IntroductionResearch on the impact of cancer on close relationships brings up conflicting results. This systematic review collects empirical evidence on the research questions whether a cancer diagnosis in general or the type of cancer affects the divorce rate.Materials and MethodsThis systematic review was conducted according to the guidelines of the Cochrane Collaboration and the PRISMA statement. The following electronic databases were searched: Web of Science, Ovid SP MEDLINE, PsycINFO, PsyINDEX, CINAHL, ERIC. Risk of bias assessment was performed with the preliminary (...) risk of bias for exposures tool template. The grading of methodological quality was assessed with the Newcastle-Ottawa Scale.ResultsOf 13,929 identified records, 15 were included in the qualitative synthesis. In 263,616 cancer patients and 3.4 million healthy individuals, we found that cancer is associated with a slightly decreased divorce rate, except for cervical cancer, which seems to be associated with an increased divorce rate.DiscussionAccording to this systematic review, cancer is associated with a tendency to a slightly decreased divorce rate. However, most of the included studies have methodologic weaknesses and an increased risk of bias. Further studies are needed. (shrink)

Someday soon (if it hasn't happened in secret already), a human will be cloned, and mankind will embark on a scientific and moral journey whose destination cannot be foretold. In Copycats: The Science and Ethics of Cloning, Arlene Judith Klotzko describes the new world of possibilities that can be glimpsed over the horizon. In a lucid and engaging narrative, she explains that the technology to create clones of living beings already exists, inaugurated in 1996 by Dolly the sheep, (...) the first mammal cloned from a single adult cell. Dolly is the culmination of a long scientific quest to understand the puzzle of our development from one cell into a complex organism--the outcome of a "fantastic experiment" envisioned six decades before her birth. Scientists have since cloned mice, cows, goats, pigs, rabbits and cats. Using the same laboratory tools and techniques, they are trying to grow an embryo, cloned from a single cell of a human being. Their goal is not to make copies of existing people, but to design therapies for currently untreatable diseases and the afflictions of old age. Our fascination with cloning is about much more than science and its extraordinary medical implications. In riveting prose, full of illusions to art, music and the cinema, Klotzko shows why the prospect of human cloning triggers our dearest hopes and especially our darkest fears, forcing us to ponder anew what it means to be human. And what it would be like to have "a clone of your own.". (shrink)

Dolly, as we all know, is a sheep. And a very remarkable sheep. Not because of what she is, but because of the mode by which she appeared in our midst. Dolly was cloned in a laboratory by a technique called nuclear transfer; she is virtually genetically identical to a sheep born six years before she was. And wewill never be the same again.

It has become a commonplace to observe that the people of the world will soon be divided into two classesfor everyone else—how much worse it would be if we made a slight alteration in our description. How much worse it would be if the vast majority of people were possessed of too little information to allow them to make informed decisions about their own lives, health, and genetic inheritance. Unfortunately, this is the reality. And as scientific advances rocket far ahead (...) of both our bemused journalistic establishment and our limping regulatory apparatus, the reality becomes ever more pernicious. (shrink)

For a very long time, the scientific and animal welfare communities have faced each other across a seemingly unbridgeable divide. Each side tends to view the other in simplistic and distorted terms. Animal welfare advocates see scientists as, at worst, sadists who enjoy torturing animals, and at best, as self-interested careerists intent on building careers out of publishing more papers and getting more grants, irrespective of the cost to animals. Scientists committed to research see the animal movement as consisting of, (...) at best, ignorant, simple-minded people awash in emotion and sensationalism, and at worst, violent and dangerous fanatics who claim to care for animals but are indifferent to human suffering. (shrink)

: New genetic technologies continue to emerge that allow us to control the genetic endowment of future children. Increasingly the claim is made that it is morally "irresponsible" for parents to fail to use such technologies when they know their possible children are at risk for a serious genetic disorder. We believe such charges are often unwarranted. Our goal in this article is to offer a careful conceptual analysis of the language of irresponsibility in an effort to encourage more care (...) in its use. Two of our more important sub-claims are: A fair judgment of genetic irresponsibility necessarily requires a thick background description of the specific reproductive choice; and there is no necessary connection between an act's being morally wrong and its being irresponsible. These are distinct judgments requiring distinct justifications. (shrink)

Martha C. Nussbaum, Hiding from Humanity: Disgust, Shame, and the Law. Princeton Nf: Princeton University Press, 2004, xv #;pl 413 pp.

Joel Feinberg, Offense to Others New York: Oxford University Press, 1985, xix + 328 pp.

The view that children's understanding of mind is constructed through social interaction is consistent with other social-constructivist models. We provide examples of similar claims in research on emotion perception, pretense understanding, autobiographical memory, and event knowledge. Identification of common elements from such socio-cultural perspectives may lead to greater theoretical integration and provide a new framework for exploring human development.

