Wait, what? I've been fired?” I repeated, in the middle of morning rounds in the neonatal intensive care unit. Finally, the nurse who was taking care of our patient, Angela, responded, “Her parents fired you last night. They've already called Patient Relations. They want a new doctor.” My heart sank. Only days into my block of service time as the attending physician in the NICU and I was fired, axed, canned, rejected by a family. How could this have happened? On (...) my first day of service, I had introduced myself to Angela's parents, and I had then met with them daily to review results and the plan and to answer their questions. I thought we had connected well. I thought I had done everything right. I thought they trusted me to care for their daughter. (shrink)

With advancing rank in medical training comes increased academic and clinical responsibility, including education and supervision of trainees and junior staff. When I became a senior postdoctoral fellow sub‐specializing in neonatology, I assumed the role of co‐attending in the neonatal intensive care unit. At that point in my training, I felt well prepared for the challenging task. I would be in charge, make decisions independently with the team, and supervise, as well as teach, the junior fellows, residents, and practitioners. In (...) short, I would assume full responsibility for the care of the patients, their families, and the medical team. My mentor, an experienced attending, would discuss every patient with me each day, but would otherwise stand in the shadows, available for help and guidance when needed. On the very first day, one of the smaller premature babies on our service started having difficulty breathing, and it was soon clear that she would need to have her endotracheal tube reinserted. (shrink)

Background Intestinal transplant in infants with severe short bowel syndrome (SBS) is an emerging therapy, yet without sufficient long-term data or established guidelines, resulting in possible variation in practice. Objectives To assess current attitudes and counselling practices among physicians regarding intestinal transplant in infants with SBS, and to determine whether counselling and management vary between subspecialists or centres. Methods A national sample of practicing paediatric surgeons and neonatologists was surveyed via the American Academy of Paediatrics listserves. Results were analysed by (...) physician subspecialty and again by presence or absence of intestinal transplant at respondent's centre. Results The survey was completed by 433 respondents, consisting of 363 neonatologists and 70 paediatric surgeons. Fifty-seven respondents (13.2%) practiced at a centre that performed intestinal transplants in children. The vast majority of respondents (91% for preterm, 95% for term neonates) felt that maintaining a neonate with SBS on total parenteral nutrition for intestinal transplant was ethically optional (neither impermissible nor obligatory), and that parents should be given an informed choice whether to pursue that option. However, only 33% indicated they often/always offer intestinal transplant as a treatment option to families in this situation. Conclusions There is a marked disparity between individual physicians’ beliefs regarding the acceptability of intestinal transplant for severe SBS and their reported practice. Wide variability exists among physicians with respect to their knowledge, beliefs and practice regarding severe SBS, raising concerns about transparency and justice. Survival data prior to transplant, currently unavailable, are essential to rational decision making and informed parental permission. (shrink)

This arts- based project creatively introduces residents to photography, self-portraiture and narratives to document the longitudinal journey of becoming a family physician. Visual arts and writing can foster reflection: an important skill to cultivate in developing physicians. Unfortunately, arts based programs are lacking in many residency programs. Tools and venues that nourish physician well being and resilience may be important in today’s changing healthcare environment and epidemic of physician burnout. Residents created self-portraits with accompanying narratives throughout their three-year training. Analysis (...) of the portraits and accompanying narratives completed the assessment. Residents created a body of work that includes 182 creative and deeply personal portraits and narratives. The five most frequent themes of portraits included “Residency is Difficult,” “Hobbies,” “Family,” “Growing as a Doctor,” and “Coping Mechanisms.” Self-portrait photography and reflection gives insight into the journey of becoming a family medicine physician at a deeply personal and professional level. Further partnerships between residency programs and the arts should be explored to promote reflection. (shrink)

The complex regulatory framework governing the U.S. health care system can be an obstacle to programming that address health-related social needs. In particular, health care fraud and abuse law is a pernicious barrier as health care organizations may minimize or forego programming altogether out of real and perceived concern for compliance. And because health care organizations have varying resources to navigate and resolve compliance concerns, as well as different levels of risk tolerance, fears related to the legal landscape may further (...) entrench inequities in access to meaningful programs that improve health outcomes. This article uses food and nutrition programming as a case study to explore the complexities presented by this area of law and to highlight pathways forward. (shrink)

