In spite of advances in medicine and public health, malaria and other mosquito‐borne diseases are on the rise worldwide. Although vaccines, genetically modified mosquitoes and safer insecticides are under development, herein we examine a promising new approach to malaria control through better repellents. Current repellents, usually based on DEET, inhibit host finding by impeding insect olfaction, but have significant drawbacks. We discuss how comparative genomics, using data from the Anopheles genome project, allows the rapid identification of members of three protein (...) classes critical to insect olfaction: odorant‐binding proteins, G‐protein‐coupled receptors, and odorant‐degrading enzymes. A rational design approach similar to that used by the pharmaceutical industry for drug development can then be applied to the development of products that interfere with mosquito olfaction. Such products have the potential to provide more complete, safer and longer lasting protection than conventional repellents, preventing disease transmission by interrupting the parasite life cycle. BioEssays 25:1011–1020, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

Cambridge Quarterly of Healthcare Ethics. What values and principles should inform the regulation of new human genetic technologies? To adequately answer this question we need an account of genetic justice. That is, an account of what constitutes a fair distribution of genetic endowments that influence our expected life-time acquisition of natural primary goods. These are goods that every rational person has an interest in. The decisions we now make regarding the regulation of human genetic technologies (...) will determine how quickly and effectively these benefits are brought into existence, as well as who receives these benefits. In this paper I argue that a necessary condition of a defensible account of genetic justice is that it must track genetic complexity. Genetic complexity encompasses phenomena such as polygenetic traits, gene-gene interactions and complex environmental influences. More specifically, I argue that pluralistic prioritarianism is a theoretical position well-suited for tracking genetic complexity. (shrink)

In her recent article, Prince has identified a critical challenge for those who advocate genetic enhancement to reduce social injustices. The gene–environment interaction prevents genetic enhancement from having equitable effects at the phenotypic level, even if enhancement were available to the entire population. The poor would benefit less than the rich from their improved genes because their genotypes would interact with more unfavourable socioeconomic environments. Therefore, Prince believes that genetic enhancement should not be used to combat social (...) inequalities, since it can likely aggravate them. In this article, I raise various objections to this conclusion. I argue first that genetic enhancement need not necessarily magnify social injustices. I then show that genetic enhancement can play a modest but not insignificant role in the quest for social justice in the future. Finally, I conclude by arguing for the need to consider the complex interplay between the social lottery and the natural lottery in our aspirations for justice linked to genetic technologies. (shrink)

The structure of our ethical experience depends, crucially, on a fundamental distinction between what we are responsible for doing or deciding and what is given to us. As such, the boundary between chance and choice is the spine of our conventional morality, and any serious shift in that boundary is thoroughly dislocating. Against this background, I analyze the way in which techniques of prenatal genetic diagnosis (PGD) pose such a fundamental challenge to our conventional ideas of justice and (...) moral responsibility. After a short description of the situation, I first examine the influential luck egalitarian theory of justice, which is based on the distinction between choice and luck or, more specifically, between option luck and brute luck, and the way in which it would approach PGD (section II), followed by an analysis of the conceptual incoherencies (in section III) and moral problems (in section IV) that come with such an approach. Put shortly, the case of PGD shows that the luck egalitarian approach fails to express equal respect for the individual choices of people. The paradox of the matter is that by overemphasizing the fact of choice as such, without regard for the social framework in which they are being made, or for the fundamental and existential nature of particular choices—like choosing to have children and not to undergo PGD or not to abort a handicapped fetus—such choices actually become impossible. (shrink)

Innovations in science and technology are often the source of public concern, but few have generated debates as intense and at the same time with such a popular fascination as those surrounding genetic technologies. Unequal access to preimplantation diagnosis could give some individuals the opportunity to select children with more advantageous predispositions.

Innovations in science and technology are often the source of public concern, but few have generated debates as intense and at the same time with such a popular fascination as those surrounding genetic technologies. Unequal access to preimplantation diagnosis could give some individuals the opportunity to select children with more advantageous predispositions.

