The promise of genomic medicine lies in the opportunity to improve health outcomes via a personalized approach to management, grounded in genetic and genomic variation unique to an individual. However, disparities and inequities mar this remarkable landscape of genomic innovation. Prior efforts to understand these inequities have focused on populations for which genetic testing is relatively protocolized or where test utility varies greatly by ancestry groups, where equitable outcomes are more clearly defined. We therefore consider the current landscape of rare (...) disease genomics, in which diagnostic approaches vary widely and utility remains to be fully understood, and suggest a path forward: how ecosocial theory may be used to guide novel equity‐focused initiatives that incorporate illness narratives to improve population health. We present examples of narrative medicine in rare disease and reimagine the role this discipline may play in genomic sequencing studies, toward incorporation of the unique illness narrative into clinical genetics and genomics practice. Approaches that broaden the definitions of disease and of outcomes of interest will force the field to grapple with its racist history and begin to advance health equity and promote justice so that genomic medicine may truly deliver on its promise. (shrink)

In the face of the moral pluralism that results from the death of God and the abandonment of a God's eye perspective in secular philosophy, bioethics arose in a context that renders it essentially incapable of giving answers to substantive moral questions, such as concerning the permissibility of abortion, human embryonic stem cell research, euthanasia, etc. Indeed, it is only when bioethics understands its own limitations and those of secular moral philosophy in general can it better appreciate those tasks that (...) it can actually usefully perform in both the clinical and academic setting. It is the task of this paper to understand and reevaluate bioethics by understanding these limits. Academic bioethicists can analyze ideas, concepts, and claims necessary to understanding the moral questions raised in health care, assessing the arguments related to these issues, and provide an understanding of the different moral perspectives on bioethical issues. In the clinical setting, bioethicists can provide legal advice, serve as experts on IRBs, mediating disputes, facilitating decision-making and risk management, and clarifying normative issues. However, understanding this is only possible when one understands the history, genesis, and foundations of bioethics and its inability to provide a resolution to postmodern moral pluralism. (shrink)

Midrash Genesis Rabbah takes aim at a variety of ideological adversaries, but the most subtle polemic is directed at sages who went beyond standard hermeneutical practices to embrace mystical approaches to Torah learning. This essay seeks to expose the use of satire and other literary forms of critique among passages treating cosmology and Torah study. Analytic tools developed by Pierre Bourdieu, especially as they pertain to exposing the use of the symbolic language intrinsic to the establishment of systems of social (...) authority, will be employed to delineate the ideological conflict among sages developing diverse approaches to ascending the religious hierarchy within early rabbinism. (shrink)

Description: Ancient Indian logic by itself is a very vast subject. The ancient Sanskrit term nyaya which was first used in a different or in a much more general sense, was later specifically applied to the Nyaya school. The physics and physiology and psychology of the Nyaya doctrine are not specifically its own, being from the first indistinguishable from those of its sister Sastra, the Vaisesika. What characterizes it specifically is the development of the nyaya or five-membered method of demonstration (...) and its insistence on the four sources of knowledge, corresponding to the first four members of its demonstrative formula, or 'Syllogism.' The importance of Nyaya is in its doctrine of the pramanas, or sources of proof, and in its formulation of the nyaya, or method of demonstration. Indian Logic in its Early Schools by H.N. Randle is an interpretation of Indian logical theory in its historical development based on the study of original texts wherever reference to Nyaya as a method of logic has been made, and thus, covers a very wide field of Indian philosophy. An indispensable work for students of Indian philosophy, it is especially important for those who are interested in Nyayadarsana in its relation to the early logic of other schools. (shrink)

The dominant approach to environmental policy endorsed by conservative and libertarian policy thinkers, so-called “free market environmentalism”, is grounded in the recognition and protection of property rights in environmental resources. Despite this normative commitment to property rights, most self-described FME advocates adopt a utilitarian, welfare-maximization approach to climate change policy, arguing that the costs of mitigation measures could outweigh the costs of climate change itself. Yet even if anthropogenic climate change is decidedly less than catastrophic, human-induced climate change is likely (...) to contribute to environmental changes that violate traditional conceptions of property rights. Viewed globally, the actions of some countries—primarily industrialized nations—are likely to increase environmental harms suffered by other countries—less developed nations that have not made any significant contribution to climate change. It may well be that aggregate human welfare would be maximized in a warmer, wealthier world, or that the gains from climate change will offset environmental losses. Yet such claims, even if demonstrated, would not address the normative concern that the consequences of anthropogenic global warming would infringe upon the rights of people in less-developed nations. As a consequence, this paper calls for a rethinking of FME approaches to climate change policy. (shrink)

