Prenatal screening and testing are preference‐based health care options. They are offered so that pregnant women and their partners can learn genetic information about the developing fetus. In this literature review, I summarize studies of women’s and their partners’ psychological responses to prenatal testing and screening. These studies investigate the experiences of pregnant women, largely in the United States, who have access to health care services. Although the results indicate that these women are receptive to prenatal testing and screening and (...) seem to have limited negative psychological consequences, pregnant women without access to these services are not represented and may have different experiences. With that caveat in mind, based on the evidence, women generally do well psychologically as they manage the options that arise for them in the prenatal context. (shrink)

There is limited knowledge about cancer patients' experiences of uncertainty while waiting for genome sequencing results, and whether prolonged uncertainty contributes to psychological factors in this context. To investigate uncertainty in patients with a cancer of likely hereditary origin while waiting for genome sequencing results, we collected questionnaire and interview data at baseline, and at three and 12 months follow up. Participants had negative attitudes towards uncertainty at baseline, and low levels of uncertainty at three and 12 months. Uncertainty about (...) genome sequencing did not change significantly over time [t = 0.660, p = 0.510]. Greater perceived susceptibility for cancer [r = 0.14, p < 0.01], fear of cancer recurrence [r = 0.19, p < 0.01], perceived importance of genome sequencing [r = 0.24, p < 0.01], intention to change behavior if a gene variant indicating risk is found [r = 0.29, p < 0.01], perceived ability to cope with results [r = 0.36, p < 0.01], and satisfaction with decision to have genome sequencing [r = 0.52, p < 0.01] were significantly correlated with negative attitudes towards uncertainty at baseline. Multiple primary cancer diagnoses [B = −2.364 [−4.238, −0.491], p = 0.014], lower perceived ability to cope with results [B = −0.1.881 [−3.403, −0.359], p = 0.016] at baseline, greater anxiety about genome sequencing [B = 0.347 [0.148, 0.546], p = 0.0012] at 3 months, and greater perceived uncertainty about genome sequencing [B = 0.494 [0.267, 0.721] p = 0.000] at 3 months significantly predicted greater perceived uncertainty about genome sequencing at 12 months. Greater perceived uncertainty about genome sequencing at 3 months significantly predicted greater anxiety about genome sequencing at 12 months [B = 0.291 [0.072, 0.509], p = 0.009]. Semi-structured interviews revealed that while participants were motivated to pursue genome sequencing as a strategy to reduce their illness and risk uncertainty, genome sequencing generated additional practical, scientific and personal uncertainties. Some uncertainties were consistently discussed over the 12 months, while others emerged over time. Similarly, some uncertainty coping strategies were consistent over time, while others emerged while patients waited for their genome sequencing results. This study demonstrates the complexity of uncertainty generated by genome sequencing for cancer patients and provides further support for the inter-relationship between uncertainty and anxiety. Helping patients manage their uncertainty may ameliorate psychological morbidity. (shrink)

Integral Science's most distinctive effect is to shift the context of human interactions from competition against one another to seeking what is good for both one's self and the larger whole. The partnership environment it suggests creates a foundation of relationship that powerfully increases organizational intelligence. This simple switch creates the potential for both more humanistic and more effective organizations that are better able to meet the needs of the populations they serve.

Surgery is an important part of health care worldwide. Without access to surgical treatments, morbidity and mortality increase. Access to surgical treatment is a significant problem in global public health because surgical services are not equally distributed in the world. There is a disproportionate scarcity of surgical access in low-income countries. There are many charitable organizations around the world that sponsor surgical missions to under served nations. One such organization is Operation Smile International, a group with which both authors have (...) volunteered. This paper will describe the purpose and processes involved in Operation Smile and identify some of the key ethical issues that arise in short term medical volunteer work highlighting the importance of sustainability. (shrink)