Should nonprejudiced reproducers genetically select embryos for light skin under background conditions of racism and colourism, given that darker skin will be disadvantageous for their child? Many intuit that there are strong moral reasons not to select light skin in these contexts. I argue that existing procreative principles cannot adequately account for this judgement. Instead, I argue that a more compelling rationale for this intuition is that such selection completes an instance of race or colour injustice. Given this, I propose (...) a new, complementary principle—Procreative Justice—which holds that reproducers have strong pro tanto moral reasons to avoid completing race and colour injustices via their selection choices. While these reasons may be overridden by competing considerations, they nonetheless continue to exert normative force. (shrink)

The use of genetic testing has prompted the question of whether insurance companies should be able to use predictive genetic test results (GTRs) in their risk classification of clients. While some jurisdictions have passed legislation to prohibit this practice, the UK has instead adopted a voluntary code of practice that merely restricts the ways in which insurance companies may use GTRs. Critics have invoked various theories of justice to argue that this approach is unfair. However, as well (...) as sometimes relying on somewhat idealised assumptions, these analyses have tended to invoke theories that have wide-ranging and highly revisionary implications for insurance. Moreover, they fail to adequately engage with a conception of justice that plausibly undergirds the status quo approach to insurance in the UK. I argue that it is a mistake to simply invoke a single contestable theory in seeking to develop sound policy on the use of GTRs in insurance. To that end, in this paper, I outline three plausible principles of justice that policy on this issue ought to balance: A principle of equity, a principle of equal access and a principle of need. In doing so, I shall offer a pluralist justice-based argument in support of the spirit, if not the precise letter, of the UK approach. (shrink)

In 2004, the Havasupai Tribe filed a lawsuit against the Arizona Board of Regents and Arizona State University researchers upon discovering their DNA samples, initially collected for genetic studies on type 2 diabetes, had been used in several other genetic studies. The lawsuit reached a settlement in April 2010 that included monetary compensation and return of DNA samples to the Havasupai but left no legal precedent for researchers. Through semistructured interviews, institutional review board chairs and human genetics researchers (...) at US research institutions revealed their perspectives on the Havasupai lawsuit. For interviewees, the suit drew attention to indigenous concerns over genetic studies and increased their awareness of indigenous views. However, interviewees perceived no direct impact from the Havasupai case on their work; if they did, it was the perceived need to safeguard themselves by obtaining broad consent or shying away from research with indigenous communities altogether, raising important questions of justice for indigenous and minority participants. If researchers and IRBs do not change their practices in light of this case, these populations will likely continue to be excluded from a majority of research studies and left with less access to resources and potential benefit from genetic research participation. (shrink)

: Genetics researchers often work with distinct communities. To take moral account of how their research affects these communities, they need a richer conception of justice and they need to make those communities equal participants in decision-making about how the research is conducted and what is produced and published out of it.

Genetics researchers often work with distinct communities. To take moral account of how their research affects these communities, they need a richer conception of justice and they need to make those communities equal participants in decision‐making about how the research is conducted and what is produced and published out of it.

This book, written by four internationally renowned bioethicists and first published in 2000, was the first systematic treatment of the fundamental ethical issues underlying the application of genetic technologies to human beings. Probing the implications of the remarkable advances in genetics, the authors ask how should these affect our understanding of distributive justice, equality of opportunity, the rights and obligations as parents, the meaning of disability, and the role of the concept of human nature in ethical theory and (...) practice. The book offers a historical context to contemporary debate over the use of these technologies by examining the eugenics movement of the late nineteenth and early twentieth centuries. The questions raised in this book will be of interest to any reflective reader concerned about science and society and the rapid development of biotechnology, as well as to professionals in such areas as philosophy, bioethics, medical ethics, health management, law, and political science. (shrink)

Introduction to the Ethical Perspectives Theme Issue (19/1) on Genetics and Justice, with contributions by Greg Bognar, David Hunter, Michele Loi, Oliver Feeney, Vilhjálmur Arnason, Durnin et al.

: This paper explores some of the challenges raised by human genetic interventions for debates about distributive justice, focusing on the challenges that face prioritarian theories of justice and their relation to the argument advanced by Ronald Lindsay elsewhere in this issue of the Kennedy Institute of Ethics Journal. Also examined are the implications of germ-line genetic enhancements for intergenerational justice, and an argument is given against Fritz Allhoff's conclusion, found in this issue as well, (...) that such enhancements are morally permissible if and only if they augment primary goods. (shrink)