Associations between screen time and mental health may be driven by increased use in young people with heightened symptoms as a means of modifying negative mood. However, the direct effect of technology use on mood remains unclear. This study aimed to investigate the effect of active and passive social media use on an induced sad or neutral mood by randomising young people (16–24 years; N = 116) to a sad or neutral mood induction task and assessing mood after being instructed (...) to engage in active or passive social media use. We found both active and passive social media use alleviated sad mood but had no effect on neutral mood. Active social media use was associated with functional emotion regulation strategies relative to passive social media use. These findings suggest a possible beneficial effect of social media use on sad mood, however, longer-term effects on mental health are yet to be determined. (shrink)

The cortical visual mechanisms involved in processing spatial relationships remain subject to debate. According to one current view, the ''dorsal stream'' of visual areas, emanating from primary visual cortex and culminating in the posterior parietal cortex, mediates this aspect of visual processing. More recently, others have argued that while the dorsal stream provides egocentric coding of visual location for motor control, the separate ''ventral'' stream is needed for allocentric spatial coding. We have assessed the visual form agnosic patient DF, whose (...) lesion mainly affects the ventral stream, on a prehension task requiring allocentric spatial coding. She was presented with transparent circular disks. Each disk had circular holes cut in it. DF was asked to reach out and grasp the disk by placing her fingers through the holes. The disks either had three holes (for forefinger, middle finger, and thumb) or two holes (for forefinger and thumb). The distance between the forefinger and thumb holes, and the orientation of the line formed by them, were independently varied. DF was quite unable to adjust her grip aperture or her hand orientation in the three-hole task. Although she was able to orient her hand appropriately for the two-hole disks, she still remained unable to adjust her grip aperture to the distance between the holes. These findings are consistent with the idea that allocentric processing of spatial information requires a functioning ventral stream, even when the information is being used to guide a motor response. (shrink)

The act of exchanging one thing for another seems to involve a promise. The confidence needed to relinquish something one has on the understanding that one will receive what another has in exchange can be expressed in terms of resolve. In binding oneself, one thinks that if the other binds himself or herself to perform a given action, then he or she will do that action. In cases in which one person's action does not precede the other's, one's promise involves (...) thinking that if the other binds himself or herself, then he or she will carry out the promised action. (shrink)

H. Tristram Engelhardt, Jr.; Roman Catholic Social Teaching and Religious Hospital Identity in a Post-Christian Age, Christian bioethics: Non-Ecumenical Studies.

The author re-Examines the evidence (including the manuscript evidence) relevant to an understanding of the historico-Philosophical relationship of john locke to rene descartes and, Consequently, Of the relationship of "the empirical school" to "rationalism." arguing against a standardly accepted view (that of, Among others, Richard aaron), He suggests that, Both early and late, In the drafts of 1671 and in the "mature" "essay", Locke rejected descartes' science and philosophy of science precisely because he rejected his epistemology; furthermore, He rejected descartes' (...) epistemology precisely because he rejected his method and logic. (shrink)

Edmund D. Pellegrino has played a central role in shaping the fields of bioethics and the philosophy of medicine. His writings encompass original explorations of the healing relationship, the need to place humanism in the medical curriculum, the nature of the patient’s good, and the importance of a virtue-based normative ethics for health care. In this anthology, H. Tristram Engelhardt, Jr., and Fabrice Jotterand have created a rich presentation of Pellegrino’s thought and its development. Pellegrino’s work has been dedicated to (...) showing that bioethics must be understood in the context of medical humanities, and that medical humanities, in turn, must be understood in the context of the philosophy of medicine. Arguing that bioethics should not be restricted to topics such as abortion, third-party-assisted reproduction, physician-assisted suicide, or cloning, Pellegrino has instead stressed that such issues are shaped by foundational views regarding the nature of the physician-patient relationship and the goals of medicine, which are the proper focus of the philosophy of medicine. This volume includes a preface by Dr. Pellegrino and a comprehensive Introduction by the editors. Of interest to medical ethicists as well as students, scholars, and physicians, _The Philosophy of Medicine Reborn_ offers fascinating insights into the emergence of a field and the work of one of its pioneers. “After a long period of dormancy, philosophy of medicine has blossomed with new life. The single most important physician-philosopher in that rebirth has been Edmund Pellegrino. His contributions to virtue theory, the concept of beneficence, the dispute over the internal and external sources of a morality for medicine, and the role of the Hippocratic tradition are all critical. The essays collected in this volume have changed the history of the philosophy of medicine. He shows that philosophy of medicine can be done with both passion and compassion.” —_Robert M. Veatch, Kennedy Institute of Ethics, Georgetown University_ “Edmund Pellegrino's words have helped medical students, faculty, scholars and patients address the challenges they encounter in medicine and medical practice. His personal support has also been critical for many of us in developing programs in medical ethics and philosophy of medicine in our universities. Dr. Pellegrino combines the wisdom of a great physician with those of a great philosopher to produce a body of writing that will continue to inspire us all. This volume contains some of his best and most influential work.” —_Loretta Kopelman, The Brody School of Medicine, East Carolina University_ _ _ “Edmund Pellegrino has been a leading light in the philosophy of medicine for a generation. He was instrumental in the birth of bioethics, founded one of the leading journals, and provided able leadership in organizing early activities of the profession. He has served as department chairman, dean, and university president. Most recently, he chairs the President’s Council on Bioethics. In all this, first and foremost, he has been a physician. Those who are ill and suffering make a claim upon him. To respond to this claim, Pellegrino creatively brings together the worlds of science and of the humanities. For him, that is what medicine is about, making it the most scientific of the humanities and the most humane of the sciences. Fortunately for us, Pellegrino brings these worlds together in thought, as well as in practice. In this selection from his writings, Engelhardt and Jotterand have captured the heart of Pellegrino’s project, both in depth and breadth, so we can also hear that claim of the ill and so we can see what worlds must come together if we are to respond in the appropriate way.” —_George Khushf, University of South Carolina_ “Pellegrino’s work is both a treasure and important for understanding bioethics. His work in philosophy of medicine addresses the crucial questions that are so important to understanding the practice of medicine and the ethics of health care.” —_Kevin Wildes, President, Loyola University_ _ _. (shrink)

