The year 2018 was the 40th anniversary of the birth of Louise Joy Brown, marking four decades of clinical in vitro fertilization and embryo transfer. Though this milestone, reached first by Steptoe and Edwards in the United Kingdom, is well acknowledged through Nobel accolade, the achievement was not entirely celebrated at the time. Global contention was not just moral, but political and legislative. In the United States, the achievement led in 1978 to the freezing of federal funds by the National (...) Institute of Health for research on human embryos and oocytes.A report published on May 4, 1979, by the Ethics Advisory Board of the Department of Health... (shrink)

Bone marrow is the main site for hematopoiesis in adults. It acts as a niche for hematopoietic stem cells (HSCs) and contains non‐hematopoietic cells that contribute to stem cell dormancy, quiescence, self‐renewal, and differentiation. HSC also exist in resting spleen of several species, although their contribution to hematopoiesis under steady‐state conditions is unknown. The spleen can however undergo extramedullary hematopoiesis (EMH) triggered by physiological stress or disease. With the loss of bone marrow niches in aging and disease, the spleen as (...) an alternative tissue site for hematopoiesis is an important consideration for future therapy, particularly during HSC transplantation. In terms of harnessing the spleen as a site for hematopoiesis, here the remarkable regenerative capacity of the spleen is considered with a view to forming additional or ectopic spleen tissue through cell engraftment. Studies in mice indicate the potential for such grafts to support the influx of hematopoietic cells leading to the development of normal spleen architecture. An important goal will be the formation of functional ectopic spleen tissue as an aid to hematopoietic recovery following clinical treatments that impact bone marrow. For example, expansion or replacement of niches could be considered where myeloablation ahead of HSC transplantation compromises treatment outcomes. (shrink)

Legalisation of assisted suicide presents a dilemma for society. This arises because of a lack of consensus regarding the precedence to be accorded freedom of choice versus the inviolability of human life. A combination of factors has served to throw this dilemma into sharper focus in recent times. These include population aging,1,2 increased openness regarding end-of-life care,3 development of patients' rights, and increasing secularisation and multiculturalism in society. Against this backdrop and within a context where several countries have addressed legislation (...) of …. (shrink)

Environmental problems have an ethical dimension. They are not just about the efficient use of resources. Justice in the distribution of environmental goods and burdens, fairness in the processes of environmental decision-making, the moral claims of future generations and non-humans, these and other ethical values inform the responses of citizens to environmental problems. How can these concerns enter into good policy-making processes?Two expert-based approaches are commonly advocated for incorporating ethical values into environmental decision-making. One is an 'economic capture' approach, according (...) to which existing economic methods can be successfully extended to include ethical concerns. For example, stated preference methods, especially contingent valuation, have been developed to try and capture ethical responses as 'non-use values' of the environment, in particular 'existence values'. The other is a 'moral expert' approach which confines economic methods to the analysis of welfare gains, and assumes committees of ethical experts will complement economic expertise.Both approaches face problems in terms of addressing many widely held ethical values about the environment. Furthermore, both face problems concerning the democratic legitimacy of their procedures. How can policy-making be made responsive to different ethical values? What role is there for new deliberative and participatory methods? How far do existing decision-making institutions have the capacities to incorporate different modes of articulating environmental values?This policy brief examines the limitations of current attempts to capture ethical values within existing economic instruments and considers how these limitations might be overcome. Section 1 examines the assumptions that standard economic theory makes about individuals when they express values and make choices about the environment. The current models of agents that inform policy-making are seen to be ill-suited to incorporating the ethical responses of agents and this reveals some of the policy failures that may result. Section 2 shows how the physical and social properties of many environmental goods prevent their being treated as commodities. Section 3 considers the problems surrounding conceptions of fairness and legitimacy in processes for environmental valuation. Section 4 raises questions concerning the capacities of policy-making institutions to take cognisance of the results of different methods for articulating environmental values. (shrink)

