Much has been published about the ethical issues encountered by clinicians in genetics/genomics, but those experienced by clinical laboratory scientists are less well described. Clinical laboratory scientists now frequently face navigating ethical problems in their work, but how they should be best supported to do this is underexplored. This lack of attention is also reflected in the ethics tools available to clinical laboratory scientists such as guidance and deliberative ethics forums, developed primarily to manage issues arising within the clinic.We explore (...) what ethical issues are being experienced by clinical scientists, how they think such issues could be best analysed and managed, and whether their practice might be enhanced by more situated approaches to ethics deliberation and practice such as ethical preparedness. From thematic analysis of cases presented by clinical scientists at a specially convened meeting of the UK Genethics Forum, we derived three main ethical themes: (1) the redistribution of labour and responsibilities resulting from the practice of genomic medicine; (2) the interpretation and certainty of results and (3) the proposal that better standardisation and consistency of ethical approaches (for example, more guidelines and policy) could resolve some of the challenges arising.We argue that although standardisation is important for promoting shared understandings of good (including ethical) practice, supplementary approaches to enhance and sustain ethical preparedness will be important to help clinical scientists and others in the recently expanded genetic/genomic medicine environment foster quality ethical thinking. (shrink)

Open peer commentary on the article “Perception-Action Mutuality Obviates Mental Construction” by Martin Flament Fultot, Lin Nie & Claudia Carello. Upshot: Fultot, Nie, and Carello are correct that enactive researchers should be more aware of the research literature on ecological psychology, but their charge of mental construction is off-target. Enactivism and ecological psychology are compatible frameworks with different, complementary, emphases.

This study examines the specificvalues held by consumers towards organic andconventionally produced meat, with particularreference to moral issues surrounding foodanimal production. A quota sample of 30 femalesfrom both a rural and an urban area of Scotland, were interviewed. Overall, there was lowcommitment towards the purchase of organicmeats and little concern for ethical issues.Price and product appearance were the primarymeat selection criteria, the latter being usedas a predictor of eating quality. Manyattitude-behavior anomalies were identified,mainly as a result of respondents' cognitivedissonance and (...) lack of understanding regardingmeat production criteria underpinning meatquality marks, e.g., Soil Association label.Responsibilities for ethical issues appeared tobe delegated by the consumer to the meatretailer or government. This raises issuesabout educating consumers and bringingconsumers closer to understanding meatproduction systems. A conceptual framework isproposed that illustrates the significance ofconsumer involvement in how meat-purchasingdecisions are approached in terms of theevaluation of tangible and or intangiblequality attributes. The results also point tothe need for further research into thoseaspects of quality that individuals tend toaddress at the level of the citizen,rather than at the point of purchase. (shrink)

Scholars offer several options for Matthew’s value of the leper’s story in his narrative that range from revealing Jesus’ attributes of compassion and sympathy, manifesting God’s empire, to portraying Jesus’ function as a temple. Although these suggestions aptly portray Matthew’s rhetorical use of the leper’s healing in his narrative to address societal concerns of his time, for lack of referring to the social setting of the narrative, they do not capture the holistic healthcare system embodied by Jesus in Matthew’s narrative (...) that portrays Jesus as a superior healer to the rest of the other healers in the Roman Empire. The findings of the research for this article establish the argument that employing ethnomedical anthropology as a lens to read the leper’s healing narrative in Matthew 8:1–4 in the context of Matthew’s social setting reveals Matthew’s ideology for a transcendent and immanent Christology. The aim of the article is to demonstrate the effectiveness of medical anthropological theory in explaining the dynamics of health and healing reflected in biblical texts.Contributions: This article contributes to the interdisciplinary approach to the study of religion by employing a ethnomedical anthropological perspective to read the leper’s healing in Matthew 8.1–4 in reference to the first century CE health systems in the Roman Empire. This approach procured that Matthew’s immanent and transcendent perspectives of Christology is crucial in demonstrating the text’s function in constructing and sustaining the identity of Matthew’s community in antiquity. (shrink)

One central strand in Quine's criticism of common-sense notions of linguistic meaning is an argument from the holism of empirical content. This paper explores (with many digressions) the several versions of the argument, and discovers them to be uniformly bad. There is a kernel of truth in the idea that ?holism?, in some sense, ?undermines the analytic?synthetic distinction?, in some sense; but it has little to do with Quine's radical empiricism, or his radical scepticism about meaning.

