testing offer, we argue that current (...) practices of information provision are insufficient and that there is a place – and a need – for informed consent in personal genome testing, also when it is offered commercially. The increasing quantity, complexity and diversity of most testing offers, however, pose challenges for information provision and informed consent. Both specific and generic models for informed consent fail to meet its moral aims when applied to personal genome testing. Consumers should be enabled to know the limitations, risks and implications of personal genome testing and should be given control over the genetic information they do or do not wish to obtain. We present the outline of a new model for informed consent which can meet both the norm of providing sufficient information and the norm of providing understandable information. The model can be used for personal genome testing, but will also be applicable to other, future forms of broad genetic testing or screening in commercial and clinical settings. (shrink)

Broad genome-wide testing is increasingly finding its way to the public through the online direct-to-consumer marketing of so-called personal genome tests. Personal genome tests estimate genetic susceptibilities to multiple diseases and other phenotypic traits simultaneously. Providers commonly make use of Terms of Service agreements rather than informed consent procedures. However, to protect consumers from the potential physical, psychological and social harms associated with personal genome testing and to promote autonomous decision-making with regard to the testing offer, we argue that current (...) practices of information provision are insufficient and that there is a place – and a need – for informed consent in personal genome testing, also when it is offered commercially. The increasing quantity, complexity and diversity of most testing offers, however, pose challenges for information provision and informed consent. Both specific and generic models for informed consent fail to meet its moral aims when applied to personal genome testing. Consumers should be enabled to know the limitations, risks and implications of personal genome testing and should be given control over the genetic information they do or do not wish to obtain. We present the outline of a new model for informed consent which can meet both the norm of providing sufficient information and the norm of providing understandable information. The model can be used for personal genome testing, but will also be applicable to other, future forms of broad genetic testing or screening in commercial and clinical settings. (shrink)

The tobacco industry first began to promote the idea that a minority of smokers are 'genetically predisposed' to lung cancer in the 1950s. We used tobacco industry documents available as a result of litigation to investigate the role of the tobacco industry in funding the 'scientific bandwagon' described by Fujimura, in which genetics has come to dominate the cancer research agenda. From 1990-1995 inclusive, 52% of the project funding allocated by British American Tobacco's Scientific Research Group went to genetic research, (...) mainly based in universities and at one cancer charity. The largest project involved a pharmacogenetic research unit, based in a UK medical school, which was established with the help of tobacco industry PR consultants in 1988. The unit received half its project funding from the industry in 1992. Its main aim was to identify a minority of smokers who are supposedly 'genetically susceptible' to lung cancer, so that smoking cessation measures could be targeted at them. This aim was adopted and promoted by influential scientists at the US National Institutes of Health and the UK Medical Research Council in the late 1980s, in the run up to the Human Genome Project.BAT's research funds were also used to counter claims by others to have identified a unique 'genetic fingerprint' for tobacco smoke in lung cancer cells. We conclude that the tobacco industry has played a significant role in shaping research agendas, in particular, by promoting the idea that individual genome screening would be of benefit to public health. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Close Enemies: The Relationship of Psychiatry and Psychology in the Assessment of Mental DisordersPhilippe Le Moigne, PhDAs Peter Zachar rightly points out in his comment, the assessment of mental disorders underwent new developments with the release of the Diagnostic and Statistical Manual of Mental Disorders-V in 2013 (American Psychiatric Association, 2013). Whereas in 1980, the manual had been thought of in a rigorously categorical way, on the basis of (...) distinct and closed syndromic entities, this new version advocated the development of a radically dimensionalist approach, with the diagnosis aiming this time to restore the whole symptomatological picture of the patient on a spectrum of ratings are supposed to cover the entirety of psychiatric semiology (American Psychiatric Association, 2013).For its part, my article aimed to show how standardized assessment, guided by the return of psychiatry’s authority and the assertion of its legitimacy in the diagnostic field, gave the ascendancy in the 1980s to the classificatory tradition and thus to the categorical model, to the detriment of personality approach and test psychology which offered a competing solution here. This perspective, historically dated, may have led the reader to think that there is an antagonism that cannot be overcome here. Rather, it should be seen as a form of structuring opposition, or even a “complementarity inscribed in rivalry,” between psychiatry and psychology, which is naturally susceptible to change over time.Indeed, the reversal operated by the Diagnostic and Statistical Manual of Mental Disorders-V is not total because it cannot be total. The defense of the dimensionalist approach, dear to the psychological testing tradition, was intended here to allow the identification of co-morbidities, present in most patients but poorly apprehended by the categorical approach, and to open up diagnosis to prevention by screening for minor manifestations of psychopathology when they suggest the [End Page 259] development of a manifest episode of the disease in the more or less long term. The risk here is that we end up with overdiagnosis and thus an over-representation of false positives (Wakefield, 2015). In other words, this type of approach does not escape the obligation to determine threshold scores, likely to indicate the lower limit of the disorder, and thus to resort to a categorical approach. There is a first affinity between the two perspectives which obeys, beyond the divergences in principle, a technical requirement.But the two approaches have even more in common when we look at their epistemological background: they share the idea that the representation and the intervention on mental disorder, to use Ian Hacking’s expression (1983), must be based on the model proposed by the physical and natural sciences. And as Greta Kaluzeviciute aptly points out in her comment, this orientation leads to the idea of measuring mental disorder in particular to conduct elaborate quantification operations to determine, for example, whether two entities are statistically distinct or whether a drug has a significant effect on the evolution of a pathology.This is in fact an old question that can be formulated as follows, to use the expression of the psychometrician Joel Michell (1999): are psychological dimensions metric? In other words, if we want to apply the language of numbers to mental disorders, they must share its properties, two of which seem essential: it must be possible to establish that each mental disorder, in the same way as qualities attributable to length for example, has a zero and can be divided by means of gradients (or degrees of intensity) whose interval is constant (Le Moigne, 2018; Michell, 1999). For lack of space, let us only address the second condition. This one has already been denied by many, starting with Bergson at the end of the nineteenth century (1889). He does not believe in the quantification of psychological expressions, starting with sensations. What is the common point, he wrote, between the feeling of a mild pain, as one feels a stiffness, and the sensation of a needle being hammered into your flesh? For him, one and the other of these intensities are incomparable, so that they do not belong to a similar register of sensations that one could stage from a 0 toward a... (shrink)

