There has been much discussion about what, if any, legal and moral duties professionals have to disclose relevant genetic information to the family members of someone with an identified disease predisposing mutation. Here, we present a case report where dissemination of such a genetic test result did not take place within a family. In contrast to previous literature, there appeared to be no deliberate withholding of information, instead distant relatives were unable to communicate relevant information appropriately. When communication was facilitated (...) through the follow-up of a chance remark, the patient was able to avoid planned major surgery, with its attendant morbidity, and her high anxiety levels were much reduced. We believe this case highlights the need for an ongoing debate on how genetic services can best support patients and their families with disclosing relevant genetic information to other family members. (shrink)

Aims: To describe individuals’ perceptions of the activities that take place within the cancer genetics clinic, the relationships between these activities and how these relationships are sustained. Design: Qualitative interview study. Participants: Forty individuals involved in carrying out cancer genetics research in either a clinical (n = 28) or research-only (n = 12) capacity in the UK. Findings: Interviewees perceive research and clinical practice in the subspecialty of cancer genetics as interdependent. The boundary between research and clinical practice is described (...) as vague or blurred, and this ambiguity is regarded as being sustained by a range of methodological, ethical and economic factors. The implications of these findings for the “therapeutic misconception” are explored. It is argued that while research participation is seen as having therapeutic benefit for individual patients, the interviewees are not labouring under any misconceptions about the relationship between research and clinical care. It is suggested that concepts such as the “therapeutic misconception” may have less relevance in highly technological specialities that are characterised by a developing evidence base. (shrink)

Design: Qualitative interview study. Participants: Fifty-nine patients with a family history of cancer who attend a regional cancer genetics clinic in the UK were interviewed about their current and previous research experiences. Findings: Interviewees gave a range of explanations for research participation. These were categorised as social—research participation benefits the wider society by progressing science and improving treatment for everyone; familial—research participation may improve healthcare and benefit current or future generations of the participant’s family; and personal—research participation provides therapeutic or (...) non-therapeutic benefits for oneself. Conclusions: We discuss the distinction drawn between motives for research participation focused upon self and others, and observe that personal, social and familial motives can be seen as interdependent. For example, research participation that is undertaken to benefit others, particularly relatives, may also offer a number of personal benefits for self, such as enabling participants to feel that they have discharged their social or familial obligations. We argue for the need to move away from simple, static, individualised notions of research participation to a more complex, dynamic and inherently social account. (shrink)

It is widely supposed that, in Hilary Putnam’s phrase, there are no “ready-made objects” (Putnam 1982; cf. Putnam 1981, Ch. 3). Instead the objects we consider real are partly of our own making: we carve them out of the world (or out of experience). The usual reason for supposing this lies in the claim that there are available to us alternative ways of “dividing reality” into objects (to quote the title of Hirsch 1993), ways which would afford us every bit (...) as much practical and cognitive mastery as we now possess. Hence there is no warrant for supposing that the objects recognized by such alternative schemes are any less real than the objects we actually consider real—unless we are to appeal to a “God’s-eye perspective”, which virtually no one wants to do. The reasonable conclusion, many philosophers suppose, is that any system of objects exists only relative to a particular conceptual scheme or system of predicates. Our system of objects is, in this sense, partly of our own making. But this claim should not be heard as a reaffirmation of the idealism of Fichte or Husserl. It is more accurate to take it merely as a claim about sameness and difference among the objects of the world. It is the claim that sameness and difference, whether at the level of kinds or of individual objects, do not obtain mind-independently, but only relative to a conceptual scheme or predicate system (see, e.g., Putnam 1981, pp. 53-54). That is, whether two objects are of the same kind, and whether one and the same individual object now exists at such-and-such.. (shrink)

This book provides a focus for future discussion in one of the most important debates within historical theology within the protestant tradition - the debate about the definition of a category of analysis that operates over five centuries of religious faith and practice and in a globalising religion. In March 2009, TIME magazine listed ‘the new Calvinism’ as being among the ‘ten ideas shaping the world.’ In response to this revitalisation of reformation thought, R. Scott Clark and D. G. Hart (...) have proposed a definition of ‘Reformed’ that excludes many of the theologians who have done most to promote this driver of global religious change. In this book, the Clark-Hart proposal becomes the focus of a debate. Matthew Bingham, Chris Caughey, and Crawford Gribben suggest a broader and more historically responsible definition for ‘Reformed,’ as Hart and Scott respond to their arguments. (shrink)