Residency training in the Netherlands is to be restructured over the coming years. To this end a general competence profile for medical specialists has been introduced. This profile is nearly the same as the Canadian CanMEDS 2000 model, which describes seven general areas of medical specialist competence, one of which is professionalism. In order to establish a training programme for residents and their instructors based on this competence, it is necessary to develop a vision that does justice to everyday medical (...) practice. The two most prevailing views of professionalism—as personal, or as a behavioural characteristic—fall short of this. Only when professionalism is understood as reflective professionalism does it encompass the fundamental contextuality of medical treatment. This means that the focus of training and assessment must be shifted to accountability for treatment. (shrink)

Objectives: To assess French district nurses’ opinions towards euthanasia and to study factors associated with these opinions, with emphasis on attitudes towards terminal patients.Design and setting: An anonymous telephone survey carried out in 2005 among a national random sample of French district nurses.Participants: District nurses currently delivering home care who have at least 1 year of professional experience. Of 803 district nurses contacted, 602 agreed to participate .Main outcome measures: Opinion towards the legalisation of euthanasia , attitudes towards terminal patients (...) .Results: Overall, 65% of the 602 nurses favoured legalising euthanasia. Regarding associated factors, this proportion was higher among those who discuss end-of-life issues with terminal patients , who consider competent patients should always be told their prognosis and who value the role of advance directives and surrogates in end-of-life decision-making for incompetent patients . Women and older nurses were less likely to favour legalising euthanasia, as were those who believed in a god who masters their destiny.Conclusions: French nurses are more in favour of legalising euthanasia than French physicians; these two populations contrast greatly in the factors associated with this support. Further research is needed to investigate how and to what extent such attitudes may affect nursing practice and emotional well-being in the specific context of end-of-life home care. (shrink)

This paper explores difficulties around consent in the context of organ retention and return. It addresses the proposals of the Independent Review Group in Scotland on the Retention of Organs at Post Mortem to speak of authorisation rather than consent. Practical problems about whose consent determines disputes in relation to organ retention are explored. If a young child dies and his mother refuses consent but his father agrees what should ensue? Should the expressed wishes of a deceased adult override the (...) objections of surviving relatives? The paper suggests much broader understanding of the issues embedded in organ retention is needed to provide solutions which truly meet families' and society's needs. (shrink)

This article considers the sort of diversity in perspective appropriate for a presidential commission on bioethics, and by implication, high-level governmental commissions on ethics more generally. It takes as its point of comparison the respective reports on human cloning produced by the National Bioethics Advisory Commission, appointed by President Bill Clinton, and George W. Bush's President's Council on Bioethics, under the leadership of its original chair, Leon Kass. I argue that the Clinton Commission Report exemplifies forensic diversity (the type of (...) diversity between contesting parties in a legal case), while the Kass Council Report exemplifies academic diversity (the diversity found in a medieval disputatio). Drawing upon Thomas Aquinas, I argue that the type of diversity most appropriate for such advisory bodies is deliberative diversity, which facilitates the President's process of taking counsel. After considering their respective charges, I suggest that neither the Clinton Commission nor the Kass Council possessed an adequate degree of deliberative diversity for their respective tasks. (shrink)

Self-esteem and self-respect refer to a way through which one relates to oneself, although they can be used as a synonymous expressions. On the basis of long tradition, since Kant ties self-respect to morality, all reference to self-respect has to be based on morality. Self-respect has a deeper root than self-esteem which is used to indicate a simple feeling of satisfaction with oneself without any value meaning. Self-respect is not a duty in itself but rather an acknowledgment of moral law (...) which means the recognition of all moral duties. In Kantian ethics self-esteem comes from duty to treat oneself considering mankind in his person. From self-respect derive duties to oneself which are the foundation of duties to other people. Honesty has been understood as a commitment to find the truth and to live according to it. Honesty as a virtue means refusing any falsification of facts. Honesty is the most remarkable expression of self-respect and other-respect, without any concessions to self-deception or other-deception. The aim of the paper is to establish the differences between self-respect and self-esteem and to relate the two with the virtue of honesty. (shrink)

