The purpose of this article is to provide a critical examination of two aspects of culture and biomedicine that have helped to shape the meaning and practice of genetic testing for breast cancer. These are: the cultural construction of fear of breast cancer, which has been fuelled in part by the predominance of a ‘risk’ paradigm in contemporary biomedicine. The increasing elaboration and delineation of risk factors and risk numbers are in part intended to help women to contend with their (...) fear of breast cancer. However, because there is no known cure or foolproof prevention for breast cancer, risk designations bring with them recommendations for vigilant surveillance strategies and screening guidelines. We argue that these in effect exacerbate women’s fears of breast cancer itself. The volatile combination of discourses of fear, risk and surveillance have significant ethical and social consequences for women’s lives and well-being. Genetic testing decisions are made within this context; if nurses understand this context they can play an important role in helping women to cope with the anxiety and fear of breast cancer risk. (shrink)

The purpose of this article is to provide a critical examination of two aspects of culture and biomedicine that have helped to shape the meaning and practice of genetic testing for breast cancer. These are: (1) the cultural construction of fear of breast cancer, which has been fuelled in part by (2) the predominance of a ‘risk’ paradigm in contemporary biomedicine. The increasing elaboration and delineation of risk factors and risk numbers are in part intended to help women to contend (...) with their fear of breast cancer. However, because there is no known cure or foolproof prevention for breast cancer, risk designations bring with them recommendations for vigilant surveillance strategies and screening guidelines. We argue that these in effect exacerbate women’s fears of breast cancer itself. The volatile combination of discourses of fear, risk and surveillance have significant ethical and social consequences for women’s lives and well-being. Genetic testing decisions are made within this context; if nurses understand this context they can play an important role in helping women to cope with the anxiety and fear of breast cancer risk. (shrink)

The language of “participant-driven research,” “crowdsourcing” and “citizen science” is increasingly being used to encourage the public to become involved in research ventures as both subjects and scientists....

The language of “participant-driven research,” “crowdsourcing” and “citizen science” is increasingly being used to encourage the public to become involved in research ventures as both subjects and scientists. Originally, these labels were invoked by volunteer research efforts propelled by amateurs outside of traditional research institutions and aimed at appealing to those looking for more “democratic,” “patient-centric,” or “lay” alternatives to the professional science establishment. As mainstream translational biomedical research requires increasingly larger participant pools, however, corporate, academic and governmental research programs (...) are embracing this populist rhetoric to encourage wider public participation. We examine the ethical and social implications of this recruitment strategy. We begin by surveying examples of “citizen science” outside of biomedicine, as paradigmatic of the aspirations this democratizing rhetoric was originally meant to embody. Next, we discuss the ways these aspirations become articulated in the biomedical context, with a view to drawing out the multiple and potentially conflicting meanings of “public engagement” when citizens are also the subjects of the science. We then illustrate two uses of public engagement rhetoric to gain public support for national biomedical research efforts: its post-hoc use in the “care.data” project of the National Health Service in England, and its proactive uses in the “Precision Medicine Initiative” of the United States White House. These examples will serve as the basis for a normative analysis, discussing the potential ethical and social ramifications of this rhetoric. We pay particular attention to the implications of government strategies that cultivate the idea that members of the public have a civic duty to participate in government-sponsored research initiatives. We argue that such initiatives should draw from policy frameworks that support normative analysis of the role of citizenry. And, we conclude it is imperative to make visible and clear the full spectrum of meanings of “citizen science,” the contexts in which it is used, and its demands with respect to participation, engagement, and governance. (shrink)

The National Institute of Mental Health (Bethesda, MD) reports that approximately 5.2 million Americans experience post-traumatic stress disorder (PTSD) each year. PTSD can be severely debilitating and diminish quality of life for patients and those who care for them. Studies have indicated that propranolol, a beta-blocker, reduces consolidation of emotional memory. When administered immediately after a psychic trauma, it is efficacious as a prophylactic for PTSD. Use of such memory-altering drugs raises important ethical concerns, including some futuristic dystopias put forth (...) by the President's Council on Bioethics. We think that adequate informed consent should facilitate ethical research using propranolol and, if it proves efficacious, routine treatment. Clinical evidence from studies should certainly continue to evaluate realistic concerns about possible ill effects of diminishing memory. If memory-attenuating drugs prove effective, we believe that the most immediate social concern is the over-medicalization of bad memories, and its subsequent exploitation by the pharmaceutical industry. (shrink)