The objective of the article is to examine the extensions of a clinical measure of efficacy, the Number Needed to Treat (NNT), in different settings including screening, scanning, genetic testing and primary prevention, and the associated ethical implications. We examine several situations in which the use of the NNT or NNS (Number Needed to Screen) has been suggested, such as Prostate-Specific Antigen for prostate cancer, Magnetic Resonance Imaging scans, genetic testing and banning of smoking. For each application, we explore (...) the ethical implications of the relevant measure. We have found that the different measures have different ethical implications. For example, the Number Needed to Prevent is the only measure that can be lower than one, indicating with a numerical example that prevention is better than cure. Conversely, we raise questions about the acceptability of genetic screening. In a realistic example, we show that primary prevention of the effects of arsenic in drinking water, targeted to the most susceptible, would require to genetically screen a large number of subjects, whereas giving rise to ethical concerns. We warn against the abuse of testing, in particular genetic testing, we show that different measures are associated with different ethical issues and that prevention tends to be better than cure. (shrink)

Joaquin Segura. Untitled (fig. 40) . 2007 continent. 1.2 (2011): 117-124. The interview that follows is a dialogue between artist and gallerist with the intent of unearthing the artist’s working strategies for a general public. Joaquin Segura is at once an anomaly in Mexico’s contemporary art scene at the same time as he is one of the most emblematic representatives of a larger shift toward a post-national identity among its youngest generation of artists. If Mexico looks increasingly like a foreclosed (...) home burning to the ground, Segura could likely be the one walking away, charred matchstick between thumb and forefinger and shit-eating grin on his face. His corrosive attacks on institutions, ideologies, and power reflect a deep general distrust of authority, increasingly evident within the work of younger Mexican artists. It is perhaps most directly the result of President Calderon’s deeply unpopular war against the cartels but no doubt equally the product of decades upon decades of rampant corruption and errant policy within Mexico. Brett W Schultz (BWS): A recurring—if not dominant—theme within your current work and investigation explores ideological extremism in reaction to some perceived political and economic disenfranchisement, especially that espoused and practiced by right-wing groups in United States. That's exactly why I thought of you when I was approached to contribute a piece to an issue on the subject of the moraine—taken metaphorically here to signify a certain set of beliefs that have resurfaced within mainstream American culture in the wake of a probably over-exaggerated political sea-change, marked by Obama's election. You're a Mexican artist who now lives and works in Guadalajara, far from the border cities where such concerns would seem more likely to be relevant to a contemporary artist; of course, you're even farther from the culture that birthed this nature of extremism. What interests you so intensely about this movement, if we can call it that? Joaquin Segura (JS): I think there are several seminal points that you touch on in this particular question. There's a very specific set of interests that make me address the socio-political issues I've been dissecting through my practice in the last few years. First of all, I don't really consider myself a 'mexican' artist. As I've made clear in the past, I don't really believe in the notion of 'identity' or the idea of 'nation', which I find totally laughable and heartwarmingly passé. I'm convinced that these are totally outdated models of understanding our differences and similarities, expanding our already immense and irreconcilable cultural abysses instead of bringing them together, thus resulting in their total dispersion among the complex and extremely arbitrary weaving of contemporary social nucleii. Pretty much a frankly bad joke, if I may say so. The fact that I live and work in Mexico is a completely random geographical and temporal factor, which of course affects what I think and what I do, but I've chosen not to be limited by this specific circumstance. In the past, while working abroad, I've taken advantage of this preconception of Mexico—to be more exact, pretty much all of Latin America—as one of the last barbaric bastions of western civilization. Totally amusing, if you ask me about it. I consider my practice to be, among other things, a gonzo strategy of deceit: there are quite a few roles you can adopt in this approach that may actually reveal themselves to be a privileged vantage point. In my experience, the gentle savage is one of the most effective ones to establish my standing position. Thus, I'm a mexican artist if I need it to prove my point. If it's not necessary in a specific circumstance, I'm not. Quite simple, I think. Said in other words, it's just an ace I can play to win a particular match. It has worked so far, at least for me. L: Hey, America… , 2009. R: The Inaugural Address , 2009. I am interested in the nature of power and the rise and fall of totalitarian ideological and political apparatuses nowadays. But I guess, going even further, I'm essentially fascinated by the fissures and contradictions that have made these structures spectacularly crumble to the ground. I do believe extreme ideologies have played a crucial role in the globalization of socio-political crisis. In the end, our world is nothing more than a fading monument to all things gone wrong—the inspiring triumph of failure, in every sense. I see this as an exciting parable. And of course, it is an undeniable fact that the US, through their influence in world economy, international policies and general attitude towards the rest of the planet is the largest structure waiting to collapse. I think we are all secretly awaiting that moment of splendor, even americans. It'll be disastrous and as nasty as it can get, but it will also be liberating and incredibly inspirational. Not just because it’s the US but because it'll prove that absolutely everything is susceptible to fall. And not only that, most importantly, it would confirm that radical change may actually be possible and not just one more of the unfulfilled promises modernity has left us to struggle with on our own. BWS: I want to talk first about two of your works in particular: Hey, America... and The Inaugural Address . I feel like your more recent work has a subtle —or even hidden—sinisterness, but these two works are perfect examples of how brutally confrontational your earlier work has been. When we showed Hey, America... at Mexico City's Zona Maco art fair in 2010, there were at least a couple visitors to our stand who were absolutely ready to punch me in my gringo face for having done so. Certainly the shock value of these works is crucial to their central ideas, but can you tell me more about your intentions and how these works relate to your general oeuvre? JS: So funny. Perhaps we do deserve to be punched in the face. I think that's what I'm sometimes looking for, but I hardly ever get it. I do think of such works as some sort of logical trap, a somewhat perverse ambush waiting for someone to walk into head-on. I think what I tried to do with those two