Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 and X-linked CLDN2 through a two-stage genome-wide study. The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is (...) associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men. © 2012 Nature America, Inc. All rights reserved. (shrink)

Working retrospectively in an uncertain field of knowledge, physicians are engaged in an interpretive practice that is guided by couterweighted, competing, sometimes paradoxical maxims. When you hear hoofbeats, don't think zebras, is the chief of these, the epitome of medicine's practical wisdom, its hermeneutic rule. The accumulated and contradictory wisdom distilled in clinical maxims arises necessarily from the case-based nature of medical practice and the narrative rationality that good practice requires. That these maxims all have their opposites enforces in students (...) and physicians a practical skepticism that encourages them to question their expectations, interrupt patterns, and adjust to new developments as a case unfolds. Yet medicine resolutely ignores both the maxims and the tension between the practical reasoning they represent and the claim that medicine is a science. Indeed, resolute epistemological naivete is part of medicine's accommodation to uncertainty; counterweighted, competing, apparently paradoxical (but always situational) rules enable physicians simultaneously to express and to ignore the practical reason that characterizes their practice. (shrink)

Evidence-based practice in education involves basing decisions about what to do on evidence about the relative effectiveness of available interventions (e.g. programmes, products, practices). This paper considers two influential critiques of evidence-based education (EBE) pertaining to its treatment of values. The ‘general critique’ condemns EBE for excluding values from decisions about what to do in education. The ‘specific critique’ condemns EBE for relying on a deterministic view of causality in education which disregards the complex, value-laden nature of educational contexts. I (...) argue that virtually all versions of EBE escape the general critique, including the dominant intervention-centered approach that relies on experimental research to discover ‘what works’, because the predictions EBE aims to support are only one premise in a broader normative argument. Further, intervention-centered EBE can avoid much of the specific values-based critique because it is consistent with a probabilistic, rather than deterministic, understanding of causality. However, I argue that only a context-centered approach to EBE that relies on evidence about the specific target setting from local sources in addition to evidence from theory and mixed methods research can fully address the specific critique by accommodating critics’ descriptive claims about the nature of educational contexts. (shrink)

In Moral Passages, Kathryn Pyne Addelson presents an original moral theory suited for contemporary life and its moral problems. Her basic principle is that knowledge and morality are generated in collective action, and she develops it through a critical examination of theories in philosophy, sociology and women's studies, most of which hide the collective nature and as a result hide the lives and knowledge of many people. At issue are the questions of what morality is, and how moral theories (...) (whether traditional or feminist) are implemented. Addelson takes up a large number of historical cases and contemporary social problems, including teen pregnancy, contraception and abortion, and gay rights. These cases allow her to see how the knowledge and lives of some people are declared deviant or immoral, while those of others appear to show the public consensus. One case she uses throughout the book is Margaret Sanger's early work on birth control with the anarcho-syndicalist movement--a revisionist history that reveals rather than hides the collective nature of morality and knowledge. Addelson shows how the usual individualist philosophies promote theories which hide the authority of the professionals who make them. A collectivist approach, she argues, must show the part professionals play in collective action. Her aim is to allow professional knowledge makers to be morally and intellectually responsible. Based on Addelson's twenty years of work in feminist philosophy and interactionist sociology as well as her long-standing involvement in women's community organization, Moral Passages investigates how morality and knowledge are collectively enacted in today's world. (shrink)

Our experiences with many sorts of evils yield debates about the role of forgiveness as a possible moral response. These debates include (1) the preliminary question whether evils are, by definition, unforgivable, (2) the contention that evils may be forgivable but that forgiveness cannot entail reconciliation with one’s evildoer, (3) the concern that only direct victims of evils are in a position to decide if forgiveness is appropriate, (4) the conceptual worry that forgiveness of evil may not be genuine or (...) complete if hard feelings recur, (5) the interest of many in holding that forgiveness is never required, and (6) the concern that analyses of evil ought to prioritize the suffering, and credit the perspectives, of victims of evils, in tension with the possibility that forgiveness concerns the well-being of offenders. In this paper, I critically evaluate these concerns from the perspective of nonideal theory. I conclude that crediting victims’ perspectives is importantly basic to empirically informed moral theory, and that objections to forgiveness including (1) evil’s unforgivability ignore victims’ differing accounts. When we take actualities and experiences to be informative and central, some of the usual debates become less pressing, perhaps even moot. (shrink)