The National Institute of Mental Health reports that approximately 5.2 million Americans experience post-traumatic stress disorder each year. PTSD can be severely debilitating and diminish quality of life for patients and those who care for them. Studies have indicated that propranolol, a beta-blocker, reduces consolidation of emotional memory. When administered immediately after a psychic trauma, it is efficacious as a prophylactic for PTSD. Use of such memory-altering drugs raises important ethical concerns, including some futuristic dystopias put forth by the President's (...) Council on Bioethics. We think that adequate informed consent should facilitate ethical research using propranolol and, if it proves efficacious, routine treatment. Clinical evidence from studies should certainly continue to evaluate realistic concerns about possible ill effects of diminishing memory. If memory-attenuating drugs prove effective, we believe that the most immediate social concern is the over-medicalization of bad memories, and its subsequent exploitation by the pharmaceutical industry. (shrink)

Moral leadership matters. As world politics enters a new and dangerous era, judgment, constancy, moral purpose, and a willingness to overcome partisan politicking are essential for America's leaders. Tempered Strength finds the alternative standard of leadership that Americans are seeking in the classical philosophy of prudence. Ethan Fishman's new work brings together leading American political scientists—including Ronald Beiner, Kenneth L. Deutsch, and George Anastaplo—to discuss the evolution of a standard of prudential leadership both reasonable in nature and practical in (...) scope. Section One studies the meaning of prudence and its evolution in the history of political science from Aristotelian phronesis to Xenophon, Thomas Aquinas, Edmund Burke, and Michael Oakeshott. Section Two demonstrates how the theory of prudential leadership can be applied to practical political issues. (shrink)

In this article, Lucas maintains the falseness of Mechanism - the attempt to explain minds as machines - by means of Incompleteness Theorem of Gödel. Gödel’s theorem shows that in any system consistent and adequate for simple arithmetic there are formulae which cannot be proved in the system but that human minds can recognize as true; Lucas points out in his turn that Gödel’s theorem applies to machines because a machine is the concrete instantiation of a formal system: therefore, for (...) every machine consistent and able of doing simple arithmetic, there is a formula that it can’t produce as true but that we can see to be true, and so human minds and machines have to be different. Lucas considers as well in this article some possible objections to his argument: for any Gödelian formula we could, for instance, construct a machine able to produce it or we could put the Gödelian formulae that we had proved as axioms of a further machine. However - as Lucas underlines - for every of such machines we could again formulate another Gödelian formula, the Gödelian formula of these machines, that they are not able to proof but that we can recognize as true. More general arguments, such as the possibility to escape Gödelian argument by suggesting that Gödel’s theorem applies to consistent systems while we could be inconsistent ones, are moreover refuted by Lucas by maintaining that our inconsistency corresponds to occasional malfunctioning of a machine and not to his normal inconsistency; indeed, a inconsistent machine is characterized by producing any statement, on the contrary human being are selective and not disposed to assert anything. (shrink)

This paper addresses the definition and the operational use of intuitions in philosophical methods in the form of a research study encompassing several regions of the globe, involving 282 philosophers from a wide array of academic backgrounds and areas of specialisation. The authors tested whether philosophers agree on the conceptual definition and the operational use of intuitions, and investigated whether specific demographic variables and philosophical specialisation influence how philosophers define and use intuitions. The results obtained point to a number of (...) significant findings, including that philosophers distinguish between intuitions used to formulate (discovery) and to test (justification) philosophical theory. The survey results suggest that strategies implemented to characterise philosophical intuition are not well motivated since, even though philosophers do not agree on a single account of intuition, they fail to capture a preferred usage of intuitions as aspects of discovery. The quantitative summary of survey findings informs the debate on this topic, and advances more defined routes for subsequent approaches to the study of intuitions. (shrink)