Suffering is a universal human phenomenon. In a time when religious differences are evident and often fuel conflict, shared narratives may provide common ground in which true understanding may take root. This paper will consider the problem of suffering and address how adherents of the three great monotheistic traditions seek understanding, comfort, and the believer’s appropriate response from the same story found within their respective sacred texts: the story of Job, the servant of Yahweh in the Tanakh/Old Testament of Judaism (...) and Christianity— known as Ayyub, prophet of Allah, in the Qur’an. The story of Job addresses more than the distribution of evil problem. At stake in the story is Job’s very relationship to his God. This paper will consider a few of the many Jewish, Christian, and Islamic insights from the ancient story, hopefully leading to mutual understanding and empathy. Keywords: suffering, Tanakh, Qur’an, Job, Ayyub. (shrink)

American Academy of Pediatrics (AAP) and American College of Medical Genetics (ACMG) recently provided two recommendations about predictive genetic testing of children. The Clinical Sequencing Exploratory Research Consortium's Pediatrics Working Group compared these recommendations, focusing on operational and ethical issues specific to decision making for children. Content analysis of the statements addresses two issues: (1) how these recommendations characterize and analyze locus of decision making, as well as the risks and benefits of testing, and (2) whether the guidelines conflict or (...) come to different but compatible conclusions because they consider different testing scenarios. These statements differ in ethically significant ways. AAP/ACMG analyzes risks and benefits using best interests of the child and recommends that, absent ameliorative interventions available during childhood, clinicians should generally decline to order testing. Parents authorize focused tests. ACMG analyzes risks and benefits using the interests of the child and other family members and recommends that sequencing results be examined for additional variants that can lead to ameliorative interventions, regardless of age, which laboratories should report to clinicians who should contextualize the results. Parents must accept additional analysis. The ethical arguments in these statements appear to be in tension with each other. (shrink)

The purpose of the current study was to examine the reliability and validity of the RESTQ-Sport-36 for use in the collegiate student-athlete population. A total of 494 collegiate student-athletes competing in National Collegiate Athletic Association Division I, II, or III sanctioned sport completed the RESTQ-Sport-36 and Brief Profile of Mood States. Structural equation modeling procedures were used to compare first order to hierarchical model structures. Results of a confirmatory factor analysis and exploratory structural equation modeling analysis indicated that the first (...) order 12-factor structure demonstrated the best fit of all models tested. Support was not observed for the fit of any hierarchical model. Moderate to strong correlations were observed between stress and recovery subscales and mood states, thus supporting the construct validity of the abbreviated RESTQ measurement model. The current findings provide support for the measure’s use in this population and give pause as it relates to the scoring and interpretation of hierarchical factors such as Total Stress and Total Recovery. Overall, the current results indicate that the RESTQ-Sport-36 may be a useful tool for collegiate student-athlete training load and competition monitoring. (shrink)

During the past two decades, several reports have documented substantial support from clinicians, policy-makers, and the general public for the use of advance directives, yet studies continue to find that only a minority of individuals have completed these legal documents. Advance directives are written instructions, such as living wills or durable powers of attorney for health care, which describe an individual's medical treatment wishes in the event that individual becomes incapacitated in the future. The completion and use of advance directives (...) is one of several components of the broader activity of advance care planning, that is, the overall planning and communication of personal wishes concerning future medical care.In December 1991, the federal Patient Self-Determination Act became effective. Promoted as a federal initiative to enhance an individual's control over medical treatment decision making and, therefore, patient autonomy and self-determination, PSDA placed several new requirements on health care organizations receiving Medicare or Medicaid payments. (shrink)

During the past two decades, several reports have documented substantial support from clinicians, policy-makers, and the general public for the use of advance directives, yet studies continue to find that only a minority of individuals have completed these legal documents. Advance directives are written instructions, such as living wills or durable powers of attorney for health care, which describe an individual's medical treatment wishes in the event that individual becomes incapacitated in the future. The completion and use of advance directives (...) is one of several components of the broader activity of advance care planning, that is, the overall planning and communication of personal wishes concerning future medical care.In December 1991, the federal Patient Self-Determination Act became effective. Promoted as a federal initiative to enhance an individual's control over medical treatment decision making and, therefore, patient autonomy and self-determination, PSDA placed several new requirements on health care organizations receiving Medicare or Medicaid payments. (shrink)