Rationale: Deep brain stimulation (DBS) of the hippocampus is proposed for enhancement of memory impaired by injury or disease. Many pre-clinical DBS paradigms can be addressed in epilepsy patients undergoing intracranial monitoring for seizure localization, since they already have electrodes implanted in brain areas of interest. Even though epilepsy is usually not a memory disorder targeted by DBS, the studies can nevertheless model other memory-impacting disorders, such as Traumatic Brain Injury (TBI). Methods: Human patients undergoing Phase II invasive monitoring for (...) intractable epilepsy were implanted with depth electrodes capable of recording neurophysiological signals. Subjects performed a delayed-match-to-sample (DMS) memory task while hippocampal ensembles from CA1 and CA3 cell layers were recorded to estimate a multi-input, multi-output (MIMO) model of CA3-to-CA1 neural encoding and a memory decoding model (MDM) to decode memory information from CA3 and CA1 neuronal signals. After model estimation, subjects again performed the DMS task while either MIMO-based or MDM-based patterned stimulation was delivered to CA1 electrode sites during the encoding phase of the DMS trials. Each subject was sorted (post hoc) by prior experience of repeated and/or mild-to-moderate brain injury (RMBI), TBI, or no history (control) and scored for percentage successful delayed recognition (DR) recall on stimulated vs. non-stimulated DMS trials. The subject’s medical history was unknown to the experimenters until after individual subject memory retention results were scored. Results: When examined compared to control subjects, both TBI and RMBI subjects showed increased memory retention in response to both MIMO and MDM-based hippocampal stimulation. Furthermore, effects of stimulation were also greater in subjects who were evaluated as having pre-existing mild-to-moderate memory impairment. Conclusion: These results show that hippocampal stimulation for memory facilitation was more beneficial for subjects who had previously suffered a brain injury (other than epilepsy), compared to control (epilepsy) subjects who had not suffered a brain injury. This study demonstrates that the epilepsy/intracranial recording model can be extended to test the ability of DBS to restore memory function in subjects who previously suffered a brain injury other than epilepsy, and support further investigation into the beneficial effect of DBS in TBI patients. (shrink)

The objective of this paper is to discuss the relationship between the functional properties and information-processing modes of the human brain and the evolution of scientific thought. Science has emerged as a tool to carry out predictive operations that exceed the accuracy, temporal scale, and intrinsic operational limitations of the human brain. Yet the scientific method unavoidably reflects some fundamental characteristics of the information-acquisition and -analysis modes of the brain, which impose a priori boundary conditions upon how science can develop (...) and how the physical universe can be “understood.” A brief description of physical and biological interactions is given, with emphasis on the defining role played by the concept of information. Current views on the information-processing and information-generating mechanisms of the human brain are briefly reviewed. It is shown how some particular features of superstition, natural philosophy, physical thought, and intuition can be linked to certain characteristic information-processing modes of the brain. A discussion is given of how greatly expanded knowledge of brain functions might affect the future of science and technology. (shrink)

This article argues that the use of genetic testing to determine eligibility for worker compensation and/or social security disability benefits would seriously undermine the social purposes of the laws.

