There is a global shortage of organs for transplantation and despite many governments making significant changes to their organ donation systems, there are not enough kidneys available to meet the demand. This has led scientists and clinicians to explore alternative means of meeting this organ shortfall. One of the alternatives to human organ transplantation is xenotransplantation, which is the transplantation of organs, tissues, or cells between different species. The resurgence of interest in xenotransplantation and recent scientific breakthroughs suggest that genetically-engineered (...) pigs may soon present a realistic alternative as sources of kidneys for clinical transplantation. It is therefore important for nurses and allied health professionals to understand what is involved in xenotransplantation and its future implications for their clinical practices. First, we explore the insufficiency of different organ donation systems to meet the kidney shortage. Second, we provide a background and a summary of the progress made so far in xenotransplantation research. Third, we discuss some of the scientific, technological, ethical, and economic issues associated with xenotransplantation. Finally, we summarise the literature on the attitudes of healthcare professionals toward xenotransplantation. (shrink)

Formal clinical trials of pig-to-human organ transplant—known as xenotransplantation—may begin this decade, with the first trials likely to consist of either adult renal transplants or pediatric cardiac transplant patients. Xenotransplantation as a systematic scientific study only reaches back to the latter half of the 20th century, with episodic xenotransplantation events occurring prior to that. As the science of xenotransplantation has progressed in the 20th and 21st centuries, the public's knowledge of the potential therapy has also increased. With this, there have (...) been shifting ethical stances toward xenotransplantation in key areas, such as religious and public viewpoints towards xenotransplantation, animal rights, and public health concerns. This review provides a historical–ethical account of xenotransplantation and details if or how viewpoints have shifted over time. (shrink)

Florence Ashley has argued that requiring patients with gender dysphoria to undergo an assessment and referral from a mental health professional before undergoing hormone replacement therapy is unethical and may represent an unconscious hostility towards transgender people. We respond, first, by showing that Ashley has conflated the self-reporting of symptoms with self-diagnosis, and that this is not consistent with the standard model of informed consent to medical treatment. Second, we note that the model of informed consent involved in cosmetic surgery (...) resembles the model Ashley defends, and that psychological assessment and referral is recognised as an important aspect of such a model. Third, we suggest that the increased prevalence of psychiatric morbidity in the transgender population arguably supports the requirement of assessment and referral from a mental health professional prior to undergoing HRT. (shrink)

Florence Ashley has responded to our response to ‘Gatekeeping hormone replacement therapy for transgender patients is dehumanising.’ Ashley criticises some of our objections to their view that patients seeking hormone replacement therapy (HRT) for gender dysphoria should not have to undergo a prior psychological assessment. Here we clarify our objections, most importantly that concerning the parity between cosmetic surgery and the sort of intervention Ashley has in mind. Firstly, we show Ashley’s criticism of our comparison is insubstantial. We then examine (...) their comments regarding the analogy between abortion and HRT, and the language of informed consent. We also scrutinize the data upon which Ashley relies to defend the claim that informed consent without assessment always yields positive outcomes, finding this conclusion to be overstated. Finally, even if Ashley’s arguments were vindicated, the claim that the gatekeeping of HRT is motivated by hostility towards transgender people remains unsupported. (shrink)

In a recent article in this journal, Abram Brummett argues that new and future assisted reproductive technologies will provide challenging ethical questions relating to lesbian, gay, bisexual and transgender (LGBT) persons. Brummett notes that it is likely that some clinicians may wish to conscientiously object to offering assisted reproductive technologies to LGBT couples on moral or religious grounds, and argues that such appeals to conscience should be constrained. We argue that Brummett's case is unsuccessful because he: does not adequately interact (...) with his opponents’ views; equivocates on the meaning of ‘natural’; fails to show that the practice he opposes is eugenic in any non‐trivial sense; and fails to justify and explicate the relevance of the naturalism he proposes. We do not argue that conscience protections should exist for those objecting to providing LGBT people with artificial reproductive technologies, but only show that Brummett's arguments are insufficient to prove that they should not. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

This paper applies models of the onset of adolescent sexual intercourse using national data from Denmark and the USA. The model gave excellent fits to data on Danish Whites and a good fit to American Whites, but the model-fits for American Blacks and Hispanics were not as good. The weakness of the latter model fits may reflect either real processes that the model does not capture or problems in the reliability of adolescent sexuality data.