To understand political power it's necessary to comprehend why individuals and entire nations make the choices they do. Two influential approaches to understanding the intentions behind human behavior are known as realism and liberalism. Neoliberalism developed in response to the charge that liberalism represented an overly utopian view of the world. To explain whether cooperation or conflict should be expected between two parties, international relations scholars often try to calculate costs and benefits of either strategy. Among the most famous of (...) their scenarios is the “Prisoner's Dilemma”. In the case of Ender's Game, the humans and buggers face a dilemma about whether or not to cooperate with one another or defect, which means fighting a war for survival. The dilemma for Ender and the I.F. is complicated by the fact that there seems to be no possibility of communication between humans and buggers. (shrink)

Nanomedicine is yielding new and improved treatments and diagnostics for a range of diseases and disorders. Nanomedicine applications incorporate materials and components with nanoscale dimensions where novel physiochemical properties emerge as a result of size-dependent phenomena and high surface-to-mass ratio. Nanotherapeutics and in vivo nanodiagnostics are a subset of nanomedicine products that enter the human body. These include drugs, biological products, implantable medical devices, and combination products that are designed to function in the body in ways unachievable at larger scales. (...) Nanotherapeutics andin vivonanodiagnostics incorporate materials that are engineered at the nanoscale to express novel properties that are medicinally useful. These nanomedicine applications can also contain nanomaterials that are biologically active, producing interactions that depend on biological triggers. Examples include nanoscale formulations of insoluble drugs to improve bioavailability and pharmacokinetics, drugs encapsulated in hollow nanoparticles with the ability to target and cross cellular and tissue membranes and to release their payload at a specific time or location, imaging agents that demonstrate novel optical properties to aid in locating micrometastases, and antimicrobial and drug-eluting components or coatings of implantable medical devices such as stents. (shrink)

Volume 20, Issue 7, July 2020, Page 174-177.

Nanomaterials have the promise of revolutionizing current treatment and diagnosis of diseases, which has led to 33 nanotherapeutics drugs currently on the market and many more in various stages of clinical trials. With an increasing number of products available and in development, along with the unique, emergent properties of the nanoparticle therapeutics themselves, regulatory agencies are now faced with decisions regarding the regulation of such novel technologies. Regulatory guidance, particularly in pre-clinical stages, has the potential to facilitate quick and safe (...) development of these novel materials, but new regulation beyond what is currently in place must be justified in a clear and distinctive toxic response. Herein, we examine literature that compares and correlates in vivo and in vitro nanotoxicity studies to gain a deeper understanding of the modes of nanoparticle toxicity. Additionally, this comparison aims to identify clear and unique toxicity responses caused by nanoparticles, which informs our perspective on pre-clinical nanotherapeutic oversight. (shrink)

Much of the focus of the published 2011 symposium that inspired this work focused on the question, “When have you reduced risk enough to move from bench/animal studies to ‘first in-human’ studies?” Building applied research ethics related to nanotherapeutics requires bench and clinical scientists to have a clear vision about how to test nanotherapeutic safety, and it is clear that there is still much to be considered at the steps before “in-human” assessment. Herein, the perspective of the bench scientist is (...) brought to bear on using in vivo and in vitro models to assess the safety of nanotherapeutics. Much of this work falls under the purview of the field of nanotoxicology that aims to understand the toxicological impact of engineered nanoscale materials. Engineered nanomaterials include a wide variety of materials that are manipulated and controlled on the nanoscale level where, typically, the nanoparticle or nanomaterial has some dimension that is less than 100 nm. (shrink)

Christie is a member of the Department of Religious Studies at Baldwin-Wallace College, Cleveland, Ohio (U.S.A.).