In The Medical Right, Remaking Medicine in Their Image (2007) (Medical Right Report or Report), the Religious Coalition for Reproductive Choice (RCRC) applies the term "Medical Right" to refer to religiously influenced medical, bioethics and health policy organizations of the Religious Right. This extremely important, well researched Report examines how the political agenda of the Religious Right, a political force comprised of fundamentalists primarily in the Protestant and Roman Catholic traditions, impacts reproductive health care. The growing influence of medical associations (...) that apply fundamentalist Christian "biblical values" to research and policy affecting reproductive health care is explored. The Report reveals that many consortiums, think tanks, institutes, and programs apply Religious Right ideology to medical concerns under the mantle of "bioethics" or "biomedical ethics." These groups work with conservative advocacy, outreach, and legal organizations, along with politicians, to advance the policy agendas of the Religious Right. The confluence of conservative politics, fundamentalist religion, and ideologically influenced medicine and science, poses a threat to reproductive health care services, as discussed in detail in the Report. While the Report is comprehensive in its discussion of the Religious Right's involvement in reproductive health issues, it addresses in only a cursory fashion how the Medical Right engages health law and policy governing end-of-life care. The purpose of this paper is to explore this area of concern more thoroughly. (shrink)

There is conflicting experimental evidence about whether the “stakes” or importance of being wrong affect judgments about whether a subject knows a proposition. To date, judgments about stakes effects on knowledge have been investigated using binary paradigms: responses to “low” stakes cases are compared with responses to “high stakes” cases. However, stakes or importance are not binary properties—they are scalar: whether a situation is “high” or “low” stakes is a matter of degree. So far, no experimental work has investigated the (...) scalar nature of stakes effects on knowledge: do stakes effects increase as the stakes get higher? Do stakes effects only appear once a certain threshold of stakes has been crossed? Does the effect plateau at a certain point? To address these questions, we conducted experiments that probe for the scalarity of stakes effects using several experimental approaches. We found evidence of scalar stakes effects using an “evidence seeking” experimental design, but no evidence of scalar effects using a traditional “evidence-fixed” experimental design. In addition, using the evidence-seeking design, we uncovered a large, but previously unnoticed framing effect on whether participants are skeptical about whether someone can know something, no matter how much evidence they have. The rate of skeptical responses and the rate at which participants were willing to attribute “lazy knowledge”—that someone can know something without having to check—were themselves subject to a stakes effect: participants were more skeptical when the stakes were higher, and more prone to attribute lazy knowledge when the stakes were lower. We argue that the novel skeptical stakes effect provides resources to respond to criticisms of the evidence-seeking approach that argue that it does not target knowledge. (shrink)

The nature of moral action versus moral judgment has been extensively debated in numerous disciplines. We introduce Virtual Reality (VR) moral paradigms examining the action individuals take in a high emotionally arousing, direct action-focused, moral scenario. In two studies involving qualitatively different populations, we found a greater endorsement of utilitarian responses–killing one in order to save many others–when action was required in moral virtual dilemmas compared to their judgment counterparts. Heart rate in virtual moral dilemmas was significantly increased when compared (...) to both judgment counterparts and control virtual tasks. Our research suggests that moral action may be viewed as an independent construct to moral judgment, with VR methods delivering new prospects for investigating and assessing moral behaviour. (shrink)

Pretty much everyone knows that our genes have at least something to do with how able or how high achieving we are. Some believe that we should not speak of this common knowledge, nor inquire into how genetic influence works or what it might mean. If we do not keep an open mind to the fact of genetic influence on academic achievement, however, then we cannot explore its possible implications. And if we do not consider the implications, then we cannot, (...) as a society, harness any potential benefits or avoid possible pitfalls. So that's what this essay is about—exploring what behavioral genetics research might be able to offer to educational theory, policy, and practice.We cannot yet use biological information to make accurate predictions for all children. We do know, however, that academic achievement is heritable, which is to say that differences between individuals are influenced by differences in their DNA. If genes are part of the problem for some pupils (to take the negative spin on this), then it seems likely that studying them could be part of a solution. And that's what behavioral geneticists are trying to do—to chart and understand pathways from DNA to behavior and to identify interventions that can maximize outcomes for all. The fact is, though, that we have an awfully long way to go. (shrink)