A change in sense of self is an outcome commonly associated with Buddhist meditation. However, the sense of self is construed in multiple ways, and which changes in self-related processing are expected, intended, or possible through meditation is not well understood. In a qualitative study of meditation-related challenges, six discrete changes in sense of self were reported by Buddhist meditators: change in narrative self, loss of sense of ownership, loss of sense of agency, change in sense of embodiment, change in (...) self-other or self-world boundaries, and loss of sense of basic self. Changes in sense of self could be transient or enduring, positive or distressing, enhancing or impairing. These changes were also given varied appraisals, ranging from insights associated with Buddhist doctrines to psychopathologies such as depersonalization. In this study of practitioners reporting meditation-related challenges, more global changes in sense of self were associated with higher levels of impairment. These results have implications for both Buddhist meditation as well as mindfulness-based interventions. (shrink)

We extend the theory of “Fine structure and iteration trees” to models having more than one Woodin cardinal.

That space and time should be integrated into a single entity, spacetime, is the great insight of Einstein's special theory of relativity, and leads us to regard spacetime as a fundamental context in which to make sense of the world around us. But it is not the only one. Causality is equally important and at least as far as the special theory goes, it cannot be subsumed under a fundamentally geometrical form of explanation. In fact, the agent of propagation of (...) causal influence is electromagnetic radiation. In this examination, the authors find support for a rationalist approach to physics, never neglecting experimentation, but rejecting a simple empiricist or positivist view of science. (shrink)

The application of Gödel’s theorem to the problem of minds and machines is difficult. Paul Benacerraf makes the entirely valid ‘Duhemian’ point that the argument is not, and cannot be, a purely mathematical one, but needs some philosophical premisses to be able to yield any philosophical conclusions. Moreover, the philosophical premisses are of very different kinds. Some are concerned with what is essential to being a machine—these are typically intricate, but definite, easily formalised by the mathematician, but unintelligible to the (...) layman: others attempt to capture what is essential to being a mind, a person or a self—these are typically intuitive, but vague; resistant to exact definition by the logician, but, none the less, widely used and well understood. Gödel’s theorem itself, like many other truths, can be taken either way: it can be taken as a formal proof sequence yielding certain syntactical results about a certain class of formal systems, but it can also be taken as giving us a certain type or style of argument, which we can understand, and, once having got the hang of it, adapt and apply in innumerable different circumstances. In my dispute with the mechanist, I take Gödel’s argument both ways: I first take it as an argument which the mechanist, even according to his own mechanist principles, must accept as scoring some point against his favourite machine; and then I hope that the mechanist, as a man, will see that he can do better and that this sort of argument will always apply against any form of mechanism he espouses. (shrink)

In this paper Lucas comes back to Gödelian argument against Mecanism to clarify some points. First of all, he explains his use of Gödel’s theorem instead of Turing’s theorem, showing how Gödel’ theorem, but not Turing’s theorem, raises questions concerning truth and reasoning that bear on the nature of mind and how Turing’s theorem suggests that there is something that cannot be done by any computers but not that it can be done by human minds. He considers moreover how Gödel’s (...) theorem can be interpreted as a sophisticated form of the Cretan paradox, posed by Epimenides, able to escape the viciously self-referential nature of the Cretan paradox, and how it can be used against Mechanism as a schema of disproof. Finally, Lucas suggests some answers to the most recurrent criticisms against his argument: criticisms about the implicit idealisation in the way he set up the context between mind and machine; questions concerning modality and finitude, issues of transfinite arithmetic; questions concerning the need of formalizing rational inference and some questions about consistency. (shrink)

From all points of the political compass, from widely different groups, have come indignant outcries against the trade in human organs from live vendors. Opponents contend that such practices constitute a morally outrageous and gross exploitation of the poor, inherently coercive and obviously intolerable in any civilized society. This article examines the arguments typically offered in defense of these claims, and finds serious problems with all of them. The prohibition of organ sales is derived not from the principles and argument (...) usually invoked in support of prohibition, but rather, from strong feelings of repugnance which exert an invisible but powerful influence on the debate, distorting the arguments [and working] to the detriment of the [very] people most in need of protection. (shrink)