Dans cet article, je reviens sur l’héritage laissé par Karl Marx dans la pensée de Michel Foucault. Organisant l’analyse autour de quelques « oppositions » conceptuelles cruciales – accumulation et discipline, reproduction et biopouvoir, régime de vérité et idéologie, révolution et ascèse –, je tente de mettre au point quatre grands schèmes relationnels susceptibles d’éclairer leurs rapports : la complémentarité, la confrontation productive, le rejet, et la réconciliation. L’objectif de cette analyse est de proposer une alternative à un nombre croissant (...) d’interprétations conservatrices de Foucault en montrant que d’autres grilles de compréhension de son œuvre sont possibles, tout en essayant de mettre en lumière ce que cette lecture « minoritaire » pourrait amener en termes de stratégie et de luttes politiques. (shrink)

The Transatlantic slave trade radically impaired Africa's potential to develop economically and maintain its social and political stability. The arrival of Europeans on the West African Coast and their establishment of slave ports in various parts of the continent triggered a continuous process of exploitation of Africa's human resources, labor, and commodities. This exploitative commerce influenced the African political and religious aristocracies, the warrior classes and the biracial elite, who made small gains from the slave trade, to participate in the (...) oppression of their own people. The Europeans, on the other hand, greatly benefited from the Atlantic trade, since it allowed them to amass the raw materials that fed the Industrial Revolution to the detriment of African societies whose capacity to transform their modes of production into a viable entrepreneurial economy was severely halted. (shrink)

Prolonging neonatal lifeThe paradox that medicine’s success breeds medicine’s problems is well known to readers of the Journal of Medical Ethics. Advances in neonatal medicine have worked wonders. Not long ago, extremely premature birth babies, or those born with very serious health problems, would inevitably have died. Today, neonatologists can resuscitate babies born at ever-earlier stages of gestation. And very ill babies also benefit from advances in neonatal intensive care. Infant lives can be prolonged. Unfortunately, several such babies will not (...) survive for long whatever is done for them. Others will live to leave hospital, but face severe health problems. Doctors have gained the ability to prolong neonatal life. But should they always do so? This question is central to the recent report of the Nuffield Council on Bioethics, Critical care decisions in fetal and neonatal medicine.1 In many quarters, the report received a very positive response, commended in The Lancet as “thoughtful, sensitive and sensible” and welcomed by the premature baby charity BLISS. Critics attacked on both flanks. The report goes too far—ushering in a culture of “throw away babies”. Or it does not go far enough—failing to endorse the Dutch precedent to sanction active neonatal euthanasia.TOO FAR?One of the key recommendations of the report is that guidelines be developed in relation to the institution of intensive neonatal care. It is these guidelines, which have been savaged by some parts of the media. The BMA called them “blanket rules” smothering clinical discretion. The guidelines on resuscitation at birth apply to babies born at the borderline of viability, that is, at or before a gestational age of 25 weeks 6 days. The earlier the baby is born, the lower are the chances that he/she will survive to leave hospital. Before 21 weeks 6 days, none of …. (shrink)

This paper uses Margaret Urban Walker’s “expressive collaborative” method of moral inquiry to examine and illustrate the morality of nurses in Great Britain from around 1860 to 1915, as well as nursing complicity in one of the first eugenic policies. The authors aim to focus on how context shapes and limits morality and agency in nurses and contributes to a better understanding of debates in nursing ethics both in the past and present.