Addressing both collegiate and professional sports, the updated edition of Fair Play: The Ethics of Sport explores the ethical presuppositions of competitive athletics and their connection both to ethical theory and to concrete moral dilemmas that arise in actual athletic competition. This fourth edition has been updated with new examples, including a discussion of Spygate by the New England Patriots and recent discoveries on the use of performance enhancing drugs by top athletes. Two additional authors, Cesar R. Torres and Peter (...) F. Hager, bring to this edition a discussion of the moral issues involved in youth sports and the ethics of being a fan, as well as a fresh perspective on the theories of broad internalism and the quest for excellence. Furthermore, major criticisms of broad internalism by philosophers William J. Morgan and Scott Kretchmar add a new dimension to the discussion on the moral foundations of winning. (shrink)

In their article “The Rise of Citizen Science in Health and Biomedical Research,” Wiggins and Wilbanks (2019) present a new typology for understanding the complex landscape of health and biomedical...

Background Citizen science is increasingly prevalent in the biomedical sciences, including the field of human genomics. Genomic citizen science initiatives present new opportunities to engage individuals in scientific discovery, but they also are provoking new questions regarding who owns the outputs of the research, including intangible ideas and discoveries and tangible writings, tools, technologies, and products. The legal and ethical claims of participants to research outputs become stronger—and also more likely to conflict with those of institution-based researchers and other stakeholders—as (...) participants become more involved, quantitatively and qualitatively, in the research process. It is not yet known, however, how genomic citizen science initiatives are managing the interests of their participants in accessing and controlling research outputs in practice. To help fill this gap, we conducted an in-depth review of relevant policies and practices of U.S.-based genomic citizen science initiatives. Methods We queried the peer-reviewed literature and grey literature to identify 22 genomic citizen science initiatives that satisfied six inclusion criteria. A data collection form was used to capture initiative features, policies, and practices relevant to participants’ access to and control over research outputs. Results This analysis revealed that the genomic citizen science landscape is diverse and includes many initiatives that do not have institutional affiliations. Two trends that are in apparent tension were identified: commercialization and operationalization of a philosophy of openness. While most initiatives supported participants’ access to research outputs, including datasets and published findings, none supported participants’ control over results via intellectual property, licensing, or commercialization rights. However, several initiatives disclaimed their own rights to profit from outputs. Conclusions There are opportunities for citizen science initiatives to incorporate more features that support participants’ access to and control over research outputs, consistent with their specific objectives, operations, and technical capabilities. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Changing Human Nature: Ecology, Ethics, Genes, and God by James C. PetersonDolores L. ChristieChanging Human Nature: Ecology, Ethics, Genes, and God James C. Peterson Grand Rapids, Mich.: Eerdmans, 2010. 259 pp. $18.00Grounding himself in the Christian tradition, James Peterson argues for the moral efficacy of human genetic manipulation. Interpreting intentional intervention as part of human stewardship rather than as a wrongful interference with some divine plan, he takes (...) on the sticky questions, making critical distinctions, for example, between cure and enhancement or welcoming children as they come and making them “better.” Not neglecting future implications of current tinkering with human biology, even in such taboo areas as gamete selection, he contends that engineering a baby free of harmful genes (for example, Tay-Sachs or Down syndrome) not only makes that person better, but it also eliminates an ongoing burden to family, to society, and perhaps to future generations. Treading gingerly among the sacred cows of some Christian ethicists, he advocates the implanting of selected embryos free of unwanted genes; in his view, embryos are not yet persons.Peterson considers serious concerns such as eugenics projects and racial bias but offers standards to address them. He contends that intentionally increasing choices for our children is not only acceptable but also praiseworthy. What parents would not optimize the educational and social opportunities for their child, even without the child’s consent? Interventions should be safe, offer genuine improvement, increase the recipient’s capacity, and make the best use of limited resources. Peterson is not so naive that he does not recognize that technology does not always make us better. He recognizes, too, that his standards do not eliminate risk.Fair enough, but the issue of what “improvement” may mean to the individual as well as to the greater community remains somewhat ambiguous. Peterson suggests that broadening the decision making among a variety of professional and individual cohorts would help, but his argument is not totally persuasive. In sum, Peterson’s treatment falls short of offering a totally satisfying standard for determining which characteristics should be manipulated and which should be accepted. Nor does he demonstrate definitively how a [End Page 187] Christian perspective would contribute to sorting out possible choices. Does the deaf parents’ desire for their child to be deaf like them constitute an instance where intervention should not be attempted? Can the disparate cohorts he suggests as arbiters rise