The objective of this study is to describe researchers', health-care providers' and other stakeholders' views of ethical review and research governance procedures. The study design involved qualitative semi-structured interviews. Participants included 60 individuals who either undertook research in the subspecialty of cancer genetics (n = 40) or were involved in biomedical research in other capacities (n = 20), e.g. research governance and oversight, patient support groups or research funding. While all interviewees observed that oversight is necessary to protect research participants, (...) ethical review and research governance (ERG) arrangements were described negatively throughout these interviews. Interviewees identified a number of problems with ERG, including: over-bureaucratization, over-standardization of information requirements for different types of research, a lack of standardization in the types of information required by different committees for the same research and a lack of consistency in different committees' responses. A number of solutions were proposed including streamlining application procedures and harmonizing committees' responses and information requirements. Recent reports suggest that ethical review procedures and research governance arrangements threaten the possibility of undertaking clinical research in the UK, hence the introduction of the Integrated Research Application System (IRAS) is long overdue. However, while IRAS may solve some of the problems identified by interviewees, it remains to be seen to what extent it will impact upon the very negative perceptions of ethics and research governance procedures reported here. (shrink)

The aim of this study is to assess patients' recall of their previous research participation. Recall was established during interviews and compared with entries from clinical notes. Participants were 49 patients who had previously participated in different types of research. Of the 49 patients, 45 (92%) interviewees recalled 69 of 109 (63%) study participations. Level of recall varied according to the type of research, some participants clearly recalled the details of research aims, giving consent and research procedures. Others recalled procedures (...) (e.g. DNA testing) but were unclear about their purpose. There was no significant effect of time on recall. Some types of research participation (e.g. DNA testing) may be recalled as clinical care. We argue that such misunderstandings may have the potential to undermine participants' ongoing consent, particularly in ongoing/longitudinal studies. Valid consent may be best achieved by re-assessing the scope of consent and relating it to the nature of the interventions themselves rather than the reasons for undertaking them. (shrink)

Modal conventionalism is the view that two crucial forms of sameness are mind-dependent. There is no phenomenon of sameness in kind, on this view, except in virtue of our conventions for individuating nature’s kinds; there is no phenomenon of numerical sameness across time, for an individual member of some natural kind, except in virtue of our conventions for individuating such members.1 Modal conventionalism has its realist opponents. These opponents have argued, following Kripke’s lead more than thirty years ago (Kripke 1972), (...) that the boundaries of at least many of nature’s kinds are carved out by nature itself, and not by our classifi catory practices (e.g., Millikan 2000: passim, e.g., pp. 25 and 72). But they have not generally argued, with anything approaching the same vigor, that modal conventionalism is wrong in its other main claim. They have not in general argued that the world-given connections among properties, that make those properties mind-independently be membership conditions for some natural kind, at the same time make those properties mind-independently be persistence conditions for the members of the kind—properties the departure of which constitutes a ceasing-to-exist for the object that formerly had them. On the contrary, opponents of modal conventionalism have.. (shrink)

James decides that the best price today on pork chops is at Supermarket S, then James makes driving motions for twenty minutes, then James’ car enters the parking lot at Supermarket S. Common sense supposes that the stages in this sequence may be causally connected, and that the pattern is commonplace: James’ belief (together with his desire for pork chops) causes bodily behavior, and the behavior causes a change in James’ whereabouts. Anyone committed to the idea that beliefs and desires (...) are states installed by evolution must, it seems, think something similar. For how can one see beliefs and desires as conferring selective advantage if not by supposing that, by causing bodily behavior in their subjects, they brought about changes in their subjects’ surroundings? Yet many, many philosophers currently think or worry that mental causation is illusory (see, e.g., Heil and Mele 1993, or Macdonald and Macdonald 1995). Any physical changes which a mental state appears to cause can be viewed as a complex event involving microparticles, and for any such complex event, many philosophers suppose, there will have been previous microphysical occurrences sufficient to cause it. Barring routine overdetermination of such complex events, the apparent causation of mental events seems to be excluded. Nor does it help to say that some salient segment of the previous microphysical event just is the mental event, differently described (Davidson 1970). For describing the previous events as microphysical seems to spotlight the very features in virtue of which they did their causal work; the mental features seem epiphenomenal (Yablo 1992b: pp. 425-36; Yablo 1992a). This paper argues that the complex physical events, which mental events seem excluded from causing, are not caused at all. For they are either accidents, in something like Aristotle’s sense (Sorabji 1980: pp. 3-25), or coincidences, in a sense which David Owens has recently sharpened (Owens 1992). (shrink)