In Book VII, p. 520, Socrates describes the arguments by which the philosophers must be induced to “return to the cave,” that is to say, to resume the practical business of politics from which they have escaped into the better life of contemplation. They must be shown that this sacrifice is a debt which they owe to the city in return for the opportunity which it has afforded them of becoming philosophers. “Will our pupils,"1 he continues, “when they hear this, (...) refuse to share in turn the toils of state, when they are allowed to spend the greater part of their time with one another in the heaven of ideas?” “Impossible,” Glaucon replies; “for they are just men, and the commands which we impose on them are just; there can be no doubt that every one of them will take office as a stern necessity, and not like our present ministers of state’. (shrink)

The Neuroscience Institute of Schizophrenia and Allied Disorders’s “Gift of Hope” Tissue Donor Program is a volunteer programme for people who wish to donate their brain when they die for neuroscience research into schizophrenia. Organ donation for purposes of research differs from transplant donation in a number of ways, most notably the absence of a single recipient. Within a particular community, however, the single recipient is replaced by a sense of shared experience and preventing suffering in others. Donors have an (...) investment in the research. (shrink)

In the first Critique Kant introduced the analytic/synthetic distinction and illustrated it with theoretical propositions. As his main aim in that work was to justify synthetic a priori propositions, Kant was able to bring his central questions into relief and discuss the methodology of their solution by contrasting synthetic propositions, such as: “Every event has a cause” with analytic propositions, such as: “Every effect has a cause.” Consequently, few commentators have any difficulty in stating as propositions the propositions Kant is (...) justifying in the first Critique or in pointing out the difficulty of justifying such propositions. (shrink)

Naturalism about the mind is often taken to be equivalent to some form of physicalism: the existence of mental properties must be shown not to compromise the autonomy of the physical realm. It is argued that this leads to a choice between reductionism, eliminativism, epiphenomenalism or interactionism. The central aim of the paper is to outline an Aristotelian alternative to the physicalist conception of natural bodies. It is argued that the distinction between form and matter, and an ontology which treats (...) individual natural bodies as real, unified things, rather than as complexes, enables us to achieve the non-reductionist, non-epiphenomenalist and non-interactionist position which eludes the post-Cartesian. (shrink)

Peace is a hallmark of human societies. However, certain ant species engage in long-term intergroup resource sharing, which is remarkably similar to peace among human groups. We discuss how individual and group payoff distributions are affected by kinship, dispersal, and age structure; the challenges of diagnosing peace; and the benefits of comparing convergent complex behaviours in disparate taxa.

With disparate rates of morbidity and mortality among minoritized communities, COVID-19 illuminated the need for equity-informed practices in public health. Pacia et al posit FQHCs as entities that addressed inequity when others failed. This commentary further situates how FQHCs address the public health crisis of institutional racism and related health inequities every day and presents a FQHC-led Ethics and Equity Framework and Workflow Checklist to guide ethical and equitable engagement with FQHCs.

Despite its uniform appearance, the cerebellar cortex is highly heterogeneous in terms of structure, genetics and physiology. Purkinje cells (PCs), the principal and sole output neurons of the cerebellar cortex, can be categorized into multiple populations that differentially express molecular markers and display distinctive physiological features. Such features include action potential rate, but also their propensity for synaptic and intrinsic plasticity. However, the precise molecular and genetic factors that correlate with the differential physiological properties of PCs remain elusive. In this (...) article, we provide a detailed overview of the cellular mechanisms that regulate PC activity and plasticity. We further perform a pathway analysis to highlight how molecular characteristics of specific PC populations may influence their physiology and plasticity mechanisms. (shrink)

Experience of matter can be described in the context of time and space, whereas, some people say, experience of mind may be described according to time only. Accordingly, though time and space together are regarded as objective forms, one may have a propensity for treating time alone as a particular form of the subjective consciousness. For space is indeed referred to the self-evidence of being, while time is thought to belong rather to the self-evidence of our own consciousness. According to (...) my opinion, however, even the spatial description is indispensable for the state of “mind”. For instance, the contents of our consciousness can be described only in terms of the localized phases of their images. Contrary to Kant, who regarded time and space together as forms of the outer intuition (i.e. as conditions of sensation), and time alone as form of the inner sense, I have a firm intention to assert them both as two forms of objective being because it is the being itself that can be the ultimate object of any of our cognitive powers — sensation, understanding and reason. Time and space are not forms proper to a particular “being” such as conscious existence like ours; they are also, nay, above all, two objective forms of being in general that transcends all such limited existences. It follows that these forms themselves, once abstracted in our mind, must, first of all, be valid for material beings; after that, i.e. derivatively and analogically, they may also be valid for mind-beings. The main aim of this paper is “dialectically” to elucidate that fact on the subject of time in particular. (shrink)