Pharmacogenomics is a quickly evolving field of research that increasingly impacts individuals and society. As some innovations in biotechnology have experienced strong public opposition during the 1990s, interaction between producers and users of these innovations may help in increasing their success in social and economic terms. However, conditions for effective interaction have so far remained under-explored. This paper explores user-producer interactions in pharmacogenomics from an innovation and science communication perspective in the Netherlands. To find possible ways of engaging stakeholders in (...) an early stage of technology development, ie, when science policy is in the making, we present communication activities derived from the field of policy analysis. To articulate motives for two-way public participation in genomics innovation processes, we describe two levels at which pharmacogenomics developments will have an input:1) at the meso-level of medical practice with already established medical technologies, values and routines, suppliers and health professionals (general practitioners, pharmacists), and 2) at the macro-level of society at large, with established institutions, infrastructures, and broadly shared values and beliefs among citizens in general. Thereby we offer a starting point for optimising decision-making processes in the field of pharmacogenomics innovations, including important aims to be reached, stakeholders to be involved, and some criteria for designing interactive communication activities. (shrink)

Background Informed consent procedures for large population-based cohort studies should be comprehensive and easy-to-use. This is particularly challenging when participants from different socio-economic groups and multicultural ethnic backgrounds are involved. Recently, more and more studies have tried to use multimedia in informed consent procedures. We describe the development and testing of a digital informed consent app and elaborate on whether this may contribute to a comprehensive and practical procedure to obtain informed consent for public health research. Methods In a sample (...) of parents with young children, we used a mixed method approach to study the user experience of an informed consent app and evaluate whether it can be used to adequately inform people and register their consent. Through semi-structured interviews we investigated participants’ experiences with and opinions about the app, with a special focus on comprehensibility of the content and the usability of the app. Information retention questions were asked to evaluate to what extent participants could recall key aspects of the provided study information. Results The 30 participants in this study used the app between 4 and 15 min to give their consent. Overall, they found the app well-designed, informative and easy to use. To learn more about the study for which informed consent is asked, most of the participants chose to watch the animated film, which was generally found to convey information in a clear manner. The identification process was met with mixed reactions, with some feeling it as a secure way to give consent, while for others it contradicted their view of using data anonymously. Information retention questions showed that while all participants remembered various aspects of the study, fewer than half answered all four questions satisfactorily. Conclusion Our study shows that a well-designed informed consent app can be an effective tool to inform eligible participants and to record consents. Still, some issues remain, including trust barriers towards the identification procedure and lack of information retention in some participants. When implementing consent procedures that incorporate digital formats, it may be beneficial to also invest in a complementary face-to-face recruitment approach. (shrink)

A continuoxis t- norm is a continuous map * from [0, 1]² into [0,1] such that is a commutative totally ordered monoid. Since the natural ordering on [0,1] is a complete lattice ordering, each continuous t-norm induces naturally a residuation → and becomes a commutative naturally ordered residuated monoid, also called a hoop. The variety of basic hoops is precisely the variety generated by all algebras, where * is a continuous t-norm. In this paper we investigate the structure of the (...) variety of basic hoops and some of its subvarieties. In particular we provide a complete description of the finite subdirectly irreducible basic hoops, and we show that the variety of basic hoops is generated as a quasivariety by its finite algebras. We extend these results to Hájek's BL-algebras, and we give an alternative proof of the fact that the variety of BL-algebras is generated by all algebras arising from continuous t-norms on [ 0,1] and their residua. The last part of the paper is devoted to the investigation of the subreducts of BL- algebras, of Gödel algebras and of product algebras. (shrink)

The criminal law presently distinguishes between actions and omissions, and only rarely proscribes failures to avert consequences that it would be an offense to bring about. Why? In recent years it has been persuasively argued by both Glover and Bennett that, celeris paribus, omissions to prevent a harm are just as culpable as are actions which bring that harm about. On the other hand, and acknowledging that hitherto “lawyers have not been very successful in finding a rationale for it,” Tony (...) Honoré has sought to defend the law's differential treatment. He proposes a “distinct-duties theory” that in addition to the general duties we owe to everyone, we also owe distinct duties to a more limited collection of people and associations, specified by features of our relationship with them. Where a distinct duty holds, breach by omission may well be no better than breach by positive action. But absent a distinct duty, omissions, per Honoré, are less culpable. They are mere failures to intervene and improve or rectify things, whereas actions are positive interventions which make things worse. And, thus, the law has good reason to differentiate between them. (shrink)