specific works, as well as some other past projects, is just emphasize issues or themes that do disturb or make me uneasy and restless. I consider my essential intention a need to make clear that we do not have to look the other way, ignore or forget. We must address, understand and solve these manifestations of senseless violence and absurdity because if we don't confront them this way, they'll end up consuming us. In other words, I do consider these works as a personal need of coming to terms with the nonsense of the world we all are living in. I don't particularly consider myself to be someone with a clear set of beliefs. Perhaps my only certainty would be that everything is there to be denied, demolished and obliterated—even my supposed unquestionability of that particular 'dogma.' My practice is a reflection of that paradox, and I do think that's how these two pieces relate to a wider body of work. Every democratic system and so-called developed contemporary society is deeply flawed on the inside, and that is because each has swept things under the rug. Of course, there's tolerance, good will and eagerness to make a difference but there's also hatred, pain and fear lingering all around. We must learn to relate to both sides of the spectrum. In a way, I approach the themes behind these particular works in what I think to be a non-biased, somewhat 'neutral' way. I do think there's an encryption process going on in the way I work, some sort of formal refinement of this somewhat outrageous content. A digest of infamy, if we can refer to it that way. It is up to the individual experiencing the work to decide which way these pieces lean. They can easily be seen from both positions and I'm ok with that. If you look closely at these works, there's nothing that establishes an unrelenting position—neither support nor rejection. I don't want my personal political views to directly set an agenda for the spectator as that’s essentially propaganda, which is one of the things I absolutely despise. To sum it up, I strive for the spectator to complete the piece in that sense. The work then becomes a reflection of his or her own contradictions, a playground of the mind. I'm interested in achieving a deadpan and deadlock state in the observer. So, in a way, those visitors threatening to beat the shit out of you unconsciously became that particular issue the work is alluding to. Just blind and senseless reaction to god knows what people feel must be defended, the overwhelming virtue of ambiguity. Beautiful. Perhaps you can also think of my practice as a uber-sophisticated and snobbish version of Punk'd. And you wouldn't be far from what I'm trying to convey. Untitled (Disturbance Scenarios #2) . 2010. BWS: To me, an important transitional marker in the overall trajectory of your work is the series, Disturbance Scenarios , which evokes a similar generalized state of panic, paranoia, and impending doom through its incorporation of sensationalist newspaper headlines, yet also suggests this slyly mysterious meta-narrative via the context in which the newspaper itself is placed. How did you arrive at this series and why did you choose photorealistic painting as the medium for it? JS: I consider this series to be a by-product of the process I follow when making work. I spend an important part of my time just doing research, going through documentation and accumulating visual or historical references for the themes or episodes I'm interested in, in that particular moment. These are, of course, valuable assets that connect among themselves in a mysterious and almost undetectable manner, sometimes a few years between one and the other. I've employed similar production strategies in the past, in ongoing series like Random Moments of Urban Decay , in which I document what I consider to be physical traces of ethnic, religious or ideological violence in the form of text graffiti, invisibly scattered in different cities of the world, mostly in the US. Disturbance Scenarios was started in early 2010, following a particularly intense period of traveling here and there that lasted for most of the year. I've always felt compelled by text, as I find quite intriguing the idea of how words can create equally intense evocations of what I call a mental panorama of uneasiness than those produced by aesthetically-charged imagery; of course, if handled right. I have a close relationship to print media—due both to my academic background and to my attraction to its ubiquity and almost unlimited influence, which in the end, is nothing else but power—so I found myself with a growing archive of newspaper headlines snapshots from cities like Melbourne, Auckland, London, and LA. Going through them, I noticed that they had in common a very specific thematic slant: they were all about some sort of conflict: energy crisis, political unrest, local episodes of domestic violence, you name it. So as you very well put it, I felt they all connected through this feeling of anxiety and anguish and I decided to start thinking of them as a body of work. Basically, I felt an interest in creating what I think of as my personal fragmented prefigurements of the end of civilization. There were few elements on the shots that could give away its actual location, geographically speaking, and I liked that. I find this sensation of vagueness and uncertainty quite alluring. The more subtle, the more perverse. The formal resolution of the series—as photo-realistic painting—is linked to my intention of creating distance between me as the artist and the themes I work with. I rarely execute my own work, and that is more a personal choice as I'm more interested in the ideas I mingle with than in the actual outcome of that process, understood as an "art-object" with certain market value. I did some tests with light-jet prints of those snapshots and I found them devoid of that nightmarish, disturbing indistinctness that I felt was so important for them to be able to project the turmoil I experienced upon encountering them and in conceiving of them as a series. So I thought that photorealistic painting would be an interesting resource to play with, as I hardly had worked with that medium before because of my lenient animosity toward painters and their craft. So they were executed like that and I think it turned out to be just right. Homemade (Napalm #2) . 2010. BWS: Though Disturbance Scenarios remains ongoing, it's an interesting contrast to another series of yours, Homemade, which are these beautifully banal photographs of the ingredients used to make improvised explosives. Whereas Disturbance Scenarios still confronts the viewer aggressively with its visual emphasis on loaded texts, in Homemade , you've dropped the surface-level bravado entirely. They're pieces that require explanation to someone not already versed in the fine art of amateur explosive-making. You weren't known for subtlety in your past work; why this change in direction? JS: I'm personally convinced that these are just two angles of the same conceptual preoccupation. I mentioned before my obsession with the idea of encryption. I'm quite enticed by how these processes of translation can politically and semantically alter and deviate purportedly subversive materials such as the ones these works allude to. I do think subversion is futile. I was really troubled by that thought for some time, but I think now I understand that it's not really that important. What is really significant is to elaborate on these alternate views, to