On the fiftieth anniversary of Philosophy and Rhetoric I hope a future for the journal that not only continues to publish scholarship that reflects seriously on the productive possibilities of putting the unique understandings of the human condition delivered by philosophy into contact with the singular insights into the power and perils of speech, writing, and gesture offered up by rhetoric. I also wish for it printed pages on which scholars engage thoughtfully the challenges posed by worlds and loss of (...) worlds. Never before in my lifetime has this task seemed so urgent and so necessary. This article is delivered in that spirit.On 13 July 2013 a jury of six women in Sanford, Florida, returned a verdict of not... (shrink)

The theme of this special issue is Post-truth. No doubt it was my exasperation with the terminological state of our collective situation that incited me in the spring of 2017 to settle upon it. What, exactly, does the hyphenated couplet mean or to what does it refer? What is its significance or sense? How is it being used, by whom, for what purpose, and with what consequences—for whom? And if, as was being asserted on nearly every side, we currently find (...) ourselves in post-truth, how might we ever get out, presuming we may one day want as much? The original contributions by Sarah Burgess, James Crosswhite, Jason David Myres, Bradford Vivian, and Eric King Watts published herein go a long way toward answering these... (shrink)

: The accelerated discovery of gene mutations that lead to increased risk of disease has led to the rapid development of predictive genetic tests. These tests improve the accuracy of assigning risk, but at a time when intervention or prevention strategies are largely unproved. In coming years, however, data will become increasingly available to guide treatment of genetic diseases. Eventually genetic testing will be performed for common diseases as well as for rare genetic conditions. This will challenge genetic counseling practice. (...) The ethical principles that now guide this practice take into account the personal nature of test decision making, the need to respect individual self-determination, and the importance of client confidentiality. Certain of these principles may have to be modified as genetic testing becomes more widespread in order to meet the changing needs of clients and society. This paper offers recommendations to ensure that genetic counselors will take a leading role in the future delivery of ethical genetic services. (shrink)

To understand public discourse in the United States on genetic causation of behavioral disorders, we analyzed media representations of genetic research on addiction published between 1990 and 2010. We conclude first that the media simplistically represent biological bases of addiction and willpower as being mutually exclusive: behaviors are either genetically determined, or they are a choice. Second, most articles provide only cursory or no treatment of the environmental contribution. A media focus on genetics directs attention away from environmental factors. Rhetorically, (...) media neglect the complexity underlying the etiology the addiction and direct focus back toward individual causation and responsibility. (shrink)

How does evolution grow bigger brains? It has been widely assumed that growth of individual structures and functional systems in response to niche-specific cognitive challenges is the most plausible mechanism for brain expansion in mammals. Comparison of multiple regressions on allometric data for 131 mammalian species, however, suggests that for 9 of 11 brain structures taxonomic and body size factors are less important than covariance of these major structures with each other. Which structure grows biggest is largely predicted by a (...) conserved order of neurogenesis that can be derived from the basic axial structure of the developing brain. This conserved order of neurogenesis predicts the relative scaling not only of gross brain regions like the isocortex or mesencephalon, but also the level of detail of individual thalamic nuclei. Special selection of particular areas for specific functions does occur, but it is a minor factor compared to the large-scale covariance of the whole brain. The idea that enlarged isocortex could be a a by-product of structural constraints later adapted for various behaviors, contrasts with approaches to selection of particular brain regions for cognitively advanced uses, as is commonly assumed in the case of hominid brain evolution. (shrink)

Until recently, it was assumed that co-representation of others’ actions, an essential part in joint action, is biologically tuned. However, research demonstrated that we also simulate actions of non-biological interaction partners under certain conditions. In the present study, we investigated whether perceived intentionality or perspective taking is the underlying mechanisms of this phenomenon. Participants saw a short video fragment of a non-biological agent as main character. The movements of this agent were either described as intentional or as unintentional. Furthermore, participants (...) were instructed to either take the perspective of this non-biological agent or not. Results show that perspective taking and perceived intentionality both lead to action co-representation of non-biological actions. Possible explanations for these findings are discussed. (shrink)