above their own biases? Does Christianity and its belief system offer answers? Readers—even readers who call themselves Christian—will likely be persuaded that genetic intervention is a good, and even compatible with their religious perspective. Nonetheless, they will harbor lingering doubts about how the questions can best be solved, who should solve them, and how Christian belief helps sort among the possibilities. In his closing comments Peterson appears to agree.The book is rich in research and in provocative ideas. It is an exciting book. It is a readable and enlightened contribution to the professional conversation on gene therapy. Peterson’s research is extensive, his argumentation balanced. His attempt to locate the question within the Christian tradition is laudable. Happily, Peterson eschews a creationist approach to world and human origins. Unhappily, his approach to the scriptural text is not always nuanced. His assertion that Jesus himself was different biologically from other human beings (132) seems a stretch. If one takes the passages of Jesus’s biological origins literally, as apparently does the author, what happens to the assertion that Jesus is like other human beings “in all things but sin”? And where did Jesus get the Y chromosomes? While he persuades the reader that genetic intervention is compatible with a Christian worldview, Peterson does not offer—at least in this reviewer’s view—an adequate criterion for navigating this new world of the possible.Dolores L. ChristieJohn Carroll UniversityCopyright © 2013 Society of Christian Ethics... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Ethics and the Elderly: The Challenge of Long-Term Care by Sarah M. Moses, and: Loving Later Life: An Ethics of Aging by Frits de LangeDolores L. ChristieEthics and the Elderly: The Challenge of Long-Term Care Sarah M. Moses maryknoll, ny: orbis, 2015. 206 pp. $38.00Loving Later Life: An Ethics of Aging Frits de Lange grand rapids, mi: eerdmans, 2015. 169 pp. $19.00Today many women and men live beyond (...) the so-called third age of life and enter their eighties, the "fourth age," during which the toll of time and the growing incidence of life-limiting conditions wear down even the best-preserved of the human species. Debilitating disease and normal ebbing of human function become more concentrated in this demographic bubble. As people enter their eighties, their world tends to narrow both physically and mentally, creating a need for increasing care. Often the elderly are rendered passive and dependent, forced to cede both autonomy and dignity. They become objects with little voice, requiring greater care and increasing cash. Likewise, as the baby boom generation enters this group, those living in the fourth age make up an increasing percentage of the population. Additionally, modern models of care for the elderly, often based on efficiency and cost-effectiveness, tend to erode their human dignity. Together these factors demonstrate a growing moral problem.What to do? These two books provide valuable road maps for how to proceed. They detail the reality and moral urgency of the situation. Both offer principles from philosophical and religious traditions that outline a good moral model: one of care, compassion, dignity, and community. They draw insights from Augustine and Thomas Aquinas, Karl Barth, and Dietrich Bonhoeffer, among [End Page 214] others. Both reference the Western biblical tradition, which honors the elderly even in the face of their limitations.Although the authors offer wise and thoughtful suggestions to address this growing moral crisis, they approach the serious moral issue very differently. Sarah Moses outlines a compelling case for a new interventional model for elderly living. While her book plays some muted chords that hint at "dissertation," the melody it conveys is strikingly forte and well worth the read.She presents two concrete examples of what good interaction with the elderly might look like. One draws from the international intentional outreach and residential community (the Community of Sant'Egidio), the other is a brick-and-mortar model (the Green House Project). Using both biblical paradigms and church teaching over the centuries, Moses makes the case for treating all persons with dignity and promoting their involvement in decision making as much as possible. The scriptural message she highlights—both our duty to the elderly and the "disappointment and depression" (105) of growing old—is particularly compelling.In her examples of good long-term care, community development is important. In the Sant'Egidio model, volunteers share a common life "through gathering for prayer and various outreach services to the poor" (39). There is motivation to support elderly in their own homes, but the project promotes small, family-like resident facilities when this is not possible. The physical place is less emphasized than the relationship among various age and economic groups.The Green House Project is based in a new vision of homes for the challenged elderly. Results of the project show that not only did staff remain in their jobs longer (nursing home employment turnover is extensive) but visitation by family members increased. Even such a simple thing as a different physical model for the actual building—replacing long halls and routinization with a more home-like environment—has positive results.Moses calls on leadership in church and community to educate, to designate funds for elder care, and to look beyond the caring and the construction of good facilities. She notes how important it is to work politically to change attitudes and actions.She sees care for all dependent people as a responsibility of both the church community and society in general. This includes fostering awareness, encouraging ongoing participation of the elderly in life—including church life—and allocating public resources. Bottom line: she calls for smaller institutions, meaningful opportunities for the... (shrink)