Noninvasive prenatal testing promises to enhance women's reproductive autonomy by providing genetic information about the fetus, especially in the detection of genetic impairments like Down syndrome. In practice, however, NIPT provides opportunities for intensified manipulation and control over women's reproductive decisions. Applying Miranda Fricker's concept of epistemic injustice to prenatal screening, this article analyzes how medical professionals impair reproductive decision-making by perpetuating testimonial injustice. They do so by discrediting positive parental testimony about what it is like to raise (...) a child with DS. We argue that this testimonial injustice constitutes a twofold harm: people with DS and their family members who claim that parenting a child with DS may be a rewarding and joyous experience are harmed when they are systematically silenced, disbelieved, and/or denied epistemic credibility by medical professionals, and pregnant women are harmed since they might make poorly informed choices without access to all relevant information. The broader implication of the analysis is that epistemic justice is a precondition of reproductive autonomy. We conclude by calling for federal oversight of the acquisition and dissemination of information that prospective parents receive following a positive diagnosis of DS to ensure that it is comprehensive and up to date. (shrink)

This book, written by four internationally renowned bioethicists and first published in 2000, was the first systematic treatment of the fundamental ethical issues underlying the application of genetic technologies to human beings. Probing the implications of the remarkable advances in genetics, the authors ask how should these affect our understanding of distributive justice, equality of opportunity, the rights and obligations as parents, the meaning of disability, and the role of the concept of human nature in ethical theory and (...) practice. The book offers a historical context to contemporary debate over the use of these technologies by examining the eugenics movement of the late nineteenth and early twentieth centuries. The questions raised in this book will be of interest to any reflective reader concerned about science and society and the rapid development of biotechnology, as well as to professionals in such areas as philosophy, bioethics, medical ethics, health management, law, and political science. (shrink)

Under conditions with a low level of available genetic information, mutualistic private insurance markets will often create broadly just outcomes, even if by accident rather than by design. Normatively acceptable outcomes of this kind would come under threat if insurers were to have increased access to genetic information with substantial predictive content.1 As the availability of relevant individual genetic information grows, mutualistic forms of market-based insurance face a dilemma between either sacrificing individuals’ interests in genetic privacy, (...) or creating conditions for market failure due to adverse selection. My view is therefore that we have good reason to shift towards more solidaristic forms of ‘risk-sharing institutions’ with regard to functions such as life insurance and critical illness insurance, as a way of resolving normative tensions between values of equality, privacy, non-discrimination and autonomy. Such a position, I have argued, does not depend on endorsing any particular conception of social justice, but can be defended on the basis of a number of different plausible accounts of what justice demands.1 Jonathan Pugh argues against my endorsement of a shift towards solidaristic, non-market risk-sharing institutions, and instead argues broadly in favour of the status quo. He holds that it counts against my proposals that they ‘have wide-ranging and highly revisionary implications’, and argues that my approach is mistaken in relying on ‘a single contestable theory’. Pugh offers a purportedly less contestable account of the relevant normative considerations underlying insurance regimes, composed of three …. (shrink)

Recent advances in genetic research pose many complex problems for moral and political philosophers. On the one hand, these advances promise great things. Genetic enhancement techniques might allow us to prevent or cure a variety of debilitating diseases. But on the other hand, talk about intervening in people's genetic make-up conjures up memories of the sinister episodes of past eugenic movements. Such movements violated the most basic principles of justice. How can society capitalize on the benefits (...) of genetic intervention and yet avoid the injustices of past eugenic movements? What basic moral principles should guide public policy and individual choice concerning the use of genetic interventions? These important questions are tackled by Allen Buchanan, Dan Brock, Norman Daniels, and Daniel Wikler in From Chance to Choice: Genetics and Justice. This book brings together the thoughts of leading scholars in the field and is likely to set the agenda for serious debate on this topic. (shrink)

Recent advances in genetic research pose many complex problems for moral and political philosophers. On the one hand, these advances promise great things. Genetic enhancement techniques might allow us to prevent or cure a variety of debilitating diseases. But on the other hand, talk about intervening in people's genetic make-up conjures up memories of the sinister episodes of past eugenic movements. Such movements violated the most basic principles of justice. How can society capitalize on the benefits (...) of genetic intervention and yet avoid the injustices of past eugenic movements? What basic moral principles should guide public policy and individual choice concerning the use of genetic interventions? These important questions are tackled by Allen Buchanan, Dan Brock, Norman Daniels, and Daniel Wikler inFrom Chance to Choice: Genetics and Justice. This book brings together the thoughts of leading scholars in the field and is likely to set the agenda for serious debate on this topic. (shrink)