envision and refine possible escape routes. It doesn't really matter if they go nowhere, but that is because nothing really matters. A "mute" artwork is a notion that captivates me. When you look at the works you mention, you know there's something off, but it's not fully clear how and why that is. I rely on that insecurity—on that moment of hesitation. And that can also be achieved through an approach like the one I'm now interested in. Let's just call it a smoke screen, a surrogate ruse to get to the same point: to talk about impotence and defeat in contemporary life. The notion that readily accessible information is actually a weapon is a double-edged fallacy: sure, you can make use of whatever resources you can lay your hands on, but that doesn't set you free because freedom is impossible. Still, that doesn't mean you can't blow up stuff during the process, metaphorically or not. I didn't understand the nature of subtlety before. I used to think that you needed to be loud and manifest anger and unconformity in the most aggressive manner possible. Then I finally realized that you can actually permeate and rarify a battleground—because after all, this is low-intensity war—if you actually aim at silently building up the contradictions and making the symbolic value of ideas and acts clash within themselves. Or perhaps it is that I am just getting old. I guess I used to be an angry kid until recently. Now I think of myself as a disenchanted post-teenager, and of course that reflects in my work and my approach to art-making. Kind of a rite of passage and I laugh at it because, overall, it has been overwhelmingly fun. And that doesn't mean that I'm not ready to stick it in someone or something's face again if I feel like it. BWS: You're now taking the subtlety of the Homemade series even further with your newest series, Definitive Reader For a Botched Revolution , in which you photograph a series of politically-charged books side-on, negating their content entirely—essentially reducing them to purely aesthetic objects in which the subject matter is only revealed in the title of the work. Can you talk about the ideas behind this series? Furthermore, is your recent interest in this idea of the "botched revolution" an indication of a general attitudinal or philosophical shift you've since adopted? JS: This new series of works is the logical outcome of a brief period I went through. Probably the last couple years, in which due to a number of circumstances that don't really have to do with my art-making, I was forced to renegotiate my ideas, my beliefs and practically everything that surrounds me. It was quite distressful and turbulent, but in the end, I think it was also almost epiphanic. I came to terms with myself and now I'm calm and serene. That is, of course, my personal take on it but I mention it because I do think it's important to address this shift you mention. The idea of an artwork as a container for latent revelations enthralls me quite a bit. That's how I see these particular works: art as an incendiary agent. It's up to the artist and the spectator to do whatever they please with it. I think the detachment and almost surgical cleanliness from the Definitive Reader series is also my take at poking fun of the way some art is totally innocuous and uncompromising. These images may be pleasing to the eye, but there's something twisted and rotten within them, well hidden beneath. You'll either see it or not, but without a doubt, it will not cancel its presence. This series is intrinsically linked to Homemade . I'm pretty much horsing around with similar ideas and statements here. And well, yes, I do think any revolution is a botched one. There's nothing too heavy about their own downfall. Decay and breakdown are here and will not go away. Perhaps we must learn to embrace them in one way or another, for our own sake. L: Untitled (T.A.Z.). R: Untitled (United States Marine Guidebook of Essential Subjects) . 2011. BWS: Finally, let's discuss the near future. You've got an upcoming solo show at the Sala de Arte Público Siqueiros [SAPS] in Mexico City this summer. What can we expect from that? What else do you have planned? JS: I'll go and get seafood as soon as I'm done with this interview. It's pretty good here in Guadalajara. That's my top priority at this very moment. About my solo project at SAPS, it's due to open in late July. I'm quite looking forward to it. I'm still closely working with the curator on the general feel for the show but I can say that it'll be more of a revision of past works that have not been shown in Mexico City except for a couple pieces. It definitely won't be a showcase for new projects, although we may include one or two previously unseen works. What you can expect is a rereading of what I've been working on during the past few years. In a way, that's exciting to me because for some reason I don't really care about, I'm not that active in Mexico City even though that's where I lived and work for years. I've hardly shown there after my solo project at Yautepec in February of 2010. It'll be nice to see how it all comes together and I'm more thrilled about it because I totally love the space and I think they're doing an excellent job with their programming and its direction. And in a certain way it feels like going back home. About everything else, I need a period to reflect and fully understand what I've been thinking and working on. I've got a few group shows here and there: New York, San Francisco, and Melbourne are the ones happening soon. I will present my censored project Untitled ( Gringo Loco ) as part of the programming of the Museo de Arte de Zapopan in Guadalajara, two years after being escorted at gunpoint from the installation site by police sent by the extreme right-wing mayor of the city, which I found pretty amusing for an otherwise typical Saturday afternoon. I'm also involved in a couple "curatorial" projects. In my case, "curatorial" means that I help put together stuff I like and I'm interested in. One of them will open in late September of 2011 at Arena Mexico Arte Contemporaneo, and I will work with three of whom I consider to be some of the best artists in a lively and active scene such as the one here in Guadalajara. But most importantly, I've been doing heavy research so there are also a number of projects that I've yet to finalize. That'll be my main focus during the rest of the year, even though I really enjoy procrastination. There'll be time for that later. Or maybe not. We'll see. About Joaquin Segura The action, installation, intervention and photographic work of Joaquin Segura (b. Mexico City, 1980) has been shown in solo and group exhibitions in Mexico, the United States, Europe, and Asia. Some spaces that have featured his work include La Panaderia, Museo de Arte Carrillo Gil, Centro de la Imagen and Ex-Teresa Arte Actual in Mexico City; El Museo del Barrio and apexart, New York, NY; Museo Nacional Centro de Arte Reina Sofia in Madrid, Spain; National Center for Contemporary Art, Moscow, Russia; and Palace Adria in Prague, Czech Republic. In 2008 and 2009, Segura was an artist-in-residence at the International Studio and Curatorial Program, New York, NY and at the 18th Street Arts Center, Santa Monica, CA. He is represented YAUTEPEC in Mexico City and by Arena Mexico Arte Contemporáneo in Guadalajara. Further Reading Joaquin Segura’s website YAUTEPEC artist page for Joaquin Segura Capps, Kriston. “ID-ENTITY: Washington, DC.” ART PAPERS . 2009. (shrink)

