We are currently observing a shift in the relevance of ethical concerns regarding security screening systems. Due to technological progress, so my hypothesis goes, more direct consequences that such systems may have on the screening subjects' health and bodily privacy become increasingly unimportant compared to more indirect ones resulting from unrestrained information processing and excessive proliferation. However, a specific technical design of a screening system may help to prevent ethically unacceptable applications.

Large-screen human-computer interaction technology is reflected in all aspects of daily life. The dynamic gesture tracking algorithm commonly used in recent large-screen interactive technologies demonstrates compelling results but suffers from accuracy and real-time problems. This paper systematically addresses these issues by a switching federated filter method that combines particle filtering and Mean Shifting algorithms based on a 3D sensor. Compared with several algorithms, the results show that the one-hand and two-hand large-screen gesture tracking based on the switched federated filtering algorithm (...) work well, and there is no tracking failure and loss of target. Therefore, the switching federated tracking positioning algorithm can be well applied to the design of human-computer interaction system and provide new ideas for future human-computer interaction. (shrink)

Prenatal screening for foetal abnormalities such as Down's syndrome differs from other forms of population screening in that the usual aim of achieving health gains through treatment or prevention does not seem to apply. This type of screening leads to no other options but the choice between continuing or terminating the pregnancy and can only be morally justified if its aim is to provide meaningful options for reproductive choice to pregnant women and their partners. However, this aim (...) should not be understood as maximizing reproductive choice per se. Only if understood as allowing prospective parents to avoid suffering related to living with (a child with) serious disorders and handicaps can prenatal screening be a publicly or collectively funded programme. The alternative of moving prenatal testing outside the healthcare system into the private sector is problematic, as it makes these tests accessible only to those who can afford to pay for it. New developments in prenatal screening will have to be assessed in terms of whether and to what extent they either contribute to or undermine the stated aim of providing meaningful options for reproductive choice. In the light of this criterion, this article discusses the introduction of the new non‐invasive prenatal test (NIPT), the tendency to widen the scope of follow‐up testing, as well as the possible future scenarios of genome‐wide screening and ‘prenatal personalised medicine’. The article ends with recommendations for further debate, research and analysis. (shrink)

Prenatal screening for foetal abnormalities such as Down's syndrome differs from other forms of population screening in that the usual aim of achieving health gains through treatment or prevention does not seem to apply. This type of screening leads to no other options but the choice between continuing or terminating the pregnancy and can only be morally justified if its aim is to provide meaningful options for reproductive choice to pregnant women and their partners. However, this aim (...) should not be understood as maximizing reproductive choice per se. Only if understood as allowing prospective parents to avoid suffering related to living with serious disorders and handicaps can prenatal screening be a publicly or collectively funded programme. The alternative of moving prenatal testing outside the healthcare system into the private sector is problematic, as it makes these tests accessible only to those who can afford to pay for it. New developments in prenatal screening will have to be assessed in terms of whether and to what extent they either contribute to or undermine the stated aim of providing meaningful options for reproductive choice. In the light of this criterion, this article discusses the introduction of the new non-invasive prenatal test , the tendency to widen the scope of follow-up testing, as well as the possible future scenarios of genome-wide screening and ‘prenatal personalised medicine’. The article ends with recommendations for further debate, research and analysis. (shrink)