It is argued that justice in some cases provides a pro tanto reason genetically to enhance victims of the genetic lottery. Various arguments--both to the effect that justice provides no such reason and to the effect that while there may be such reasons, they are overridden by certain moral constraints--are considered and rejected. Finally, it is argued that justice provides stronger reasons to perform more traditional medical tasks (treatments), and that therefore genetic enhancements should not (...) play an important role in a public health care system. (shrink)

The Convention on Biological Diversity and its Nagoya Protocol established an Access and Benefit Sharing system between utilizers and providers of genetic resources. ABS is understood as a tool that should promote commutative justice between the involved parties. This essay discusses what exactly it is that is being exchanged in the ABS process. It critically analyses moral claims to compensation that are implied by the ABS system for genetic resources. It argues that with the exception of cases (...) in which traditional knowledge is involved, states are not automatically entitled to compensation in return for the utilization of genetic resources growing within their territory. However, biodiversity-rich states that make an effort to protect biodiversity must be compensated for complying with the requests set out in the CBD. Although it acknowledges that the NP is a step towards recognizing this claim, this essay argues that ABS is not the appropriate method to compensate for biodivers... (shrink)

What will the demands of distributive justice be in the postgenetic revolutionary world? Will genetic inheritance be regarded as socially distributed goods? This may seem a more reasonable position to assert as biotechnology progresses further toward human genetic manipulation.

Se analizan los dilemas morales asociados a los avances científicos que en la actualidad nos exigen repensar el concepto de igualdad equitativa de oportunidades. Asimismo, se pasa revista a la discusión filosófica en torno al origen de las desventajas sociales y genéticas que permiten las desigualdades sociales. This paper discusses the moral dilemmas associated with scientific advances that require rethinking the concept of fair equality of opportunity. It also reviews the philosophical discussion about the origin of the genetic and (...) social disadvantages that allow for social inequalities. (shrink)

The debate over the host of moral issues that genetic enhancement technology (GET) raises has been significant. One argument that has been advanced to impugn its moral legitimacy is the ‘unfair advantage argument’ (UAA), which states: allowing access to GET to be determined by socio-economic status would lead to unjust outcomes, namely, create a genetic caste system, and with it the exacerbation and perpetuation of existing socio-economic inequalities. Fritz Allhoff has recently objected to the argument, the kernel of (...) which is that it conflates the use of the technology with its distribution. GET, he argues, would generate unjust outcomes only if it is distributed according to principles of an unjust pattern of distribution; for if we can determine what constitutes a ‘just’ distributive scheme, then the technology can be allocated according to the principles of that scheme. In this paper I argue the following cluster of related claims: (1) both UAA and Allhoff's proposed distributive schemes ignore the importance of non-genetic factors in the development of an individual's characteristics and capacities; (2) if we accept the view that it is good to prevent unjust outcomes that arise because some have exclusive access to GET, then we have to accept wide-ranging distributive schemes; (3) by tracking genetic and non-genetic factors wide-ranging schemes do violate in some sense the widely shared value of neutrality in liberal democracies. (shrink)

: he commercialization of biotechnology, especially research and development by transnational pharmaceutical companies, is already excessive and is increasingly dangerous to distributive justice, human rights, and access of marginal populations to basic human goods. Focusing on gene patenting, this article employs the work of Margaret Jane Radin and others to argue that gene patenting ought to be more highly regulated and that it ought to be regulated with international participation and in view of concerns about solidarity and the common (...) good. The mode of argument called for on this issue is more pragmatic than logical, emphasizing persuasion based on evidence about the reality and effects of control of genetic research by profit-driven biotech companies. (shrink)

In this new post-genomic age of medicine and biomedical technology, there will be novel approaches to understanding disease, and to finding drugs and cures for diseases. Hundreds of new “disease genes” thought to be the causative agents of various genetic maladies will be identified and added to the list of hundreds of such genes already identified. Based on this knowledge, many new genetic tests will be developed and used in genetic screening programs. Genetic screening is the (...) foundation upon which reproductive technologies such as pre-natal diagnosis (PND) and preimplantation genetic diagnosis (PGD) are based. Genetic information arising from the human genome may also be used in attempts to redesign the human genetic inheritance by engineering the human germline (germline engineering). In each of these technologies—PND, PGD, and germline engineering—there are serious ethical and social concerns. Moreover, all three are eugenic in nature because they strive to control which genes are passed down to future generations. The goals of this article are threefold: 1) to introduce the science behind the three technologies; 2) to give a brief overview of eugenics in the past century and show how these genetic technologies are eugenic; and 3) to present a vision of social justice that rejects the genetic determinism upon which eugenics is based and embraces a holistic, ecological view of nature and humanity. (shrink)