Knowledge of others, then, has value; so does immunity from being known. The ability to extend one's knowledge has value; so does the ability to limit other's knowledge of oneself. I have claimed that no interest can count as a right unless it clearly outweighs opposing interests whose presence is logically entailed. I see no way to establish that my interest in not being known, simply as such, outweighs your desire to know about me. I acknowledge the intuitive attractiveness of (...) such a position; but my earlier discussion concluded that the value of privacy is ease, and the value of knowledge is understanding - and it's not obvious that either outweighs the other. Nor is it obvious that the freedom and autonomy which result from the power to limit what others know is more significant than the freedom and autonomy which result from the power to extend one's knowledge. I believe the intuitive attractiveness of the belief that privacy values outweigh knowledge values lies in the entirely correct belief that a society without any privacy would be unpleasant. But a society without mutual knowledge would be impossible.I conclude therefore that there is no right to privacy nor to control over it. Nevertheless, each of these things is a good, and a good made possible (given the presence of other people) by social structures. A desirable society will provide both privacy and control over privacy to some extent. Nothing in my analysis helps determine what the proper extent is, nor what areas of life particularly deserve protection. Those who would argue that privacy and control over it are entailed by respect for persons should, I think, choose instead some particular areas central to being a person, to counting as a person, and then show how one is less likely to exercise one's capacities there fully without privacy or without control over it. Although Gerstein's attempt fails because he inaccurately defines intimacy as a kind of absorption and incorrectly opposes absorption with publicity, I think it is the kind of attempt which must be made. Furthermore, he has probably chosen the right area of life - if anything has a special claim to privacy it is probably the union between people who care for one another. The value of being together alone may be more significant than the value of being alone, if only because words and actions are public while thoughts are not. But I will not try to develop that argument here.In any case both privacy and control over it are social goods; on egalitarian grounds they should, ceteris paribus, be equally available to everyone. This helps explain the “dehumanizing” effect of institutions which provide no privacy at all- prisons and some mental institutions. It is not so much that the inmates are totally known; it is rather that those who know them are not so fully known by them; further, that the staff has a great deal of control over what they disclose of themselves, and the inmates very little. The asymmetry of knowledge in those institutions is one aspect of the asymmetry of power; the completely powerless are likely to feel dehumanized.My analysis also helps account for the wrongness of covert observation. It is not simply that the observer violates the wishes of the observed, for the question is whose wishes trump. The observer is violating the justified expectations of the observed: expectations supported by weighty social conventions. These have more moral weight than simple desires do. The peeping torn is violating a convention which structures the distribution of knowledge, a convention from which he benefits. Without it his own activities might well be impossible. He might be more easily caught; or his victim, less trusting, might choose houses without windows. More deeply, the thrill of what he is doing depends on the existence of the convention. Even morally permissible excitement - the suggestiveness of some clothing- would disappear without conventions about nudity. Presumably, too, there are elements of his own personal life for which he values his privacy. He is on grounds of justice obligated to observe the rule which makes his benefits possible.(Some claims to privacy result from personal predilections, rather than from convention. Parent describes a person who is extremely sensitive about being short, for instance, and does not want his exact height to be common knowledge. Parent, p. 346. The grounds for these claims are obviously different from those I've been discussing. The grounds are the moral obligation not to cause needless pain, or, if the information was given in confidence, to keep one's promises.) Although there is no right to privacy or to control over it as such, there is a right to equality of consideration and to a just distribution of benefits and burdens. To put it another way: there is no natural human right to privacy or to control over it; but a good society will provide some of each, and justice requires that the rules of a good society be observed. This paper was written during Joel Feinberg's 1984 NEH Summer Seminar. I am indebted to NEH for funding, and to Professor Feinberg and the other members of the seminar for helpful comments. (shrink)

Bioethicists appearing in the media have been accused of "shooting from the hip" (Rachels, 1991). The criticism is sometimes justified. We identify some reasons our interactions with the press can have bad results and suggest remedies. In particular we describe a target (fostering better public dialogue), obstacles to hitting the target (such as intrinsic and accidental defects in our knowledge) and suggest some practical ways to surmont those obstacles (including seeking out ways to write or speak at length, rather than (...) in sound bites). We make use of our own research into the way journalists quote bioethicists. We end by suggesting that the profession as a whole look into this question more fully. (shrink)

Worldly Virtue discusses individual virtues in new ways, drawing from faith traditions, feminist analyses, and social science. The book addresses traditional virtues like honesty and generosity and articulates new virtues like those required in aging.

Moral distress is the sense that one must do, or cooperate in, what is wrong. It is paradigmatically faced by nurses, but it is almost a universal occupational hazard.

Business Ethics and medical ethics are in principle compatible: In particular, the tools of business ethics can be useful to those doing healthcare ethics. Health care could be conducted as a business and maintain its moral core.

A discussion of the ethics of stem cell research, and attempts to regulate it.

Elderhood—or old age, if one prefers—is a stage of life without much cultural meaning. It is generally viewed simply as a time of regrettable decline. Paying more attention to it, to its special pleasures and developmental achievements, will be helpful not only to elders but to those younger as well. I will argue that three existential tasks are central in elderhood, but also important at every other stage of adult life. I identify three: cherishing the present, accepting the past, and (...) investing in a future broader than one’s own. Articulating these tasks is intellectually interesting, useful to elders, and should be enlightening (as well as reassuring) to younger adults. (shrink)

Margaret Urban Walker argues that hospital ethics committees should think of their task as "keeping moral space open." I develop her suggestion with analogies: Enlarge the windows (i.e., expand what counts as an ethical issue); add rooms and doors (i.e., choose particular issues to engage). Examples include confidentiality defined as information flow, and moral distress in the healthcare workplace.