This article argues that a new diagram is emerging in the criminal justice system as it encounters developments in the neurosciences. This does not take the form that concerns many ‘neuroethicists’ — it does not entail a challenge to doctrines of free will and the notion of the autonomous legal subject — but is developing around the themes of susceptibility, risk, pre-emption and precaution. I term this diagram ‘screen and intervene’ and in this article I attempt to trace out (...) this new configuration and consider some of the consequences. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:"Terministic Screens," Social Constructionism, and the Language of Experience:Kenneth Burke's Utilization of William JamesPaul StobKenneth Burke's influence on various academic disciplines is clear in the number of books and articles published annually on his thought. It is also clear insofar as academics continue to turn to his work for insights on handling scholarly problems. That is to say, not only do we explore the dimensions of his work, we (...) also bring it to bear on current disputes in the hopes of clarifying or moving past the issues we face. His thought, in short, has a currency that transcends its historical period. "As we meet new challenges that echo the past," writes Ross Wolin, "Burke's inquiries into meaning, orientation, faction, communication, and rhetoric are as urgent today as when Burke raised them long ago and for decades after."1By bringing the terms of Burke's work to bear on current disputes, we connect him to the vocabularies and discourses that surround us. His thought becomes familiar through the lenses we employ, as we intermix his ideas with our own terminology and see his work through the language of our discussions. One example of this phenomenon is the way scholars have been describing Burke's philosophical outlook. Burke's thought, we are told, is that of a social constructionist. Edward Schiappa, for example, concludes that Burke gives us a view of the world as intersubjectively created: "Our understanding is social in the sense that our concepts are human-made and are part of a shared language. Our understanding is [End Page 130] constructed in the sense that our claims, interpretations, and orientations constitute 'conceptual fabrics' that weave together contingent sets of beliefs and social practices."2 Paul Jay turns the sentiment into a more explicitly epistemological point: "The most radical aspect of Burke's evolving theory of language at this time is his recognition that language—inherently metaphorical—constructs rather than reflects knowledge."3 James Chesebro highlights social constructionism as one of the hallmarks of Burke's dramatism: "For Burke, the realm of symbol-using is unique to the human being. Symbol-using is a solely conventional, arbitrary, and social process. It allows human beings to become self-conscious, create motives independently of physical phenomena, and ultimately to create social constructions of reality."4 Dennis Ciesielski argues that Burke's "terministic screens" define "base reality into truth-systems unique to each respective discourse community and impl[y] a neo-pragmatic, social constructionist pattern for the making of meaning."5 Finally, Robert Wess characterizes Burke's entire career as the evolution from a materialist, biological-essentialist view of the human self to a social constructionist view.6Generally speaking, "social constructionism" is a metaphor that attempts to capture the way Burke viewed the nature of the world and the function of language therein. It suggests that symbols, terms, and language form the building blocks, the bricks and mortar, of the structures of our collective life. We employ symbols that construct our social realities, similar to the way a contractor employs the materials and labor that construct a house. Consequently, the realities we face are not inherent in nature but are built up discursively and can therefore be reconstructed as we alter our discursive practices.7The social construction metaphor positions Burke's philosophical out-look in terms that are familiar to us, though not necessarily familiar to him. That is to say, the label of social constructionist is recent, and it comes not from Burke's work but from intellectual developments after he wrote the bulk of his corpus.8 We apply it to him retroactively, meshing together his intellectual milieu with our own. And as Ian Hacking reminds us, "The phrase has become code. If you use it favorably, you deem yourself rather radical. If you trash the phrase, you declare that you are rational, reasonable, and respectable."9Labeling Burke a social constructionist wraps his thought in a current metaphor, merging his perspective with a vocabulary that was not part of his project. While such a merger is not necessarily a bad thing—to some degree the process is inevitable10—a certain danger... (shrink)

This essay argues that the digitization and proliferation of contemporary screens has moved us from a “screen-scape” to an encompassing “screen-sphere” – a new topologically-bounded and systemically-organized domain that has not only radically changed our lifeworld but also our ontological and epistemological comportment in it. With reference to recent cartoons and other popular discourses as well as to Humberto Maturana and Francesco Varela’s description of, and distinction between, “autonomous” and “autopoietic systems,” the essay speculates on the organizational structure of this (...) new “screen-sphere” and, more significant, our positioning in relation to it. (shrink)