:Appeals to social justice that argue medicine and healthcare should have certain priorities and not others are common. It is an obvious question to ask: What does social justice demand of the new genetic technologies? However, it is important to note that there are many theories and sub-theories of justice. There are utilitarian theories, libertarian theories, and egalitarian theories. There are so-called luck egalitarians, equality-as-fairness thinkers, and capability theorists, with each having his or her own distinctive (...) approach to the distribution of medical goods and technologies, and to healthcare priorities. This article argues that the discussion surrounding this question is potentially hampered by an implicit assumption that if one theory of justice is applicable in one context, then it must also be applicable in others. Instead, it is proposed that one adopt the stance, influenced by Michael Waltzer, that different theories with their opposing principles may be applicable to different questions regarding justice and genetics. The specific view advanced is that to answer questions about what justice requires regarding the therapeutic and enhancement use of genetic techniques, a method of reflective equilibrium can show how intuitions, in context, may support different theories of justice. When particular pre-theoretic ethical judgments are balanced against the theories that might explain or justify them, and are in accord with what seems emotionally acceptable, then it can be seen how different general theories may be applicable in the different contexts in which questions of justice and genetics arise. (shrink)

Descartes is typically interpreted as asserting two related theses: 1) that the will is absolutely free in the sense that no bodily state can compel it or restrain its activity; and 2) that error is always avoidable, no matter what the condition of the body. On the basis of Descartes’s discussions of insanity and dreaming, I argue that both of these interpretive claims are false. In other words, Descartes acknowledged that a diseased or otherwise out of sorts body can compel (...) the will to affirm obscure and confused perceptions. After marshalling textual evidence for this conclusion, I go on to show how Descartes’s acknowledgment of physically induced impaired judgment can be squared with his unqualified assertions of free will, his commitment to the non-deceptiveness of God, and his epistemology. (shrink)

The possibility of genetic enhancement to increase the likelihood of success in sport and life’s prospects raises questions for accounts of sport and theories of justice. These questions obviously include the fairness of such enhancement and its relationship to the goals of sport and demands of justice. Of equal interest, however, is the effect on our understanding of individual effort, merit, and desert of either discovering genetic contributions to components of such effort or recognizing the influence (...) of social factors on the development and exercise of individual effort. This paper analyzes arguments about genetic enhancement with the goal of raising questions about how sport and justice regard unchosen, undeserved inequalities and what is assumed to be their opposite—namely, the exercise and results of individual effort. It is suggested that contemplating enhancement of natural assets previously outside human control may reinforce recognition of responsibility to intervene with regard to social advantages so as to support individual effort and improve individuals’ life prospects. (shrink)

With over 10 000 bases of DNA being sequenced around the world per minute, it is vital that ethical discussion continues to keep pace with genetic research. This contribution by four top theorists in bioethics carefully considers the implications of the many ways genetic information will influence human health and reproduction, by considering “the most basic moral principles that would guide public policy and individual choice concerning the use of genetic interventions in a just and humane society” (...) (4–5). Proceeding with the themes of rights, justice, and harm, problems addressed by the authors include: the significance of the moral difference between treating genetic disease and altering personality characteristics; whether the utilisation of prenatal interventions to avoid disability discriminates against the disabled, and who should have control …. (shrink)

Descartes is typically interpreted as asserting two related theses: 1) that the will is absolutely free in the sense that no bodily state can compel it or restrain its activity; and 2) that error is always avoidable, no matter what the condition of the body. On the basis of Descartes’s discussions of insanity and dreaming, I argue that both of these interpretive claims are false. In other words, Descartes acknowledged that a diseased or otherwise out of sorts body can compel (...) the will to affirm obscure and confused perceptions. After marshalling textual evidence for this conclusion, I go on to show how Descartes’s acknowledgment of physically induced impaired judgment can be squared with his unqualified assertions of free will, his commitment to the non-deceptiveness of God, and his epistemology. (shrink)

Descartes is typically interpreted as asserting two related theses: 1) that the will is absolutely free in the sense that no bodily state can compel it or restrain its activity; and 2) that error is always avoidable, no matter what the condition of the body. On the basis of Descartes’s discussions of insanity and dreaming, I argue that both of these interpretive claims are false. In other words, Descartes acknowledged that a diseased or otherwise out of sorts body can compel (...) the will to affirm obscure and confused perceptions. After marshalling textual evidence for this conclusion, I go on to show how Descartes’s acknowledgment of physically induced impaired judgment can be squared with his unqualified assertions of free will, his commitment to the non-deceptiveness of God, and his epistemology. (shrink)