In this monograph, I offer feminist reasons to develop a multidimensional account of forgiveness as a moral, and therefore at least partially deliberative, action or set of actions, which functions as a remedy in responding to blame or condemnation, releasing offenders from the fullness of their blameworthiness, in relational contexts which therefore require considerations of power between relata. I rely on feminist philosophical account of the relational self in order to contextualise these power relations. I provide accounts of forgiveness as (...) a performative utterance, third-party forgiveness, and self-forgiveness based upon this feminist and multidimensional model of forgiveness. (shrink)

The vegan ideal is entailed by arguments for ethical veganism based on traditional moral theory (rights and/or utilitarianism) extended to animals. The most ideal lifestyle would abjure the use of animals or their products for food since animals suffer and have rights not to be killed. The ideal is discriminatory because the arguments presuppose a male physiological norm that gives a privileged position to adult, middle-class males living in industrialized countries. Women, children, the aged, and others have substantially different nutritional (...) requirements and would bear a greater burden on vegetarian and vegan diets with respect to health and economic risks, than do these males. The poor and many persons in Third World nations live in circumstances that make the obligatory adoption of such diets, where they are not already a matter of sheer necessity, even more risky.Traditional moral theorists (such as Evelyn Pluhar and Gary Varner whose essays appear in this issue) argue that those who are at risk would beexcused from a duty to attain the virtue associated with ethical vegan lifestyles. The routine excuse of nearly everyone in the world besides adult, middle-class males in industrialized countries suggests bias in the perspective from which traditional arguments for animal rights and (utilitarian) animal welfare are formulated. (shrink)

Post-Traumatic Stress Disorder is a major public health concern in both civilian and military populations, across race, age, gender, and socio-economic status. While PTSD has been around for centuries by some name or another, its definition and description also continue to evolve. Within the last few years, the American Psychological Association has published the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, which includes some major changes in the diagnostic criteria for PTSD. Recent data on epidemiology, etiological (...) theories, and empirically supported methods of treatment, as well as implications for legal processes and criminal justice system personnel, are discussed. (shrink)

Religious texts and historical narratives are instrumental in defining appropriate emotions and moral reasoning in a culture. In the Bhagavad Gītā, the warrior Arjuna is faced with a twofold dilemma: are his emotions appropriate and should emotions influence his actions? The Gītā is thought to be a redacted text with three primary layers: the original verses, the Sāmkhya/Yoga layer, and the devotional bhakti layer. Cross-cultural psychological theories of emotions are employed to analyze the layers of the Gītā. It is argued (...) that each of the three layers corresponds with one of three possible moral codes as proposed by R. A. Shweder and his colleagues (1997; 2000): the Ethic of Autonomy (promoting personal well-being and avoiding shame); the Ethic of Community (maintaining social order and emotional detachment); and the Ethic of Divinity (upholding cosmic order and endorsing emotional devotion). These three perspectives remain relevant for deciding emotionally laden moral dilemmas today. (shrink)

A significant portion of the scholarship in analytic philosophy of psychiatry has been devoted to the problem of what kind of kind psychiatric disorders are. Efforts have included descriptive projects, which aim to identify what psychiatrists in fact refer to when they diagnose, and prescriptive ones, which argue over that to which diagnostic categories should refer. In other words, philosophers have occupied themselves with what I call “diagnostic kinds”. However, the pride of place traditionally given to diagnostic kinds in psychiatric (...) research has recently come under attack, most notably by a recent initiative of the National Institute of Mental Health, the Research Domain Criteria Project, that seeks to exclude diagnostic categories from experimental designs and focus on other sorts of psychiatric kinds. I argue that philosophical accounts privileging diagnostic kinds must respond to this new line of criticism, and conclude that philosophers need to either counter psychiatrists’ growing suspicion about the hegemony of diagnostic categories in the clinic and the laboratory, or join in redirecting their efforts toward the development of robust accounts of other sorts of psychiatric objects and processes. (shrink)