Focal brain metabolic effects detected by proton magnetic resonance spectroscopy (MRS) in obsessive-compulsive disorder (OCD) represent prospective indices of clinical status and guides to treatment design. Sampling bilateral pregenual anterior cingulate cortex (pACC), anterior middle cingulate cortex (aMCC), and thalamus in 40 adult patients and 16 healthy controls, we examined relationships of the neurometabolites glutamate+glutamine (Glx), creatine+phosphocreatine (Cr), and choline-compounds (Cho) with OCD diagnosis and multiple symptom types. The latter included OC core symptoms (Yale-Brown Obsessive-Compulsive Scale - YBOCS), depressive symptoms (...) (Montgomery-Åsberg Depression Rating Scale - MADRS), and general functioning (Global Assessment Scale - GAS). pACC Glx was 9.7% higher in patients than controls. Within patients, Cr and Cho correlated negatively with YBOCS and MADRS, while Cr correlated positively with the GAS. In aMCC, Cr and Cho correlated negatively with MADRS, while Cr in thalamus correlated positively with GAS. These findings present moderate support for glutamatergic and cingulocentric perspectives on OCD. Based on our prior metabolic model of OCD, we offer one possible interpretation of these group and correlational effects as consequences of a corticothalamic state of elevated glutamatergic receptor activity alongside below-normal glutamatergic transporter activity. (shrink)

Dandruff is a common scalp condition, which frequently causes psychological distress in those affected. Dandruff is considered to be caused by an interplay of several factors. However, the pathogenesis of dandruff remains under‐investigated, especially with respect to the contribution of the hair follicle. As the hair follicle exhibits unique immune‐modulatory properties, including the creation of an immunoinhibitory, immune‐privileged milieu, we propose a novel hypothesis taking into account the role of the hair follicle. We hypothesize that the changes and imbalance of (...) yeast and bacterial species, along with increasing proinflammatory sebum by‐products, leads to the activation of immune response and inflammation. Hair follicle keratinocytes may then detect these changes in scalp microbiota resulting in the recruitment of leukocytes to the inflammation site. These changes in the scalp skin immune‐microenvironment may impact hair follicle immune privilege status, which opens new avenues into exploring the role of the hair follicle in dandruff pathogenesis. Also see the video abstract here: https://youtu.be/mEZEznCYtNs. (shrink)

In June 1993, conjoined twins Amy and Angela Lakeberg became the focus of national attention. They shared a complex six‐chambered heart and one liver; only one could survive separation surgery, and even her chances were slim. The medical challenge was great and the ethical challenges were even greater.

In the last 25 years writing in bioethics, particularly in medical ethics, has generally claimed that action is ethically acceptable only if it receives informed consent from those affected. However, informed consent provides only limited justification, and may provide even less as new information technologies are used to store and handle personal data, including personal genetic data. The central philosophical weakness of relying on informed consent procedures for ethical justification is that consent is a propositional attitude, so referentially opaque: consent (...) is given to specific propositions describing limited aspects of a situation, and does not transfer even to closely related propositions. Assembling genetic data in databases creates additional difficulties for ethical justification. This is not because genetic information is intrinsically exceptional, but because the merger of genetic and information technologies make it possible to assemble massive quantities of complex information that defeat individuals' best efforts to grasp what is at stake, or to give or withhold informed consent. The future agenda for bioethics will need to take account of both these limitations of appeals to informed consent. (shrink)

How do people evaluate causal relationships? Do they just consider what actually happened, or do they also consider what could have counterfactually happened? Using eye tracking and Gaussian process modeling, we investigated how people mentally simulated past events to judge what caused the outcomes to occur. Participants played a virtual ball‐shooting game and then—while looking at a blank screen—mentally simulated (a) what actually happened, (b) what counterfactually could have happened, or (c) what caused the outcome to happen. Our findings showed (...) that participants moved their eyes in patterns consistent with the actual or counterfactual events that they mentally simulated. When simulating what caused the outcome to occur, participants moved their eyes consistent with simulations of counterfactual possibilities. These results favor counterfactual theories of causal reasoning, demonstrate how eye movements can reflect simulation during this reasoning and provide a novel approach for investigating retrospective causal reasoning and counterfactual thinking. (shrink)

Bryant’s paper, "A Logic of Multiplicities: Deleuze, Immanence, and Onticology," is useful for showing how the historical legacy of hierarchy in its many philosophical forms is still present, important, and, in fact, required even by those such as Bryant who would seek to deconstruct or ignore it. The following response will discuss Bryant’s presentation of his alternative position and throughout point out: a) the straw-man versions of hierarchy that Bryant employs; b) why what Bryant claims to be inherent negatively in (...) hierarchy is not the case; c) how Bryant’s position actually relies upon hierarchy for its own explication, and finally; d) the various principles of hierarchical metaphysics that are required in order to make sense of experience and reality. These latter include the notions that i) there are many kinds of hierarchy; ii) Being and Unity are prior to Multiplicity; iii) relation without substance is incoherent; iv) hierarchy is not inherently tyrannical; v) the distinction between essentially and accidentally ordered causal series is a real and useful one; and vi) the existence of hierarchy is more self evident than is flat ontology. (shrink)