En France, les personnes issues des minorités, principalement d'origine extra-européenne , sont susceptibles de connaître la discrimination, la stigmatisation mais aussi l'exclusion. La télévision, en tant que « lieu de reconnaissance », constitue un enjeu important pour ces populations. Cependant, le petit écran semble marginaliser depuis toujours ces minorités visibles non seulement en leur laissant une place limitée à l'antenne mais aussi en leur renvoyant des images majoritairement caricaturales et dévalorisantes d'elles-mêmes. Une enquête qualitative auprès de 43 individus d'origine africaine (...) et antillaise montre que les minorités sont capables de mettre en place des réactions défensives ou stratégies identitaires afin de réduire le décalage certain entre leur identité sociale - souvent dépréciatrice - et leur identité personnelle , prenant les médias comme ressources pour l'action.In France, persons belonging to minorities, mainly non-European origin , are likely to experience discrimination, stigmatization but also exclusion. Television as a "place of recognition," is an important issue for these people. However, the small screen seems to marginalize always visible minorities by giving them not only a limited role in the antenna but also by returning images mostly caricatures and demeaning to themselves. A qualitative survey of 43 individuals of African and Caribbean origin shows that minorities are able to implement defensive reactions or identity strategies to reduce the gap between some social identity - often dépréciatrice - and their personal identity , taking the media as resources for action. (shrink)