Until recently, it was assumed that co-representation of others’ actions, an essential part in joint action, is biologically tuned. However, research demonstrated that we also simulate actions of non-biological interaction partners under certain conditions. In the present study, we investigated whether perceived intentionality or perspective taking is the underlying mechanisms of this phenomenon. Participants saw a short video fragment of a non-biological agent as main character. The movements of this agent were either described as intentional or as unintentional. Furthermore, participants (...) were instructed to either take the perspective of this non-biological agent or not. Results show that perspective taking and perceived intentionality both lead to action co-representation of non-biological actions. Possible explanations for these findings are discussed. (shrink)

Young children initially learn to ‘count’ without understanding either what counting means, or what numerical quantities the individual number words pick out. Over a period of many months, children assign progressively more sophisticated meanings to the number words, linking them to discrete objects, to quantification, to numerosity, and so on. Eventually, children come to understand the logic of counting. Along with this knowledge comes an implicit understanding of the successor function, as well as of the principle of equinumerosity, or exact (...) equality between sets. Thus, when children arrive at a mature understanding of counting, they have a way of mentally representing exact, large numbers. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Eyes of the University: Right to Philosophy 2Barbara A. BieseckerEyes of the University: Right to Philosophy 2. Jacques Derrida Trans.Jan Plug and others. Stanford: Stanford University Press, 2004. Pp. xi, 303. $53.95, hardcover, $20.95, paperback.My motivation is doubled. First, I want to use the occasion of this review to mark out a consistent and dominant motif in the life's work of Jacques Derrida (whose passing nearly two years (...) ago left the world a considerably less hospitable place) that practitioners in my field have tended to miss altogether or have deliberately disavowed. I want, in other words, to force our encounter, however belated and brief, with Derrida's participatory and persistent critique of responsibility. Contrary to the intellectual lore and the (not so) local interests that support it, I will dare to say, with the earnest hope of provocation, Derrida never stopped thinking and writing about the subject of responsibility and, more precisely, about the experience of the aporia through which every responsible decision must necessarily "pass." To borrow a phrase, deconstruction in a nutshell: a sustained meditation on responsibility that, in affirmatively insisting on the "nonpassive endurance of the aporia [as] the condition of responsibility of decision" (1993, 16), refuses the assurances of antinomy and dialecticizable contradiction in all of its senses. To think and write about responsibility in a deconstructive key is, then, to wager an aneconomics of the act, of decision and action without guarantees. Let us (re)read what Derrida has said on numerous occasions:To protect the decision or the responsibility by knowledge, by some theoretical assurance, or by the certainty of being right, of being on the side of science, of consciousness or of reason, is to transform this experience into the deployment of a program, into a technical application of a rule or a norm, or into the subsumption of a determined "case." All these are conditions that must never be abandoned, of course, but that, as such, are only the guardrail of a responsibility to whose calling they remain radically heterogeneous.(1993, 19)Not the dismantling of the subject but the identification of the condition of possibility of an agent who labors to live up to that impossible name.But I do not want only to contest at least one field's sanctioned ignorance by recommending Eyes of the University be read solely as variations on a long-standing and significant deconstructive theme. With attentiveness to the particular [End Page 254] inflections of the pieces collected therein as well as to the complex tangle of techniques of knowledge and strategies of power that constitutes our professional or institutional present, I want also to underscore the timeliness and usefulness of the volume for Philosophy and Rhetoric's cross-disciplinary readership, an increasing percentage of whom is engaged in the business of self-(re)definition and outreach, prompted in good part by dramatic shifts in attitudes and resources on the national, state, and local levels. Eyes of the University, then, as a kind of primer for all those amongst us embroiled in shaping and provisionally securing the future of higher learning in the humanities. Indeed, over the course of this collection of lectures, essays, interviews, and reports crafted between 1975 and 1990, Derrida revisits responsibility as a question of and for the university. During a talk marking the anniversary of the founding of Columbia University's graduate school and reprinted here as "Mochlos: Eyes of the University," Derrida posits the irreducibly rhetorical question (not because it has no answer but, rather, because it has at least two) in the following way:If we could say we (but have I not already said it?), we might perhaps ask ourselves: where are we? And who are we in the university where apparently we are? What do we represent? Whom do we represent? Are we responsible? For what and to whom? If there is a university responsibility, it at least begins the moment when a need to hear these questions, to take them upon oneself and respond to them, imposes itself. This imperative of the response is the initial form and minimal requirement of responsibility.(2004, 83)Turning to... (shrink)