Open peer commentary on the article ““Black Box” Theatre: Second-Order Cybernetics and Naturalism in Rehearsal and Performance” by Tom Scholte. Upshot: What von Foerster accomplished in raising the specter of second-order cybernetics now requires experimental design and the heavy lifting of theory to complete his quest for new ways of thinking. Scholte’s “black box theatre” points to research into non-trivial systems as a formal means of grasping living systems.

The perspectives of genomic citizen scientists on ownership of research outputs are not well understood, yet they are useful for identifying alignment of participant expectations and project practices and can help guide efforts to develop innovative tools and strategies for managing ownership claims. Here, we report findings from 52 interviews conducted in 2018 and 2019 to understand genomic citizen science stakeholders’ conceptualizations of, experiences with, and preferences for ownership of research outputs. Interviewees identified four approaches for recognizing genomic citizen scientists’ (...) ownership and related credit interests in research outputs: shared governance via commons models; fractional ownership of benefits; full and creative attribution; and offensive and defensive patenting. Interviewees also agreed that the model selected by any project should at least maximize access to research outputs and, as appropriate and to the extent possible, broadly distribute rights of control and entitlements to research benefits. (shrink)

Background Empirical studies of surrogate decision-making tend to assume that surrogates should make only a 'substituted judgement'—that is, judge what the patient would want if they were mentally competent. Objectives To explore what people want in a surrogate decision-maker whom they themselves select and to test the assumption that people want their chosen surrogate to make only a substituted judgement. Methods 30 undergraduate students were recruited. They were presented with a hypothetical scenario about their expected loss of mental capacity in (...) the future and asked to answer some questions about their choice of surrogate. These data were analysed qualitatively using thematic content analysis. Results Most respondents talked about choosing someone who was caring and competent in certain ways, giving interesting evidence for their judgements. Surprisingly few highlighted how well they thought their chosen surrogate knew their preferences and would be able to make a substituted judgement. Moreover, few specified that their chosen surrogate had similar attitudes and values to their own and so would make a similar decision to theirs in the circumstances presented. Some respondents also referred to the social role of their chosen surrogate or the social dynamics of their situation which influenced their choices, as well as to ideas of reciprocity and characteristics of honesty and loyalty. Conclusion In the event that they lose mental capacity, many people will not select a surrogate to decide about medical treatments on their behalf solely on the basis that they expect their surrogate to make a substituted judgement. (shrink)

Transcription factor (TF) signaling regulates gene transcription and requires a complex network of proteins. This network includes co‐activators, co‐repressors, multiple TFs, histone‐modifying complexes, and the basal transcription machinery. It has been widely appreciated that pioneer factors, such as FoxA1 and GATA1, play an important role in opening closed chromatin regions, thereby allowing binding of a secondary factor. In this review we will focus on a newly proposed model wherein multiple TFs, such as steroid receptors (SRs), can function in a pioneering (...) role. This model, termed dynamic assisted loading, integrates data from widely divergent methodologies, including genome wide ChIP‐Seq, digital genomic footprinting, DHS‐Seq, live cell protein dynamics, and biochemical studies of ATP‐dependent remodeling complexes, to present a real time view of TF chromatin interactions. Under this view, many TFs can act as initiating factors for chromatin landscape programming. Furthermore, enhancer and promoter states are more accurately described as energy‐dependent, non‐equilibrium steady states. (shrink)