New uses of preimplantation genetic diagnosis to screen embryos prior to transfer raise ethical, legal, and policy issues that deserve close attention. Extensions for medical purposes, such as to identify susceptibility genes, late onset disease, and human leukocyte antigen matching, are usually ethically acceptable. Whether embryo screening for gender, perfect pitch, or other non-medical characteristics are also acceptable depends upon the parental needs served and the harm posed to embryos, children, and society. Speculations about potential future uses of (...) PGD should not prevent otherwise acceptable current uses of PGD. (shrink)

AIDSThe sudden appearance of a truly new disease is a wake-up call. A new global pandemic of an infectious agent, transmitted through sexual contact and blood, affecting alienated and/or deprived people and communities, infectious throughout, that causes a slowly progressive breakdown of defence against other infectious diseases, as well as causing dementia in some, and leads to a premature death, occurring in an era of extensive travel and rapid communication, is a veritable tocsin. These crude ingredients of AIDS as a (...) medical and social phenomenon, blended with the poignant personal histories revealed to clinical professionals, spiced — as if this were necessary — by the fear, the prejudice, the wild theorising and the voyeurism, have presented a substantial challenge to practical medical ethics.Familiar ethical debates have been reopened with new perspective and insight, others have been examined thoroughly for the first time. Building on the major developments in medical ethics over recent decades, AIDS has provided an opportunity, indeed a necessity, for its maturation. It continues to present new issues for debate, while those that were present from the outset continue to perplex us, as this issue of the journal should show. In teaching, AIDS offers a plethora of examples to illustrate most of the central tenets and tensions of medical ethics. As an exemplar, it has provided preparation and precedent for addressing some of the issues emerging from new challenges, such as screening for susceptibility to genetic disease.AJPBereavementThe word comes from the same germanic root as “to be robbed excessively”. Bereavement is an intensely personal and disorienting experience, to which people can react with denial, anger, guilt or depression, sometimes prolonged. In Western countries nowadays it is most commonly experienced in mid-life through the death of a parent, or in old age through that of a …. (shrink)

The ArgumentPressures to lower health-care costs remain an important stimulus to eugenic approaches. Prenatal diagnosis followed by abortion of affected fetuses has replaced sterilization as the major eugenic technique. Voluntary acceptance has replaced coercion, but subtle pressures undermine personal autonomy. The failure of the old eugenics to accurately predict who will have affected offspring virtually disappears when prenatal diagnosis is used to predict Mendelian disorders. However, when prenatal diagnosis is used to detect inherited susceptibilities to adult-onset, common, complex disorders, considerable (...) uncertainty is inherent in the prediction. Intolerance and the resurgence of genetic determinism are current pressures for a eugenic approach. The increasing use of carrier screening and of prenatal diagnosis could itself generate intolerance for those who refuse the procedures. Genetic determinism deflects society from social action that would reduce the burden of disease far more than even the maximum use of eugenics. (shrink)

Recent years have seen rapid advancements in selection assessments, shifting away from human and toward algorithmic judgments of candidates. Indeed, algorithmic recruitment tools have been created to screen candidates’ resumes, assess psychometric characteristics through game-based assessments, and judge asynchronous video interviews, among other applications. While research into candidate reactions to these technologies is still in its infancy, early research in this regard has explored user experiences and fairness perceptions. In this article, we review applicants’ perceptions of the procedural fairness of (...) algorithmic recruitment tools based on key findings from seven key studies, sampling over 1,300 participants between them. We focus on the sub-facets of behavioral control, the extent to which individuals feel their behavior can influence an outcome, and social presence, whether there is the perceived opportunity for a social connection and empathy. While perceptions of overall procedural fairness are mixed, we find that fairness perceptions concerning behavioral control and social presence are mostly negative. Participants feel less confident that they are able to influence the outcome of algorithmic assessments compared to human assessments because they are more objective and less susceptible to manipulation. Participants also feel that the human element is lost when these tools are used since there is a lack of perceived empathy and interpersonal warmth. Since this field of research is relatively under-explored, we end by proposing a research agenda, recommending that future studies could examine the role of individual differences, demographics, and neurodiversity in influencing fairness perceptions of algorithmic recruitment. (shrink)