The Roman Senate in 144 B.C. instructed the urban praetor, Q. Marcius Rex, to repair the conduits of Rome's two existing aqueducts, the Appia and the Anio , and to put an end to illegal use of their water by private citizens. Urban growth now demanded a more copious water supply, and so the Senate further I instructed Marcius to secure additional water for the city. Money was appropriated for this work, and Marcius' praetorship was prorogued for 143. At this (...) point the decemviri objected to a plan for bringing water to the Capitol. The issue was debated in the Senate in 143, and again in 140; but on both occasions Marcius' gratia prevailed, and water reached the Capitol in a new aqueduct which Marcius himself had built. A statue of Marcius was erected in later times on the Capitol, behind the temple of Jupiter, to commemorate this grand achievement.1 An everlasting glory was in fact to be his in the name of the aqueduct whose waters earned poets' praises. (shrink)

This volume contains the contributions of philosophers and psychologists to one of the Rice University semicentennial symposia and includes the papers of Koch, MacLeod, Skinner, Rodgers, Malcolm and Scriven. Discussion from the audience and among the participants is recorded, and the general result of both is a blurring of distinctions between behaviorism and phenomenology. The peculiar logical character of first person utterances is duly considered and provides the backdrop for much of the rehash of the private-public problem in philosophy and (...) psychology.—C. V. (shrink)

Principles of Philosophy was written in Latin by Rene Descartes. Published in 1644, it was intended to replace Aristotle's philosophy and traditional Scholastic Philosophy. This volume contains a letter of the author to the French translator of the Principles of Philosophy serving for a Preface and a letter to the most serene princess, Elizabeth, eldest daughter of Frederick, King of Bohemia, Count Palatine, and Elector of the Sacred Roman Empire. Principes de philosophie, by Claude Picot, under the supervision of Descartes, (...) appeared in 1647 with a letter-preface to Queen Christina of Sweden. (shrink)

Two key questions lie at the heart of the business challenge for business ethics: is it possible for business and investors to do well while doing good; and if so, how can this be achieved? This paper adopts an international investment perspective to address these questions. It demonstrates that it is possible for business and investors to achieve a triple bottom line of environmental, social and financial performance.A new integrated model of Ethical Business including an Ethical Scorecard performance measurement technology (...) is presented based on international ethical investment criteria and case studies of businesses rated highly by ethical investors. Ethical Performance Scores are presented for these businesses and New Zealand business. Examples from New Zealand are presented to illustrate the Ethical Scorecard and ethical business practice. The model and scoring system provide a basis for international benchmarking of ethical business to assist investors, managers and researchers. (shrink)

An interdisciplanary collection of essays focused on Kant's work on the concept of community.

Bazzocchi disposes the text of the Tractatus in a user-friendly manner, exactly as Wittgenstein's decimals advise. This discloses the logical form of the book by distinct reading units, linked into a fashioned hierarchical tree. The text becomes much clearer and every reader can enjoy, finally, its formal and literary qualities.

Friendship between professors and students have the potential for hurting those involved and can be hurtful to the larger society in which they occur. This paper examines what sort of boundary lines can be drawn for appropriate faculty-student relationships by considering three arguments against faculty-student friendships. After rejecting these arguments on the grounds that they rely upon a flawed conceptualization of friendship, the paper, drawing on William Rawlins’s theory of friendship, argues that faculty-student relationships are neither desirable nor undesirable per (...) se. However, if such relationships do arise, it is possible that they can be conducted in an ethically responsible and professionally appropriate way. (shrink)

Stefan Collini's Absent Minds is a rich, critical history of a cliché: that English culture is peculiarly hostile to intellectuals. Despite striking differences in the organization of intellectual life in the U.S. and Britain, precisely the same cliché pervades American writing. The explanation may lie less in structure than in the transnational mobility of the language of the intellectual.