The legend of the encounter between Wilberforce and Huxley is well established. Almost every scientist knows, and every viewer of the BBC's recent programme on Darwin was shown,* how Samuel Wilberforce, bishop of Oxford, attempted to pour scorn on Darwin's Origin of Species at a meeting of the British Association in Oxford on 30 June 1860, and had the tables turned on him by T. H. Huxley. In this memorable encounter Huxley's simple scientific sincerity humbled the prelatical insolence and clerical (...) obscurantism of Soapy Sam; the pretension of the Church to dictate to scientists the conclusions they were allowed to reach were, for good and all, decisively defeated; the autonomy of science was established in Britain and the Western world; the claim of plain unvarnished truth on men's allegiance was vindicated, however unwelcome its implications for human vanity might be; and the flood tide of Victorian faith in all its fulsomeness was turned to an ebb, which has continued to our present day and will only end when religion and superstition have been finally eliminated from the minds of all enlightened men. Even churchmen concede that it was a disastrous defeat.1 Only Owen Chadwick strikes a note of caution, observing that the account given of the incident in Wilberforce's biography seems hardly consistent with an overwhelming defeat, and maintaining that the received account must be a largely legendary creation of a later date. (shrink)

The issue is obscured by the fact that the word `space' can be used in four different ways. It can be used, first, as a term of pure mathematics, as when mathematicians talk of an `n-dimensional phase-space', an `n-dimensional vector-space', a `three-dimensional projective space' or a `twodimensional Riemannian space'. In this sense the word `space' means the totality of the abstract entities-the `points'-implicitly defined by the axioms. There is no doubt that there exist, iii this sense, non-Euclidean spaces, because all (...) that is claimed by such an assertion is that sets of non-Euclidean axioms constitute possible implicit definitions of abstract entities, that is to say that some sets of non-Euclidean axioms are consistent. If Kant or any other philosopher had denied this, he would have been wrong; but Kant himself took care not to deny it, 2 and there is little reason to suppose that any philosopher concerned about space has been using the word in this, the pure mathematician's, sense. (shrink)

Context: The past few years have presented us with a growing amount of theoretical research (yet that is often based on neuroscientific developments) in the field of enactive music cognition. Problem: Current cognitivist and embodied approaches to music cognition suffer, in our opinion, from a too firm commitment to the explanatory role of mental representations in musical experience. This particular problem can be solved by adopting an enactive approach to music cognition. Method: We present and compare cognitivist, embodied and enactive (...) approaches to music cognition and review the current research in enactive music cognition. Results: We find that, in general, the enactive approaches to human musicality are capable of explaining the basic relationship between a musical subject and a musical object according to a pre-conceptual and pre-linguistic form of understanding related to bodily motor expertise. This explanation does not rely on on sophisticated forms of representation. Implications: Proponents of enactive music cognition should, in our opinion, focus on providing a consistent explanation of the most basic level of musical understanding. Constructivist content: We hope to invite the constructivist community to engage with the discussions on the intersection between music and enactivism. (shrink)

The application of Gödel’s theorem to the problem of minds and machines is difficult. Paul Benacerraf makes the entirely valid ‘Duhemian’ point that the argument is not, and cannot be, a purely mathematical one, but needs some philosophical premisses to be able to yield any philosophical conclusions. Moreover, the philosophical premisses are of very different kinds. Some are concerned with what is essential to being a machine—these are typically intricate, but definite, easily formalised by the mathematician, but unintelligible to the (...) layman: others attempt to capture what is essential to being a mind, a person or a self—these are typically intuitive, but vague; resistant to exact definition by the logician, but, none the less, widely used and well understood. Gödel’s theorem itself, like many other truths, can be taken either way: it can be taken as a formal proof sequence yielding certain syntactical results about a certain class of formal systems, but it can also be taken as giving us a certain type or style of argument, which we can understand, and, once having got the hang of it, adapt and apply in innumerable different circumstances. In my dispute with the mechanist, I take Gödel’s argument both ways: I first take it as an argument which the mechanist, even according to his own mechanist principles, must accept as scoring some point against his favourite machine; and then I hope that the mechanist, as a man, will see that he can do better and that this sort of argument will always apply against any form of mechanism he espouses. (shrink)