Proponents of using genetically modified (GM) crops and food in the developing world often claim that it is unjust not to use GMOs (genetically modified organisms) to alleviate hunger and malnutrition in developing countries. In reply, the critics of GMOs claim that while GMOs may be useful as a technological means to increase yields and crop quality, stable and efficient institutions are required in order to provide the benefits from GMO technology. In this debate, the GMO proponents tend to rely (...) on a simple utilitarian type of calculus that highlights the benefits of GMOs to the poor, but that overlooks the complex institutional requirements necessary for GMO production. The critics, recognizing the importance of institutional conditions, focus primarily on the negative impacts of institutional deficiencies, thereby overlooking the basically Rawlsian claim that institutions per se may generate claims to justice. This article investigates how GMOs might generate claims to global justice and what type of justice is involved. The paper argues that the debate on GMOs and global justice can be categorized into three views, i.e., the cosmopolitan, the pluralist, and the sceptic. The cosmopolitan holds that GMOs can and should be used for alleviating global hunger, whereas the sceptic rejects this course of action. I will argue here for a moderately cosmopolitan approach, relying on the pluralist view of institutions and the need to exploit the benefits of GMOs. This argument rests on the premise that global cooperation on GMO production provides the relevant basis for assessing the use of GMOs by the standard of global distributive justice. (shrink)

: There is a concern that genetic engineering will exacerbate existing social divisions and inequalities, especially if only the wealthy can afford genetic enhancements. Accordingly, many argue that justice requires the imposition of constraints on genetic engineering. However, it would be unwise to decide at this time what limits should be imposed in the future. Decision makers currently lack both the theoretical tools and the factual foundation for making sound judgments about the requirements of justice (...) in a genetically transformed society. Moreover, focusing on the uncertain inequities of the future may result in failure to give priority to more pressing inequities of the present. Especially in a country that recently has enacted tax legislation that will widen existing wealth disparities, concern about the distant threat of a genetic aristocracy appears misplaced. (shrink)

The prelims comprise: Introduction Chance, Choice, and Circumstances Genes and Lifestyle Third Parties' Susceptibilities Conclusion Notes.

ABSTRACTIn 2001, Julian Savulescu wrote an article entitled ‘Procreative Beneficence: Why We Should Select the Best Children’, in which he argued for the genetic selection of intelligence in children. That article contributes to a debate on whether genetic research on intelligence should be undertaken at all and, if so, should intelligence selection be available to potential parents. As such, the question of intelligence selection relates to wider issues concerning the genetic determination of behavioural traits, i.e. alcoholism. This (...) article is designed as an engagement in the intelligence selection debate using an analysis of Savulescu's arguments to raise a series of problematic issues in relation to the ethics of parental selection of intelligence. These problematic issues relate to wider assumptions that are made in order to put forward intelligence selection as a viable ethical option. Such assumptions are more generic in character, but still relate to Savulescu's article, concerning issues of genetic determinism, private allocation and inequality, and, finally, individual versus aggregate justice. The conclusion focuses on what the implications are for the question of agency, especially if intelligence selection is allowed. (shrink)

This review is unashamedly from the perspective of English law because busy United Kingdom criminal law solicitors and barristers mostly wish to know what the law states, which case is a precedent case and whether the author has provided up-to-date legal information. This is because legal practitioners deal with real and urgent cases. The English Income Tax Act gained Royal Assent in 1799 the first government attempt to stop early tax avoidance. Later, tax avoidance schemes (which in English Law were (...) deemed a legitimate method of minimising one payment of taxation) became de rigueur all over the world and often involved creation of Deeds of Covenant and Trusts, notably Discretionary Trusts under civil law. Man’s ingenuity knows no bounds and this applies to man’s characteristic of criminality as it does to scholarship, enterprise and innovation. Despite protestations by some countries police agencies, contrary to the rise of crime, the fact is that that crime is increasing exponentially worldwide, but the number of people committing crime is not increasing because many crimes are repeated crimes committed by persons with habitual criminal behaviour, ie hard-core criminals. (shrink)

The prelims comprise: Introduction Pre‐existing Conditions Case Model of Causation Case study of ‘Genetic Disease” The Future of Medical Insurance Conclusion Notes References Suggestions for Further Reading.