It has often been charged that the doctrine of papal infallibility is either false or incoherent. These charges stem, I believe, from a misunderstanding of the logical character of infallible papal utterances, a misunderstanding shared alike by friends and foes of the doctrine. In this paper, I shall argue that the doctrine is both coherent and correct. I devote section I to uncovering some of the sources of this misunderstanding and thereby defending what might be called my negative thesis, namely, (...) that infallible papal utterances are not statements. In section II, I continue defending my negative thesis, not now as an end in itself, but rather as a means of advancing my positive thesis that infallible papal utterances are declarations and have the same logic as other declarations. The latter thesis requires a discussion of the difference between statements and declarations. Section III contains a formal speech act analysis of successful and non-defective statements and declarations with some additional explanatory notes. In section IV, I speak rather generally about the task of philosophical theology in the light of the results and procedures of sections I–III. (shrink)

Patrick McGrath has argued that my defence of papal infallibility does not succeed. His basic strategy is to establish that, contrary to my arguments, infallible papal utterances are statements and not merely declarations. He wants this result in order to go on to show that the Pope, in possession of no priviliged epistemic access to the world, is not infallible. I agree that the Pope has no priviliged epistemic access; so that is not in dispute. What is in dispute is (...) the fundamental question of whether infallible papal utterances are statements or declarations. I want to show that McGrath's arguments against my position do not work. If I am successful, then the Pope's infallibility is secure. (shrink)

The development of culture-independent strategies to study microbial diversity and function has led to a revolution in microbial ecology, enabling us to address fundamental questions about the distribution of microbes and their influence on Earth’s biogeochemical cycles. This article discusses some of the progress that scientists have made with the use of so-called “omic” techniques (metagenomics, metatranscriptomics, and metaproteomics) and the limitations and major challenges these approaches are currently facing. These ‘omic methods have been used to describe the taxonomic structure (...) of microbial communities in different environments and to discover new genes and enzymes of industrial and medical interest. However, microbial community structure varies in different spatial and temporal scales and none of the ‘omic techniques are individually able to elucidate the complex aspects of microbial communities and ecosystems. In this article we highlight the importance of a spatiotemporal sampling design, together with a multilevel ‘omic approach and a community analysis strategy (association networks and modeling) to examine and predict interacting microbial communities and their impact on the environment. (shrink)

In 1956, a few writings of Wittgenstein that he didn't publish in his lifetime were revealed to the public. These writings were gathered in the book Remarks on the Foundations of Mathematics (1956). There, we can see that Wittgenstein had some discontentment with the way philosophers, logicians, and mathematicians were thinking about paradoxes, and he even registered a few polemic reasons to not accept Gödel’s incompleteness theorems.

The book opens with a description of the smooth transition from Newtonian to Einsteinian behaviour from electrons as their energy is progressively increased, ...

Objectives To investigate empirically the motivations for not consenting to DNA biobanking in a Swedish population-based study and to discuss the implications. Design Structured questionnaires and semistructured interviews. Setting A longitudinal epidemiological project (PART) ongoing since 1998 in Stockholm, Sweden. The DNA-collection wave took place during 2006–7. Participants 903 individuals completed the questionnaire (participation rate 36%) and 23 were interviewed. All individuals had participated in both non-genetic waves of the project, but refused to contribute saliva samples during the DNA-collection wave. (...) Main outcome measures Motivations behind refusing to consent to DNA biobanking, with subsequent focus on participants' explanations regarding this unwillingness. Results Public refusal to consent to DNA biobanking, as revealed by the questionnaire, was mainly explained by a lack of personal relevance of DNA contribution and feelings of discomfort related to the DNA being used for purposes other than the respective study. Interviews of individuals representing the second motivation, revealed a significant mistrust of DNA biobank studies. The underlying beliefs and attitudes were associated with concerns about integrity, privacy, suspiciousness and insecurity. However, most interviewees were supportive of genetic research per se and interpreted their mistrust in the light of distressing environmental influences. Conclusion The results suggest a need for guidelines on benefit sharing, as well as trustworthy and stable measures to maintain privacy, as a means for increasing personal relevance and trust among potential participants in genetic research. Measures taken from biobanks seem insufficient in maintaining and increasing trust, suggesting that broader societal measures should be taken. (shrink)