Spinal muscular atrophy (SMA) is the most common genetic disease that causes infant mortality. Its treatment and prevention represent the paradigmatic example of the ethical dilemmas of 21st‐century medicine. New therapies (nusinersen and AVXS‐101) hold the promise of being able to treat, but not cure, the condition. Alternatively, genomic analysis could identify carriers, and carriers could be offered in vitro fertilization and preimplantation genetic diagnosis. In the future, gene editing could prevent the condition at the embryonic stage. How should these (...) different options be evaluated and compared within a health system? In this paper, we discuss the ethical considerations that bear on the question of how to prioritize the different treatments and preventive options for SMA, at a policy level. We argue that despite the tremendous value of what we call ‘ex‐post’ approaches to treating SMA (such as using pharmacological agents or gene therapy), there is a moral imperative to pursue ‘ex‐ante’ interventions (such as carrier screening in combination with prenatal testing and preimplantation genetic diagnosis, or gene editing) to reduce the incidence of SMA. There are moral reasons relating to autonomy, beneficence and justice to prioritize ex‐ante methods over ex‐post methods. (shrink)

With a large number of forcibly displaced people seeking safety, the EU is facing a challenge in maintaining solidarity. Europe has seen millions of asylum seekers crossing European borders, the largest number of asylum seekers since the second world war. Endemic diseases and often failing health systems in their countries of origin, and arduous conditions during transit, raise questions around how to meet the health needs of this vulnerable population on arrival in terms of screening, vaccination, and access to (...) timely and appropriate statutory health services. This paper explores the potential role of the principle of reciprocity, defined as the disposition ‘to return good in proportion to the good we receive, and to make reparations for the harm we have done’, as a mid-level principle in infectious disease screening policies. More than half of the European countries implemented screening programmes for newly arrived asylum seekers. Screening may serve to avoid potential infectious disease risks in the receiving countries as well as help identify health needs of asylum seekers. But screening may infringe upon basic rights of those screened, thus creating an ethical dilemma. The use of the principle of reciprocity can contribute to the identification of potential improvements for current screening programmes and emphasizes the importance of certain rights into guidelines for screening. It may create a two way moral obligation, upon asylum seekers to actively participate in the programme, and upon authorities to reciprocate the asylum seekers’ participation and the benefits for the control of public health. The authors argue that the reciprocity principle leads to a stronger ethical justification of screening programmes and help achieve a balance between justifiable rights claims of the host population and the asylum seekers. The principle deserves a further and more thorough exploration of its potential use in the field of screening, migration and infectious diseases. (shrink)

Providing individuals with the information necessary to make informed decisions is now considered an ethical standard for health systems and general practitioners.

Some children may face some developmental problems in one ormore areas of their developmental milestones. One of them is speech delay. Todate, a screening tool for speech delay early detection among children is stilllacking, especially in Malaysia. Parents do not know where to refer and whichorganisation can help them especially for first-time parents. The objective ofthis paper is twofold. First, this paper analyses existing screening system orapplication for speech delay in children. Second, this paper proposes a mobileapplication (...) designed for Malaysian parents to help them detect speech delayin their children. A qualitative expert review was used to design and build theapplication. The screening application proposed is for early detection and tourge parents to seek for early intervention through appropriate assessments. Inconclusion, early detection in speech delay is critically important to increasethe chances for improving speech and communication skills. Thus, a speechdelay screening tool is needed for parents to seek proper treatment for theirchildren. (shrink)

I present a puzzle about the epistemic role beliefs about experts' beliefs play in a rational agent's system of beliefs. It is shown that accepting the claim that an expert's degree of belief in a proposition, A, screens off the evidential support another proposition, B, gives to A in case the expert knows and is certain about whether B is true, leads in some cases to highly unintuitive conclusions. I suggest a solution to the puzzle according to which evidential (...) screening off is rejected, but show that the price of this solution is either giving up on the mere idea of deferring to expert's opinion or giving up on Bayesian conditionalization. (shrink)

This paper presents a Heideggerian phenomenological analysis of screens. In a world and an epoch where screens pervade a great many aspects of human experience, we submit that phenomenology, much in a traditional methodological form, can provide an interesting and novel basis for our understanding of screens. We ground our analysis in the ontology of Martin Heidegger's Being and Time [1927/1962], claiming that screens will only show themselves as they are if taken as screens-in-the-world. Thus, the phenomenon of screen is (...) not investigated in its empirical form or conceptually. It is rather taken as a grounding intentional orientation that conditions our engagement with certain surfaces as we comport ourselves towards them “as screens.” In doing this we claim to have opened up the phenomenon of screen in a new and meaningful way. (shrink)