Putnam says that "In one way of conceiving it, realism is an empirical theory." In the present work it is maintained that, in another way of conceiving it, realism is a grammatical thesis. That is, many of the principles taken to be definitive of realism, e.g., "Truth is objective," "Truth is mind-independent," Dummett's "a thought can be true only if there is something in virtue of which it is true," are what Wittgenstein would have called "grammatical remarks." They simply call (...) attention to certain features of the grammar of truth and related concepts. Thus, e.g., it is a feature of the way we use "is true" that statements are not spoken of as true for one person and not true for another. ;The character of grammar and of grammatical remarks in general is spelled out in some detail; it is argued in particular that Wittgenstein is not intending to provide, by means of these notions, a particular account of necessary truth. He is suggesting, rather, that looking upon certain philosophical claims as grammatical is a way of "deflating" them, stripping them of their appearance of profundity. Neither can grammatical remarks imply substantive philosophical theses. This is why realism, conceived as comprising grammatical remarks, does not imply scepticism, as is often supposed, and is not itself a controversial or exciting doctrine. ;There are of course some controversial formulations of realism, versions which are not simply underwritten by grammar. Thus some philosophers have held that, because the truth conditions of a proposition are essentially independent of any evidence we may have for the proposition, truth may not be accessible at all. I believe, however, that Putnam has shown, by means of an argument which is instructively viewed as a grammatical investigation, that truth is accessible, at least to an "ideal" theory. ;Recent expressions of idealism are argued to provide helpful accounts of language use and understanding, but fail to establish that truth is nothing but warranted assertibility, or that it must in some sense "arise within us." Such a conclusion runs afoul of the grammar of truth, of which realism is shown to provide the proper account. (shrink)

An important question in the current debate on the epistemic significance of peer disagreement is whether evidence of evidence is evidence. Fitelson argues that, at least on some renderings of the thesis that evidence of evidence is evidence, there are cases where evidence of evidence is not evidence. I introduce a condition and show that under this condition evidence of evidence is evidence.

Prenatal screening pathways, as nowadays offered in most Western countries consist of similar tests. First, a risk-assessment test for major aneuploides is offered to pregnant women. In case of an increased risk, invasive diagnostic tests, entailing a miscarriage risk, are offered. For decades, only conventional karyotyping was used for final diagnosis. Moreover, several foetal ultrasound scans are offered to detect major congenital anomalies, but the same scans also provide relevant information for optimal support of the pregnancy and the delivery. (...) Recent developments in prenatal screening include the application of microarrays that allow for identifying a much broader range of abnomalities than karyotyping, and non-invasive prenatal testing that enables reducing the number of invasive tests for aneuploidies considerably. In the future, broad NIPT may become possible and affordable. This article will briefly address the ethical issues raised by these technological developments. First, a safe NIPT may lead to routinisation and as such challenge the central issue of informed consent and the aim of prenatal screening: to offer opportunity for autonomous reproductive choice. Widening the scope of prenatal screening also raises the question to what extent ‘reproductive autonomy’ is meant to expand. Finally, if the same test is used for two different aims, namely detection of foetal anomalies and pregnancy-related problems, non-directive counselling can no longer be taken as a standard. Our broad outline of the ethical issues is meant as an introduction into the more detailed ethical discussions about prenatal screening in the other articles of this special issue. (shrink)

The mere presence of irrelevant external stimuli results in interference with the fidelity of details retrieved from long-term memory (LTM). Recent studies suggest that distractibility during LTM retrieval occurs when the focus of resource-limited, top-down mechanisms that guide the selection of relevant mnemonic details is disrupted by representations of external distractors. We review findings from four studies that reveal distractibility during episodic retrieval. The approach cued participants to recall previously studied visual details when their eyes were closed, or were open (...) and irrelevant visual information was present. The results showed a negative impact of the distractors on the fidelity of details retrieved from LTM. An fMRI experiment using the same paradigm replicated the behavioral results and found that diminished episodic memory was associated with the disruption of functional connectivity in whole-brain networks. Specifically, network connectivity supported recollection of details based on visual imagery when eyes were closed, but connectivity declined in the presence of visual distractors. Another experiment using auditory distractors found equivalent effects for auditory and visual distraction during cued recall, suggesting that the negative impact of distractibility is a domain-general phenomenon in LTM. Comparisons between older and younger adults revealed an aging-related increase in the negative impact of distractibility on retrieval of LTM. Finally, a new study that compared categorization abilities between younger and older adults suggests a cause underlying age-related decline of visual details in LTM. The sum of our findings suggests that cognitive control resources, although limited, have the capability to resolve interference from distractors during tasks of moderate effort, but these resources are overwhelmed when additional processes associated with episodic retrieval, or categorization of complex prototypes, are required. (shrink)