As feminist theory explicates its fundamental principles – justice for the oppressed – it can lose its essential focus on the situation of women. One example is the inattention to nurses within feminist bioethics. Nurses deserve attention because most are women, but also because their lack of power is paradigmatic of patriarchy. Those examining ethics consultations should discuss whether nurses are allowed to request them. But feminists also need to imagine ways in which nurses can be heard when, for instance, (...) their worklives are “redesigned.” Doing so would also allow attention to other classes of the disempowered. (shrink)

HOWARD POOLE ARGUES THAT "THERE IS A RATIONAL NECESSITY LINKING NEGATIVE ATTITUDES TO PORNOGRAPHY WITH A READINESS TO IMPOSE CENSORSHIP." HIS ARGUMENT HAS THREE PREMISES: FIRST, THAT TO CALL SOMETHING OBSCENE IS TO EXPRESS STRONG BUT OFTEN NONMORAL DISAPPROVAL; SECOND, THAT THIS STRONG DISAPPROVAL COMMITS ONE TO SEEK LEGISLATION KEEPING THE MATERIAL FROM CHILDREN; THIRD, THAT SUCH LEGISLATION IS A FORM OF CENSORSHIP. I QUESTION EACH PREMISE.

Hope as a virtue is an acquired disposition, shaped by reflection; as a civic virtue it must serve the good of the community. Ernst Bloch and Lord Buddha offer help in constructing such a virtue. Using a taxonomy developed by Darren Webb I distinguish open hope from goal-oriented hope, and use each thinker to develop the former. Bloch and Buddha are very different (and notoriously obscure; I do not attempt an exegesis). But they share a metaphysics of change, foundational for (...) making any sense of hope.Buddhism would seem to repudiate hope; it is a source of suffering (i.e., pain in living with reality). Seen more deeply, however, Buddhism offers material for a carefully limited virtue of hope: the habits of noticing good and acknowledging transience. This disposition, acquired through Buddhist practice among other ways, shields one against despair. The habit also frees up energy that would otherwise be wasted. Ernst Bloch gives us insight into how to use that energy, teaching us to value the yearning implicit throughout culture. Open hope becomes a civic virtue when it concerns civic matters; it can be threatened by hyperbolic discourse in political life. (shrink)

Overview of feminist bioethics for the journal of the Ewha Women's College, Seoul, South Korea.

Hope as a virtue is an acquired disposition, shaped by reflection; as a civic virtue it must serve the good of the community. Ernst Bloch and Lord Buddha offer help in constructing such a virtue. Using a taxonomy developed by Darren Webb I distinguish open hope from goal-oriented hope, and use each thinker to develop the former. Bloch and Buddha are very different (and notoriously obscure; I do not attempt an exegesis). But they share a metaphysics of change, foundational for (...) making any sense of hope.Buddhism would seem to repudiate hope; it is a source of suffering (i.e., pain in living with reality). Seen more deeply, however, Buddhism offers material for a carefully limited virtue of hope: the habits of noticing good and acknowledging transience. This disposition, acquired through Buddhist practice among other ways, shields one against despair. The habit also frees up energy that would otherwise be wasted. Ernst Bloch gives us insight into how to use that energy, teaching us to value the yearning implicit throughout culture. Open hope becomes a civic virtue when it concerns civic matters; it can be threatened by hyperbolic discourse in political life. (shrink)

The “paradox of deontology” depends partly upon ignoring the special responsibility each person has for her own actions, and partly upon ignoring the essential differences between refraining from X and persuading another to refrain. But only in part; the paradoxical situations schematized by Shaw can occasionally occur. When they do, his pragmatic defense of deontology is sound.

The “paradox of deontology” depends partly upon ignoring the special responsibility each person has for her own actions, and partly upon ignoring the essential differences between refraining from X and persuading another to refrain. But only in part; the paradoxical situations schematized by Shaw can occasionally occur. When they do, his pragmatic defense of deontology is sound.

Self-regarding acts are frequently classified as non-moral; even more frequently, they are assumed to have less moral weight than parallel other-regarding acts. I argue briefly against the first claim, and at greater length against the second. Our intuitions about the lesser moral weight of self-regarding acts arise from imperfectly recognized, and morally relevant, differences between acts which are ordinarily described in misleadingly parallel phrases. ‘Love of self,’ for instance, and ‘love of another’ are not symmetrical attitudes, in spite of the (...) symmetrical grammar. More obviously, one cannot steal from, lie to, nor force oneself in the same way one can do these things to others. I conclude, therefore, that difference in moral weight never stems merely from a difference in the person concerned, but rather from differences between the actions themselves; furthermore, that whatever it is wrong to do to a willing other, it is wrong to do to oneself. (shrink)

Because the medical humanities are multidisciplinary, participants tend to see one another's work through their own disciplinary lens. This can lead to misinterpretations.