The Lancet–O’Neill Institute/Georgetown University Commission on Global Health and Law published its report on the Legal Determinants of Health in 2019. The term ‘legal determinants of health’ draws attention to the power of law to influence upstream social and economic influences on population health. In this article, we introduce the Commission, including its background and rationale, set out its methodology, summarize its key findings and recommendations and reflect on its impact since publication. We also look to the future, making suggestions (...) as to how the global health community can make the best use of the Commission’s momentum in relation to using law and legal tools to advance population health. (shrink)

Off and on, of late years, I have studied the history and development of all religions with immense interest as being for me, at least, the most illuminating case histories of the inner life of man. Eugene O Neill writing to M. C. Sparrow, 1929While it is commonly accepted that Eugene O Neill studied Oriental mystical religions and that this study may be detected in some of his less successful experimental plays "(Lazarus Laughed, The Fountain, Marco Millions) "there has not (...) been an effort to consider systematically his immense interest and the influence it had on O Neill s thought and writing. Robinson explores the tension between Occidental and Oriental elements in the playwright s art, examining both the sources of the conflict and its manifestation in selected plays written between 1916 and 1942.Through an examination of O Neill s correspondence, research library, and manuscript materials (some of which have previously been unavailable for study) Robinson is able to reveal the origins of O Neill s Orientalism. An easy familiarity with the complex interrelationships of Eastern and Western religions and the Oriental thought that underlies the ideas of many Western philosophers, allows Robinson to address the intricate problem of Oriental influences on O Neill s favorite Western sources, including Nietzsche, Schopenhauer, Jung, Strindberg, and Emerson.Finally in a play-by-play exegesis, Robinson traces the course of O Neill s mysticism from its apparent repudiation in the deeply flawed "Dynamo "to its synthesis in "The Iceman Cometh, Long Day s Journey Into Night, "and "Hughie, "where Eastern ideas of "maya, "dynamic polarity, and the emptiness of the universe are again evident.". (shrink)

The precarious rights of senior citizens, especially those who are highly educated and who are expected to counsel and guide the younger generations, has stimulated the creation internationally of advocacy associations and opinion leader groups. The strength of these groups, however, varies from country to country. In some countries, they are supported and are the focus of intense interest; in others, they are practically ignored. For this is reason we believe that the creation of a network of all these associations (...) is essential. The proposed network would act as a support for the already-existing policies of the United Nations’ High Commission for Human Rights, of independent experts, and of the Global Alliance for the Rights of Older People. All three have long ago recommended the creation of a recognized instrument for uniting presently scattered efforts. The proposed network, therefore, will seek to promote the international exchange of relevant expertise, and it will reinforce the commitments and actions that single countries are currently taking to meet these objectives. For example, informative public events can be organised to promote particular support initiatives and to provide an opportunity for new members of the network to be presented. The network will promote health for senior citizens, disease prevention, senior mobility, safe free time for seniors, alimentary education, protection against new risks and dangers, as well as equity in the services necessary for seniors to adopt new information and communication technologies. In the case of retired academic members, the network will promote equality with respect to continuing use of digital technologies (particularly email), continuing access to research libraries, and the guaranteed ability for seniors to fund their own research programs and to deliver free seminars. (shrink)

In her BBC Reith Lectures on Trust, Onora O’Neill offers a short, but biting, criticism of transparency. People think that trust and transparency go together but in reality, says O'Neill, they are deeply opposed. Transparency forces people to conceal their actual reasons for action and invent different ones for public consumption. Transparency forces deception. I work out the details of her argument and worsen her conclusion. I focus on public transparency – that is, transparency to the public over expert (...) domains. I offer two versions of the criticism. First, the epistemic intrusion argument: The drive to transparency forces experts to explain their reasoning to non-experts. But expert reasons are, by their nature, often inaccessible to non-experts. So the demand for transparency can pressure experts to act only in those ways for which they can offer public justification. Second, the intimate reasons argument: In many cases of practical deliberation, the relevant reasons are intimate to a community and not easily explicable to those who lack a particular shared background. The demand for transparency, then, pressures community members to abandon the special understanding and sensitivity that arises from their particular experiences. Transparency, it turns out, is a form of surveillance. By forcing reasoning into the explicit and public sphere, transparency roots out corruption — but it also inhibits the full application of expert skill, sensitivity, and subtle shared understandings. The difficulty here arises from the basic fact that human knowledge vastly outstrips any individual’s capacities. We all depend on experts, which makes us vulnerable to their biases and corruption. But if we try to wholly secure our trust — if we leash groups of experts to pursuing only the goals and taking only the actions that can be justified to the non-expert public — then we will undermine their expertise. We need both trust and transparency, but they are in essential tension. This is a deep practical dilemma; it admits of no neat resolution, but only painful compromise. (shrink)