To be a realist about modality, need one claim that more exists than just the various objects and properties that populate the world—e.g. worlds other than the actual one, or maximal consistent sets of propositions? Or does the existence of objects and properties by itself involve the obtaining of necessities (and possibilities) in re? The latter position is now unpopular but not unfamiliar. Aristotle held that objects have essences, and hence necessarily have certain properties. Recently it has been argued that (...) the identity of any property is tied to the natural laws in which it figures, which entails that the occurrence of properties involves the obtaining of nomological necessities ([24], pp. 206-33 and 234-60; [23]; cf. [25] and [6]). Somewhat less recently, Wittgenstein ([28], p. 168) worried that the reality of at least some properties—precise shades of colors being a prime example—involved the obtaining in re of certain impossibilities. This paper argues that Wittgenstein’s worries were right, and not just concerning some properties, but all properties whatever. That there are objects and properties in the world at all, then, amounts to there obtaining modal states of affairs. This argument supplements, rather than replaces, the others. The position on property incompatibility advanced here actually helps defend Aristotelian essentialism against epistemological objections, or so I have argued ([15]). And while this paper’s position on property incompatibility diverges from the idea that a property’s nomic profile is essential to it—more on this in the next section—it is at least compatible with the thought that the necessity involved in the laws of nature enters into ontology at the ground level. (shrink)

More laws obtain in the world,it appears, than just those of microphysics –e.g. laws of genetics, perceptual psychology,economics. This paper assumes there indeedare laws in the special sciences, and notjust scrambled versions of microphysical laws. Yet the objects which obey them are composedwholly of microparticles. How can themicroparticles in such an object lawfully domore than what is required of them by the lawsof microphysics? Are there additional laws formicroparticles – which seems to violate closureof microphysics – or is the ``more'' (...) acoincidental outcome of microphysics itself? This paper argues that the appearance ofviolation is illusory, and the worry aboutcoincidence misleading. We cannot expect tounderstand the special sciences at the level ofthe microparticles. (shrink)

Deleuze and Guattari develop a notion of “minor literature” in their short book on Kafka, and the opposition major/minor has been used with varying degrees of success by critics working in a range of disciplines including architectural theory. Teasing out the potentially subversive implications of the major/minor opposition requires reading it in relation to other binarisms developed by Deleuze and Guattari in those same years, e.g., state/nomadic science, striated/smooth space, optic/haptic, as well as Guattari’s useful concept “machinic heterogenesis.” Then, one (...) ends up with a minor architecture concerned with partially subversive practices rather than with structure per se. A building’s minor status is figured through its deployment in and production of a space that is a technological, social and political pattern as well as a line of flight. This paper reads minor architecture by examining the minor house built by Henry David Thoreau at Walden Pond and those currently being assembled by the Mad Housers in Atlanta, Georgia. (shrink)

In this study I am going to present and discuss some of the central themes of Gustav Bergmann's theory of perception. I shall be concerned, however, only with "later Bergmann," that is, with the perceptual theory worked out in a series of essays in which Bergmann shifts from phenomenalism to a form of intentional realism. This label ("intentional realism") indicates the two dominant themes in Bergmann's later thought about perception: perceivings are analyzed as mental acts (thoughts) which are intentionally related (...) to real and mind-independent objects and states of affairs. In a timely essay, " Intentionality" (1955) Bergmann presented an impressive defense of mental acts, and although the framework of that essay was still phenomenalistic, the structural analysis of mental acts and their intentionality presented there has not been significantly altered by Bergmann in later writings. In two subsequent essays, "Acts" (1960) and "Realistic Postscript" (1963) his realistic turn was worked out in detail in the context of giving a satisfactory account of ordinary perceptual experience. These three essays will comprise the core texts of the study that follows. (shrink)

Abstract According to Russellianism, the content of a Russellian thought, in which a person ascribes a monadic property to an object, can be represented as an ordered couple of the object and the property. A consequence of this is that it is not possible for a person to believe that a is F and not to believe b is F, when a=b. Many critics of Russellianism suppose that this is possible and thus that Russellianism is false. Several arguments for this (...) claim are criticized and it is argued that Russellians need not appeal to representational notions in order to defeat them. Contrary to popular opinion, the prospects for a pure Russellianism, a Russellianism without representations, are in fact very good. (shrink)

Moritz Schlick, Rudolf Carnap and Herbert Feig are the most prominent of the positivists to formulate views on the mind-body problem (aside from Hempel’s one-off treatment in 1935). While their views differed from each other and changed over time they were all committed to some form of scientific physicalism, though a linguistic or conceptual rather than ontological form of it. In focus here are their views during the heyday of logical positivism and its immediate aftermath, though some initial scene-setting of (...) Schlick’s and Carnap’s pre-positivist views will help to understand the final opposing positions of Carnap and Feigl. (shrink)