White matter tracts are known to be susceptible to injury following concussion. The objective of this study was to determine whether contact play in sport could alter white matter metabolite levels in female varsity athletes independent of changes induced by long-term exercise. Metabolite levels were measured by single voxel proton magnetic resonance spectroscopy in the prefrontal white matter at the beginning and end of season in contact and non-contact varsity athletes. Sedentary women were scanned once, at a time equivalent to (...) the Off-Season time point. Metabolite levels in non-contact athletes did not change over a season of play, or differ from age matched sedentary women except that non-contact athletes had a slightly lower myo-inositol level. The contact athletes had lower levels of myo-inositol and glutamate, and higher levels of glutamine compared to both sedentary women and non-contact athletes. Lower levels of myo-inositol in non-contact athletes compared to sedentary women indicates long-term exercise may alter glial cell profiles in these athletes. The metabolite differences observed between contact and non-contact athletes suggest that non-contact athletes should not be used as controls in studies of concussion in high-impact sports because repetitive impacts from physical contact can alter white matter metabolite level profiles. It is imperative to use athletes engaged in the same contact sport as controls to ensure a matched metabolite profile at baseline. (shrink)

Nuclear bodies contribute to non‐random organization of the human genome and nuclear function. Using a major prototypical nuclear body, the Cajal body, as an example, we suggest that these structures assemble at specific gene loci located across the genome as a result of high transcriptional activity. Subsequently, target genes are physically clustered in close proximity in Cajal body‐containing cells. However, Cajal bodies are observed in only a limited number of human cell types, including neuronal and cancer cells. Ultimately, Cajal body (...) depletion perturbs splicing kinetics by reducing target small nuclear RNA (snRNA) transcription and limiting the levels of spliceosomal snRNPs, including their modification and turnover following each round of RNA splicing. As such, Cajal bodies are capable of shaping the chromatin interaction landscape and the transcriptome by influencing spliceosome kinetics. Future studies should concentrate on characterizing the direct influence of Cajal bodies upon snRNA gene transcriptional dynamics.Also see the video abstract here. (shrink)

Background Investigative genetic genealogy (IGG) is a technique that involves uploading genotypes developed from perpetrator DNA left at a crime scene, or DNA from unidentified remains, to public genetic genealogy databases to identify genetic relatives and, through the creation of a family tree, the individual who was the source of the DNA. As policymakers demonstrate interest in regulating IGG, it is important to understand public perspectives on IGG to determine whether proposed policies are aligned with public attitudes.Methods We conducted eight (...) focus groups with members of the public (N = 72), sampled from four geographically diverse US regions, to explore general attitudes and perspectives regarding aspects of IGG practices, applications, and policies. Five major topics were explored in each focus group: when IGG should be used; who should perform IGG; how to approach consent for genetic database users; what systems of oversight should govern IGG practitioners; and whether to notify database users if their data are involved in law enforcement (LE) matching.Results Participants were supportive of IGG in most scenarios, especially for cold and violent cases. The favorable attitudes toward IGG were, however, tempered by distrust of law enforcement among some participants. All participants agreed that databases must inform users if IGG is allowed, but they did not agree on how individual database users should be allowed to opt out or whether to notify them if their data are involved in specific investigations. All participants agreed that IGG should be subject to some prescriptive guidelines, regulations, or accountability mechanisms.Conclusions These findings suggest broad public support for IGG, and interest in developing systems of accountability for its practice. Our study provides useful insight for policy makers, genomic database stewards, law enforcement, and other stakeholders in IGG’s practice, and suggests multiple directions for future research. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Professional Sexual Ethics: A Holistic Ministry Approach ed. by Patricia Beattie Jung and Darryl W. StephensDolores L. ChristieProfessional Sexual Ethics: A Holistic Ministry Approach Edited by Patricia Beattie Jung and Darryl W. Stephens minneapolis: fortress press, 2013. 256 pp. $24.00.Sex is a powerful element in human life. It infects politics and power struggles, baby making, and the world of marketing. This book cuts across denominational lines to address (...) the impact of hot-button sexual issues on ministry. It presents a holistic approach, articulating honestly the sexual reality of the minister and the need to name and nurture it. Knowledge of the sexual self and of skills needed to deal adequately with sexual dilemmas in personal and professional relationships are essential to successful ministry.The book is made up of twenty essays and is divided into four sections. The first section, “Ethical Landscape of Ministry,” deals primarily with ministers themselves. It considers sexual wholeness, the murky area of exploitation, and boundaries in ministerial relationships. This portion of the book could serve as a valuable tutorial for novice ministers or as a refresher course for those [End Page 217] long in the ministerial tooth. The second section, “Sources of Wisdom,” considers inherited historical conclusions that influence how we think about sex, revisiting the usual suspects—Augustine and Aquinas—but also including contemporary insights from liberation and feminist thought. Culturally conditioned assumptions about marriage, gender variety, self-love and self-care, and the distinctions among friendship, love, and sex are explored. “Practices of Ministry,” the third section, covers everything from clergy dating to teaching sexual ethics in a congregational setting. The essays address such central issues as power, intimacy, and sexual feelings. One of the most interesting essays deals with the implications of sex for preaching; listeners in the pew may infer something entirely different from what preachers think they are communicating.Since most people involved in ministry have likely considered many of the aforementioned topics before reading this book, perhaps the most helpful part—even for experienced ministers—is the final section, “Pastoral Leadership.” Social media, online pornography, and the endurance of digital utterances have added a new dimension to sexual ethics in ministry. Moral lapses by congregational ministers have become an increasingly public problem.All of the essays are brief and to the point. “Thick” cases are used generously to illustrate delicate or even dangerous situations that might occur in the professional and personal lives of ministers. Each case is paired with good analysis and practical solutions, and sometimes a checklist to facilitate application of the authors’ thinking. Also offered are suggestions for personal reflection and discernment by the minister and principles or criteria for dealing with difficult issues. These include guidelines for dealing with adolescents and congregational education on sex. As a consistently taboo subject, it is refreshing to hear voices advocating for systematic sexual instruction for the local church. Each author includes a pertinent bibliography.It is difficult to review twenty essays adequately, particularly with the richness each offers. Which marvelous chocolate should I choose? The reader may decide to savor one at a time. Discussion questions demand reflection on the issues that touch the reader, like red wine to enhance the taste of each chocolate. This book teaches ethics in the best way—as a real life activity rather than a spectator sport—and there are only a few weaknesses. For some reason the book ends with an itemization of quoted scripture passages, which might have been more useful had connections been made to specific issues. And while the book affirms healthy sex and offers suggestions for dealing with sexual problems that ministers might encounter, it has little to say about the peculiar situation of celibate Catholic clergy. Nevertheless, this modest volume is a must read for both the novice minister and the seasoned practitioner. [End Page 218]Dolores L. ChristieJohn Carroll UniversityCopyright © 2016 Society of Christian Ethics... (shrink)