Open Access: Social media participation undermines individual autonomy in ways that ought to concern ethicists. Discussions in the philosophical literature are concerned primarily with egregious conduct online such as harassment and shaming, keeping the focus on obvious ills to which no one could consent; this prevents a wider understanding of the risks and harms of quotidian social media participation. Two particular concerns occupy me: social media participation carries the risks of (1) negatively formative experiences and (2) continuous partial attention due (...) to our habituation to the variable rewards that social media platforms provide. Although social media offer benefits as well as risks, self-knowledge of whether one benefits more than one suffers from one’s social media participation is vexed by the very processes involved in participating. We are not as free to leave social media as we are to enter. I conclude with a consideration and rejection of the objections that the ubiquity of the practice indicates implied consent to risks, and that users of social media can simply choose not to use such communication technologies at all. I argue that we cannot be said to consent to enter into social media usage meaningfully, even implicitly, and we do not all have equally easy options to avoid the contexts that provide the stimuli of persistent desires. (shrink)

The Benefits and Potential Harms of Genetic Testing for Huntington's Disease: A Case Study Content Type Journal Article Pages 14-19 Authors Kathryn Edge, BSC, Rheumatic Diseases Centre, CSB, Hope Hospital, The University of Manchester, Stott Lane, Salford M6 8HD, England Journal Human Reproduction & Genetic Ethics Online ISSN 2043-0469 Print ISSN 1028-7825 Journal Volume Volume 14 Journal Issue Volume 14, Number 2 / 2008.

"Change is not merely necessary to life--it is life." That's Alvin Toffler, characteristically stating the profound in a profoundly direct way. And yes, even when we see change coming--as we're about to graduate from school, take a new job, get married--it's still not so easy to accept. And when we don't see it coming--oof, we have an even harder time. Here to help us embrace change and defuse its unsettling power is Change Happens, a full-color illustrated gift book to consult, (...) to share, to give, and to keep on a night table. Curated by Kathryn and Ross Petras, the ultimate connoisseurs of quotes whose books and calendars have over 4.5 million copies in print, these words of wisdom inspire us to be open to change and remind us that nothing positive in life ever happens without it. Arranged alphabetically by subject--including Adapting, Curveballs, Faith, Letting Go, Regrets, Second Chances, Vulnerability--it's a book to turn to in moments of need, when offering advice to a friend or loved one, when urging a child to find the courage to take a step, when marking an important occasion. (shrink)

The failure of psychiatry to validate its diagnostic constructs is often attributed to the prioritizing of reliability over validity in the structure and content of the Diagnostic and Statistical Manual of Mental Disorders. Here I argue that in fact what has retarded biomedical approaches to psychopathology is unwarranted optimism about diagnostic discrimination: the assumption that our diagnostic tests group patients together in ways that allow for relevant facts about mental disorder to be discovered. I consider the Research Domain Criteria framework (...) as a new paradigm for classifying objects of psychiatric research that solves some of the challenges brought on by this assumption. (shrink)

We advance the understanding of the philosophy and psychology of curiosity by operationalizing and constructing an empirical measure of Nietzsche’s conception of inquisitive curiosity, expressed by the German term Wissbegier, (“thirst for knowledge” or “need/impetus to know”) and Neugier (“curiosity” or “inquisitiveness”). First, we show that existing empirical measures of curiosity do not tap the construct of inquisitive curiosity, though they may tap related constructs such as idle curiosity and phenomenological curiosity. Next, we map the concept of inquisitive curiosity and (...) connect it to related concepts, such as open-mindedness and intellectual humility. The bulk of the paper reports four studies: an Anglophone exploratory factor analysis, an Anglophone confirmatory factor analysis, an informant study, and a Germanophone exploratory and confirmatory factor analysis. (shrink)