Introduction. The roots of liberal-democratic theory -- Problems of interpretation -- Hobbe : the political obligation of the market. Philosophy and political theory -- Human nature and the state of nature -- Models of society -- Political obligation -- Penetration and limits of Hobbe's political theory -- The Levellers : franchise and freedom. The problem of franchise -- Types of franchise -- The record -- Theoretical implications -- Harrington : the opportunity state. Unexamined ambiguities -- The balance and the gentry (...) -- The bourgeois society -- The equal commonwealth and the equal agrarian -- The self-cancelling balance principle -- Harrington's stature --Locke : the political theory of appropriation. Interpretations -- The theory of property right -- Class differentials in natural rights and rationality -- The ambiguous state of nature -- The ambiguous civil society -- Unsettled problems reconsidered -- Possessive individualism and liberal democracy. The seventeenth-century foundations -- The twentieth-century dilemma -- Appendix : Social classes and franchise classes in England, circa 1648. (shrink)

Health Humanities draws upon the multiple and expanding fields of enquiry that link health and social care disciplines with the arts and humanities. It aims to encourage innovation and novel cross-disciplinary explorations of how the arts and humanities can inform and transform healthcare, health and wellbeing among researchers, practitioners and the public. It foregrounds a range of scholarship and innovative practice in this field. Through the development of critique and critical theory, it enables readers to question not only current practice (...) in medical and health humanities but also foundational assumptions of healthcare, health and wellbeing. Suitable for students and scholars working in this exciting interdisciplinary field, this book sets out the context for an emergent and innovative field. (shrink)

This seminal work by political philosopher C.B. Macpherson was first published by the Clarendon Press in 1962, and remains of key importance to the study of liberal-democratic theory half-a-century later. In it, Macpherson argues that the chief difficulty of the notion of individualism that underpins classical liberalism lies in what he calls its "possessive quality" - "its conception of the individual as essentially the proprietor of his own person or capacities, owing nothing to society for them." Under such a conception, (...) the essence of humanity becomes freedom from dependence on the wills of others; society is little more than a system of economic relations; and political society becomes a means of safeguarding private property and the system of economic relations rooted in property. As the New Statesman declared: "It is rare for a book to change the intellectual landscape. It is even more unusual for this to happen when the subject is one that has been thoroughly investigated by generations of historians.... Until the appearance of Professor Macpherson's book, it seemed unlikely that anything radically new could be said about so well-worn a topic. The unexpected has happened, and the shock waves are still being absorbed." A new introduction by Frank Cunningham puts the work in a twenty-first-century context. (shrink)

[T]he essays collected here... further determine the limits of experience as well as salvage something essential from that which takes place at the very limit of political and aesthetic experience. Included here are critical readings of such seminal figures as Locke, Kant, Nietzsche, Adorno, Foucault, Fanon, Lacoue-Labarthe, Badiou, and Rancière." -Cover.

This chapter contains section titles: I II III IV.

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work is in the "public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

A motivational system approach to avoidance behavior is presented. According to this approach, a motivational state increases the probability of relevant response patterns and establishes the appropriate or “ideal” consummatory stimuli as positive reinforcers. In the case of feeding motivation, for example, hungry rats are likely to explore and gnaw, and to learn to persist in activities correlated with the reception of consummatory stimuli produced by ingestion of palatable substances. In the case of defense motivation, fearful rats are likely to (...) flee or freeze, and to learn to persist in activities correlated with consummatory stimuli produced by flight from a dangerous place. Defense system activation is distinct from alarm reactions. The latter prepare the animal for probable noxious events, involve relatively intense negative affect and extinguish rapidly in situations where the noxious event no longer occurs. In contrast, defense system activation potentiates innate and modified defense reactions, thus preparing the animal for possible, but not necessarily probable, noxious events; it involves little or no negative affect and extinguishes very slowly when the noxious event no longer occurs. With these assumptions and the resulting model we attempt to resolve several long-standing problems in avoidance learning, including the low correlation between negative affect and avoidance performance, differential rates of extinction for avoidance performance and conditioned emotional responses, and evidence that some avoidance responses are much more easily learned than others. In addition, the model has implications for the study of parallels between appetitive and aversive motivation, sign tracking in aversive conditioning, and orientation of flight responses. Historical antecedents and alternative approaches are discussed. (shrink)

This is a welcome reprint of a book that continues to grow in importance.