Theories of linguistic meaning have been a major influence in twentieth century philosophy. This is due, in part, to the assumption that meaning is the crucial and interesting thing about language. To know the meaning of an expression is to understand it, and since understanding is central to philosophy in many different ways, it should be no surprise that the notion of meaning has often taken center stage. The aim of this paper is to briefly explore some influential views concerning (...) linguistic meaning. The final objective will be to demonstrate some alternatives which are open to theory with respect to this notion,for there are those who have wanted to ban talk of meaning from serious scientific discourse. The point is that many of the disadvantages of traditional notions of meaning are avoidable¾in particular, they are avoidable along a path which starts from Frege and moves on via Tarski and Davidson. (shrink)

One area of language research that has received a great deal of attention, both theoretical and empirical, is the use of anaphoric expressions. Such expressions can be thought of as serving two functions: the primary function is to refer back to a referent from previous discourse, and the secondary, but no less important, function is to help provide discourse coherence and structure. Third person pronouns such as he or she are anaphoric expressions par excellence, but fuller anaphoric expressions, including demonstrative (...) and definite noun phrases (NPs) such as that woman and the woman are also used in natural discourse. In this chapter we shall focus primarily on issues concerning definite NP anaphor resolution, and in particular we shall examine the interaction of two factors that are related to the identification of antecedents: the focus status of the antecedent and the semantic relationship between the antecedent and the anaphor (including semantic overlap). After presenting these factors, we will discuss one particular approach to anaphor resolution, Almor's (1999) Informational Load Hypothesis (ILH), and present three experiments that examined the findings presented in Almor (1999). The results of these experiments will lead us to consider in more detail the secondary, discourse-structuring function of anaphoric expressions. (shrink)

En el presente artículo se estudia la crítica que Charles Taylor ha formulado al modelo del liberalismo procedimental y a la concepción de racionalidad práctica moderna. El punto de partida es que la crítica de Taylor se sustenta en los aportes de la tradición filosófica sustantiva, la cual posibili..

This paper reports two cases in Hong Kong involving two native Chinese adolescent cancer patients (APs) who were denied their rights to consent to necessary treatments refused by their parents, resulting in serious harm. We argue that the dynamics of the 'AP-physician-family-relationship' and the dominant role Chinese families play in medical decision-making (MDM) are best understood in terms of the tendency to hierarchy and parental authoritarianism in traditional Confucianism. This ethic has been confirmed and endorsed by various Chinese writers from (...) Mainland China and Hong Kong. Rather than giving an unqualified endorsement to this ethic, based more on cultural sentimentalism than rational moral reasoning, we warn that a strong familism in MDM, which deprives 'weak' family members of rights, represents the less desirable elements of this tradition, against which healthcare professionals working in this cultural milieu need to safeguard. Specifically for APs, we suggest that parental authority and family integrity should be re-interpreted in terms of parental responsibility and the enhancement of children's interests respectively, as done in the West. This implies that when parents refuse to consent to necessary treatment and deny their adolescent children's right to consent, doctors, as the only remaining advocates of the APs' interest, have the duty to inform the state, which can override parental refusal to enable the doctors to fulfill their professional and moral obligations. In so doing the state exercises its 'parens patriae' power to defend the defenseless in society and the integrity of the medical profession. (shrink)

A collection of essays written in affectionate tribute to Gombrich.