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)

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)

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)

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)

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.

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)