Understanding the clinical significance of variants associated with hereditary cancer risk requires access to a pooled data resource or network of resources—a “cancer gene variant commons”—incorporating representative, well-characterized genetic data, metadata, and, for some purposes, pathways to case-level data. Several initiatives have invested significant resources into collecting and sharing cancer gene variant data, but further progress hinges on identifying and addressing unresolved policy issues. This commentary provides insights from a modified policy Delphi process involving experts from a range of stakeholder (...) groups involved in the data-sharing ecosystem. In particular, we describe policy issues and options generated by Delphi participants in five domains critical to the development of an effective cancer gene variant commons: incentives, financial sustainability, privacy and security, equity, and data quality. Our intention is to stimulate wider discussion and lay a foundation for further work evaluating policy options more in-depth and mapping them to those who have the power to bring about change. Addressing issues in these five domains will contribute to a cancer gene variant commons that supports better care for at-risk and affected patients, empowers patient communities, and advances research on hereditary cancers. (shrink)

Presents a plethora of approaches to developing human potential in areas not conventionally addressed. Organized in two parts, this international collection of essays provides viable educational alternatives to those currently holding sway in an era of high-stakes accountability.

Gouvernance et libéralités de Saladin: D’après les données inédites de six documents arabes. Edited by Jean-Michel Mouyon; Dominique Sourdel; and Janine Sourdel-Thomine. Documents relatifs à l’histoire des croisades, vol. 22. Paris: AcadémIe des Inscriptions et Belles-Lettred, 2015. Pp. 148. €30.

Philosophical Studies Vol. 2, No. 2, p. 163, l. 24 for ‘Pocreon’ read “Creon’ and p. 165, l.4 for “Nereus” read “Nessus”, l. 16 for “Corrolate” read “Correlate” and l. 27 for “ Trachinae ” read “ Trachiniae ”. Proffessor Mackinnon should also have been described as Norris-Hulse Professor of Divinity in the University of Cambridge and Fellow of Corpus Christi College.