This paper makes a case for the centrality of the passion of curiosity to Hobbes’s account of human nature. Hobbes describes curiosity as one of only a few capacities differentiating human beings from animals, and I argue that it is in fact the fundamen- tal cause of humanity’s uniqueness, generating other important difference-makers such as language, science and politics. I qualify Philip Pettit’s (2008) claim that Hobbes believes language to be the essence of human difference, contending that Pettit grants language (...) too central a place in Hobbes’s psychology. Language is, for Hobbes, a tech- nology adopted on account of curiosity. Further, curiosity is necessary not only for linguistic but also for scientific activity. Only after what he calls original knowledge has been gathered are names employed to generate the conditional propositions that con- stitute science. Finally, curiosity can resolve another puzzle of Hobbesian psychology that Pettit leaves unanswered: our tendency towards strife. Hobbes believes that inso- far as human beings have an implacable hunger for knowledge of the future, we are unable to rest content with present gains and must always aspire to secure the best possible outcome for ourselves. (shrink)

In this introductory essay, I describe feminist ethics as a kind of approach to morality that says we ought to pay attention to the facts on the ground and empirical information in order to know whether and how a moral problem is a gendered problem. One of the best accounts of feminist ethics is by Hilde Lindemann, who wrote that feminist ethics aims “to understand, criticize, and correct how gender operates within our moral and social beliefs and practices.” She doesn’t (...) define feminism as a theory about women, and neither do I. The term 'feminist' has more to do with the sources of this approach to ethics than the ultimate goals of such theorists; women were influential and early advocates of the view that sometimes a moral problem is a problem because it is gendered. (shrink)

In the 1970s, two events in particular, the William Tyndale School and James Callaghan's Ruskin speech, generated extensive media coverage and political activity and became 'watersheds' along the path to political and educational reform. This has shaped the system of school and governments in the 1990s. This book revisits Tyndale and Ruskin and examines their legacy. Drawing on contemporary accounts of a number of key individuals who were involved in those watershed events, it recasts their stories in the light of (...) current changes in education. The book explores the extent to which both these events shifted assumptions about education and provided the rationale for policy changes. It argues that fundamental questions need to be asked about the nature of the reform agenda and in particular, the balance of power. It also places the reform agenda within an international context. (shrink)

The sixteenth-century reckoning with extra-European peoples and cultures occurred at precisely the same moment that humanists were increasingly preoccupied with the daily life, material culture, and lived religion of classical antiquity. Leading figures in sixteenth-century antiquarianism took an abiding interest in ethnographic accounts of contemporary peoples and even produced such accounts. This article examines how sixteenth-century readers and scholars placed bodies of literature on ancient and modern customs in dialogue with one another. While scholars have long appreciated that ethnographic and (...) travel writing were deeply mediated by the study of antiquity, that mediation cut both ways. This article addresses the question of how ethnographic descriptions of modern peoples shaped sixteenth-century understandings of the customs and lived religion of antiquity. The writings of merchants and humanists testify to the ways in which the practices of ethnographic writing helped to shape travellers’ and readers’ appreciation of the cultural alterity of classical antiquity. (shrink)

It is argued that the question of whether or not one is required to be or become a strict vegetarian depends, not upon a rule or ideal that endorses vegetarianism on moral grounds, but rather upon whether one's own physical, biological nature is adapted to maintaining health and well-being on a vegetarian diet. Even if we accept the view that animals have rights, we still have no duty to make ourselves substantially worse off for the sake of other rights-holders. Moreover, (...) duties to others, such as fetuses and infants, may require one to consume meat or animal products. Seven classes of individuals who are not required to be or become vegetarians are identified and their examption is related to nutritional facts; these classes comprise most of the earth's population. The rule of vegetarianism defines a special or provisional duty rather than any general or universal rule, since its observance it based upon the biological capacities of individual humans whose genetic constitution and environment makes them suitably herbivorous. It is also argued that generalizing the vegetarian ideal as a social goal for all would be wrongful because it fails to consider the individual nutritional needs of humans at various stages of life, according to biological differences between the sexes, and because it would have the eugenic effect of limiting the adaptability of the human species. The appeal to the natural interests of omnivores will not justify any claim that humans may eat amounts of meat or animal products in excess of a reasonable safety margin since animals have rights-claims against us. (shrink)