Prenatal screening for foetal abnormalities such as Down's syndrome differs from other forms of population screening in that the usual aim of achieving health gains through treatment or prevention does not seem to apply. This type of screening leads to no other options but the choice between continuing or terminating the pregnancy and can only be morally justified if its aim is to provide meaningful options for reproductive choice to pregnant women and their partners. However, this aim (...) should not be understood as maximizing reproductive choice per se. Only if understood as allowing prospective parents to avoid suffering related to living with serious disorders and handicaps can prenatal screening be a publicly or collectively funded programme. The alternative of moving prenatal testing outside the healthcare system into the private sector is problematic, as it makes these tests accessible only to those who can afford to pay for it. New developments in prenatal screening will have to be assessed in terms of whether and to what extent they either contribute to or undermine the stated aim of providing meaningful options for reproductive choice. In the light of this criterion, this article discusses the introduction of the new non-invasive prenatal test , the tendency to widen the scope of follow-up testing, as well as the possible future scenarios of genome-wide screening and ‘prenatal personalised medicine’. The article ends with recommendations for further debate, research and analysis. (shrink)

Setting goals in the workplace can motivate improved performance but it might also compromise ethical behavior. In this paper, we propose that individual differences in the dispositional tendency to morally justify behavior moderate the effects of specific performance goals on unethical behavior. We conducted an experimental study in which working participants, who were randomly assigned to a specific goal condition or to a condition with a vague goal that lacked a specific target, completed two tasks in which they had the (...) opportunity to act unethically. In an ethical dilemma task, participants in the specific goal condition were more likely to advocate using unethical methods. However, in an anagram task, only those with high moral justification overstated their performance to a greater degree in the specific goal condition. As such, individuals may not be equally susceptible to the ‘dark side’ of goal-setting. (shrink)

Prenatal screening for foetal abnormalities such as Down's syndrome differs from other forms of population screening in that the usual aim of achieving health gains through treatment or prevention does not seem to apply. This type of screening leads to no other options but the choice between continuing or terminating the pregnancy and can only be morally justified if its aim is to provide meaningful options for reproductive choice to pregnant women and their partners. However, this aim (...) should not be understood as maximizing reproductive choice per se. Only if understood as allowing prospective parents to avoid suffering related to living with (a child with) serious disorders and handicaps can prenatal screening be a publicly or collectively funded programme. The alternative of moving prenatal testing outside the healthcare system into the private sector is problematic, as it makes these tests accessible only to those who can afford to pay for it. New developments in prenatal screening will have to be assessed in terms of whether and to what extent they either contribute to or undermine the stated aim of providing meaningful options for reproductive choice. In the light of this criterion, this article discusses the introduction of the new non‐invasive prenatal test (NIPT), the tendency to widen the scope of follow‐up testing, as well as the possible future scenarios of genome‐wide screening and ‘prenatal personalised medicine’. The article ends with recommendations for further debate, research and analysis. (shrink)

There is a growing consensus that results generated through multiplex genetic tests, even those produced as a part of research, should be reported to providers and patients when they are considered “actionable,” that is, when they could be used to inform some potentially beneficial clinical action. However, there remains controversy over the precise criterion that should be used in identifying when a result meets this standard. In this paper, we seek to refine the concept of “actionability” by exploring one proposed (...) use for genetic test results. We argue that genetic test results indicating that a patient is at risk for developing a chronic health condition should not be considered actionable if the only potential value of that result is to motivate patients to make changes in their health behaviors. Since the empirical research currently available on this question is equivocal, we explore relevant psychological theories of human motivation to demonstrate that current theory does not support the assumption that information about genetic risk will be motivating to most patients in their attempts to make changes in health behaviors. (shrink)

Brandon ([1982] 1984, 1990) has argued that Salmon's (1971) concept of screening-off can be used to characterize (i) the idea that natural selection acts directly on an organism's phenotype, only indirectly on its genotype, and (ii) the biological problem of the levels of selection. Brandon also suggests (iii) that screening-off events in a causal chain are better explanations than the events they screen off. This paper critically evaluates Brandon's proposals.

Research suggests that the reaching hand automatically deviates toward a target that changes location during the reach. In the current study, we investigated whether movement intention can influence the target jump’s impact on the hand. We compared the degree of trajectory deviation to a jumped target under three instruction conditions: GO, in which participants were told to go to the target if it jumped, STOP, in which participants were told to immediately stop their movement if the target jumped, and IGNORE, (...) in which participants were told to ignore the target if it jumped and to continue to its initial location. We observed a reduced response to the jump in the IGNORE condition relative to the other conditions, suggesting that the response to the jump is contingent on the jump being a task-relevant event. (shrink)