First, we clarify the central nature of our argument: our attempt is to apportion variation in brain size between developmental constraint, system-specific change, and change, underlining the unexpectedly large role of developmental constraint, but making no case for exclusivity. We consider the special cases of unusual hypertrophy of single structures in single species, regressive nervous systems, and the unusually variable cerebellum raised by the commentators. We defend the description of the cortex (or any developmentally-constrained structure) as a potential spandrel, and (...) weigh the implications of the spandrel concept for the course of human evolution. The empirical and statistical objections raised in the commentary of Barton are discussed at length. Finally, we catalogue and comment on the suggestions of new ways to study brain evolution, and new aspects of brain evolution to study. (shrink)

Until recently, it was assumed that co-representation of others’ actions, an essential part in joint action, is biologically tuned. However, research demonstrated that we also simulate actions of non-biological interaction partners under certain conditions. In the present study, we investigated whether perceived intentionality or perspective taking is the underlying mechanisms of this phenomenon. Participants saw a short video fragment of a non-biological agent as main character. The movements of this agent were either described as intentional or as unintentional. Furthermore, participants (...) were instructed to either take the perspective of this non-biological agent or not. Results show that perspective taking and perceived intentionality both lead to action co-representation of non-biological actions. Possible explanations for these findings are discussed. (shrink)

The aim of the paper is to show that topoi are useful in the categorial analysis of the constructive logic with strong negation. In any topos ϵ we can distinguish an object Λ and its truth-arrows such that sets ϵ have a Nelson algebra structure. The object Λ is defined by the categorial counterpart of the algebraic FIDEL-VAKARELOV construction. Then it is possible to define the universal quantifier morphism which permits us to make the first order predicate calculus. The completeness (...) theorem is proved using the Kripke-type semantic defined by THOMASON. (shrink)

Scientists seeking hard evidence of prayer's curative powers misunderstand the nature of prayer in the Western theistic traditions. Yet theistically consonant ways in which religious belief may influence health do not figure as they should in current professional practice.

Bioethicists teaching and writing about the uses of prenatal genetic testing sometimes use “difficult cases” in which people with a disability want to test and select for the presence of their disability. Such cases challenge our stereotypes but also play into them.

The first set of case studies on animal use, this volume offers a thorough, up-to-date exploration of the moral issues related to animal welfare. Its main purpose is to examine how far it is ethically justifiable to harm animals in order to benefit mankind. An excellent introduction provides a framework for the cases and sets the background of philosophical and moral concepts underlying the subject. Sixteen original, previously unpublished essays cover controversies associated with the human use of animals in a (...) broad range of contexts, including biomedical, behavioral, and wildlife research, cosmetic safety testing, education, the food industry, commerce, and animal use as pets and in religious practices. Scientific research is accorded the closest scrutiny. The authors represent a wide range of expertise within their specialized areas of research--physiology, public policy, ethics, philosophy, law, veterinary science, and psychology. The careful analysis of each case makes it possible to elevate the discourse beyond over-simplified positions, and to demonstrate the complexity of the issues. The Human Use of Animals will be welcomed by students and faculty in law, philosophy, ethics, public policy, religion, medicine, and veterinary medicine. It will also interest activists in the animal protection movement, and members of animal protection organizations and Institutional Animal Care and Use Committees. (shrink)