It is often alleged that an agent is morally responsible in a liability sense for a transgression just in case s/he deserves a negative interpersonal response for that transgression, blaming responses such as resentment and indignation being paradigms. Aside from a few exceptions, guilt is cited in recent discussions of moral responsibility, if at all, as merely an effect of being blamed, or as a reliable indicator of moral responsibility, but not itself an explanation of moral responsibility. In this paper, (...) I argue that an agent is morally responsible in a liability sense for a transgression just in case s/he deserves to feel moral guilt for that transgression. I argue that this alternative view offers all that the predominant blame-focused view offers, while also solving some puzzling features of moral responsibility. Specifically, it offers a compelling way to reconcile conflicting intuitions about the suberogatory, and allows those who do not understand what Darwall calls ‘second-personal’ reasons to be morally responsible for their immoral acts. (shrink)

When should we make use of the criminal law? Suppose that a responsible legislature seeks to enact a morally justifiable range of criminal prohibitions. What criteria should it apply when deciding whether to proscribe conduct? Crimes, Harms, and Wrongs is a philosophical analysis of the nature, significance, and ethical limits of criminalisation. The authors explore the scope and moral boundaries of harm-based prohibitions, proscriptions of offensive behaviour, and 'paternalistic' prohibitions aimed at preventing self-harm. Their aim is to develop guiding principles (...) for these various grounds of state prohibition, including an analysis of the constraints and mediating factors that weigh for and against criminalisation. Both authors have written extensively in the field. In Crimes, Harms, and Wrongs they have reworked a number of well-known essays and added several important new essays to produce an integrated, accessible, philosophically-sophisticated account that will be of great interest to legal academics, philosophers, and advanced students alike"--Provided by publisher. (shrink)

Objectives: This study attempts to analyse the ethical dilemmas arising from the microallocation of scarce health care resources, in terms of deontology and utilitarianism.Methods: A group of 395 people were interviewed in the region of Diadema, greater San Paulo, Brazil, while visiting patients in the only state hospital in town. Each interviewee was given a list of eight simulated emergencies . In each of the eight cases the interviewee had to choose which of the two patients described, both of whom (...) suffered from exactly the same problem, should receive the only hospital bed currently available. The differences between the hypothetical patients were as follows: age, gender, family dependency, and lifestyle. Each interviewee was asked to justify one of their responses. These responses were then analysed.Results: The results pointed to the co-existence of deontological and utilitarian orientations among the people interviewed. A tendency to give priority to the destitute was revealed throughout the research, contradicting the idea that society, valuing only productive people, wishes only such people to receive the most resources, thus maximising the benefits to be gained from resources. The results showed that people’s disapproval of the alcoholic was stronger than that of the nicotine abuser. (shrink)

There has been an increase in recent years in the use of empirical methods in healthcare ethics. Appeals to empirical data cannot answer moral questions, but insights into the knowledge, attitudes, experience, preferences and practice of interested parties can play an important part in the development of healthcare ethics. In particular, while we may establish a general ethical principle to provide explanatory and normative guidance for healthcare professionals, the interpretation and application of such general principles to actual practice still requires (...) interpretation and judgement. And many situations in healthcare practice are complex and may involve a variety of principles, each of which may conflict with the others. Simple surveys or interview studies may not be sufficient if we wish to develop a nuanced approach to ethical practice that can be set out in guidelines, codes or directives. We do not resolve moral questions by plebiscite. In this paper, the authors argue for the use of consensus methods to develop shared understanding of ethical practice, and they argue further for the combination of the Delphi method with the use of vignettes to illustrate the kind of situations that may occur in practice. They develop their argument in part by reference to their experience of using this approach in their recent research. (shrink)

This essay lays the groundwork for a novel conception of autonomy that may be called “effective autonomy”—a conception designed to be genuinely action guiding in bioethics. As empirical psychology research on the heuristics and biases approach shows, decision making commonly fails to correspond to people’s desires because of the biases arising from bounded cognition. People who are classified as autonomous on contemporary philosophical accounts may fail to be effectively autonomous because their decisions are uncoupled from their autonomous desires. Accordingly, continuing (...) attempts to value patient autonomy must go beyond existing philosophical conceptions of autonomy to consider the background conditions of human decision making. (shrink)

McGavin, PA The Holy Father often speaks without a prepared text, and it is amazing how accurately he reads in transcription. This was brilliantly so in Light of the World interviews. Even his brief words at pages 118-119 on condoms - so breathlessly and inaccurately treated in the media - are so cast as to withstand close scrutiny. It is with this recognition that I address his lack of precision and perception in speaking on the question of homosexuality and sacred (...) ordination. (shrink)