Informed consent is a central topic in contemporary biomedical ethics. Yet attempts to set defensible and feasible standards for consenting have led to persistent difficulties. In Rethinking Informed Consent in Bioethics Neil Manson and Onora O'Neill set debates about informed consent in medicine and research in a fresh light. They show why informed consent cannot be fully specific or fully explicit, and why more specific consent is not always ethically better. They argue that consent needs distinctive communicative transactions, by (...) which other obligations, prohibitions, and rights can be waived or set aside in controlled and specific ways. Their book offers a coherent, wide-ranging and practical account of the role of consent in biomedicine which will be valuable to readers working in a range of areas in bioethics, medicine and law. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Christ Who Meets Us in the Sacraments:The Influence of St. Ambrose on the tertia pars of St. Thomas's Summa theologiaeDamian Day O.P.IntroductionThe recent increased interest in St. Thomas Aquinas and the Fathers of the Church has produced a number of excellent studies of the Angelic Doctor's understanding of the authority of the Fathers and his use of them.1 In this article, I hope to contribute to the ongoing (...) study of Aquinas and the Fathers by examining how Thomas employs St. Ambrose in the tertia pars of his Summa theologiae [ST]. Thomas's use of Ambrose has received little detailed [End Page 103] attention. One of Leo Elders's last contributions to the study of Aquinas and the Fathers provided an overview of Ambrose's presence in Thomas's writings.2 I hope to expand upon Elders's work of cataloging and describing Thomas's numerous citations of Ambrose—Thomas names Ambrose over eleven hundred times in his writings3—by making a particular argument about Thomas's Christological and sacramental use of Ambrose. While Elders gives an excellent summary of where Ambrose appears in Thomas's corpus, he does not connect Thomas's use of Ambrose in his treatises on Christ and the Eucharist. I argue that Thomas's citations of Ambrose in the tertia pars help him develop an understanding of the Incarnation that supports his sacramental realism, especially emphasizing contact with Christ in the Eucharist.4Much recent reflection on the Eucharist has sought to deemphasize the substantial presence of Christ and emphasize his presence in other ways. Michael C. McGuckian, for example, argues that the Western emphasis on Christ's presence in the Blessed Sacrament has damaged the understanding of participation in the heavenly liturgy and obscured other ways in which Christ is present, such as in the bishop presiding and the proclamation of the word. He claims that "those other presences surpass the presence in the elements in their personal quality, their dynamic force and their effect on our [End Page 104] spirits and are not to be undervalued."5 Looking at Thomas and Ambrose, we will see that Christ's substantial presence in the Eucharist is preeminently personal, dynamic, and efficacious for our spirits. Colman O'Neill's masterful work of sacramental realism, Meeting Christ in the Sacraments, provides an entrée into such a study. The title derives from Ambrose. In his work A Defense of the Prophet David to Theodosius Augustus, Ambrose reflects on Psalm 51. Suddenly, in the middle of confessing his sins, David foresees the cleansing sacrament of baptism. In prophetic wonder, he cries out, "face-to-face you have shown yourself to me, Christ; I have discovered you in your sacraments."6 Even prior to their institution, David prophetically glimpses what the sacraments of the Old Law prefigure. In this vision, David sees "no longer in shadow, nor in figure, nor in type," but meets Christ in his sacraments.7 For Ambrose, the sacraments are real encounters with Christ. As O'Neill puts it, "Christ, who was worshipped from afar, comes near and touches the believer; and at his touch power goes out from him."8 For [End Page 105] Thomas, too, one meets Christ in the sacraments.9 While all the sacraments apply the merits of his Passion,10 the Eucharist is the locus par excellence for meeting Christ, since the whole Christ is there contained.11 The encounter is both personal and powerful.While the language of meeting or encountering Christ in the sacraments may seem to echo modern phenomenological philosophy, Thomas grounds the encounter in a realism of the Incarnation.12 His treatment of the encounter with Christ in the sacraments flows from his treatment of the Incarnation.13 Guy-Thomas Bedouelle summed up O'Neill's approach, which reflects Thomas's, as simply stressing, again and again, "that sacramental realism implies that the Church draws its life from the dynamism of the Incarnation itself."14 I argue that Thomas, in drawing his sacramental realism from the Incarnation, employs Ambrose as a key authority. First, I examine Thomas's knowledge and use of Ambrose's works. Second, I... (shrink)