The emphasis in human pluripotent stem cell (hPSC) technologies has shifted from cell therapy to in vitro disease modelling and drug screening. This review examines why this shift has occurred, and how current technological limitations might be overcome to fully realise the potential of hPSCs. Details are provided for all disease‐specific human induced pluripotent stem cell lines spanning a dozen dysfunctional organ systems. Phenotype and pharmacology have been examined in only 17 of 63 lines, primarily those that model neurological (...) and cardiac conditions. Drug screening is most advanced in hPSC‐cardiomyocytes. Responses for almost 60 agents include examples of how careful tests in hPSC‐cardiomyocytes have improved on existing in vitro assays, and how these cells have been integrated into high throughput imaging and electrophysiology industrial platforms. Such successes will provide an incentive to overcome bottlenecks in hPSC technology such as improving cell maturity and industrial scalability whilst reducing cost. (shrink)

New-born screening programs for congenital disorders and chronic disease are expanding worldwide and children “at risk” are identified by nationwide tracking systems at the earliest possible stage. These practices are never neutral and raise important social and ethical questions. An emergent concern is that a reflexive professionalism should interrogate the ever earlier interference in children’s lives. The Flemish community of Belgium was among the first to generalize the screening for hearing loss in young children and is an interesting (...) case to study the public justification of early interventions for families with deaf children. This article uses a critical lens to study the archive of the government child healthcare organization in Flanders in order to uncover underlying constructions of childhood, deafness, and preventive health. We focus on two interrelated themes. The first is the notion of exclusion of the human factor through the mediation of technology. The second is the idea of deafness as endangering a healthy development, an impairment that can nevertheless be treated if detected early enough. It is argued that, since deafness cannot be viewed as a life-threatening condition, the public interest which is implicitly defended is not the rescue of deaf children rather the exclusion of otherness. (shrink)

Health policy is increasingly confronted with the demand for financing genetic testing on inherited susceptibility to disease. Tests on polymorphism/snp associated with multicausal and chronic conditions are already offered in private commercial institutions or in academic hospitals. The increasing pressure on public health services to offer SNP testing leads to first methodological approaches for a generally valid regulatory framework applicable for inclusion or refusal of genetic tests into the public health services. Systematic search in Medline, Embase and the Web for (...) methodological papers or guidelines for the assessment of polymorphism-screening. Since genetic testing has not only clinical and economic effects on health care, but also primarily ethical consequences by profiling our understanding of “health” and “disease”, this paper gives an overview of relevant aspects and background information to consider in the assessment of genetic tests. Although 2–3 million SNPs are identified and the journals are full of reported “significant” associations between disease and mutation, only a few can be replicated unequivocally. The ACCE -framework was developed by the Center of Disease Control for the assessment of genetic testing. This standardised appraisal approach proposes collecting and evaluating: Prevalence, genotype-/phenotype-relation. Clinical presentation: natural history; the different expressions of disease. Performance of the genetic test. Implications for therapy and prevention. Conclusion for clinical applications of risk-profiling of health on their susceptibility to disease and/or for clarification of disease for therapy planning. Since genetic testing is urging its way into the health care system, the actual danger is, that population screening starts before valid evidence from big prospective studies have been carried out and delivered proofs of direct causal associations. Before diffusing into the health care system we are suggesting to take a cautious and standardised approach. (shrink)

The main purpose of this essay is to build a taxonomy of screens, inspired by Michel Callon’s and Bruno Latour’s Actor-Network Theory. Five fields are considered. Importing a model from the field of epistemology (1) screens will be seen as lenses; importing a model from the field of fictional narratives (2) screens will be seen as doors; importing a model from the field of art (3) screens will be seen as picture-hanging systems; importing a model from the field of reading (...) (4) screens will be seen as tablets; importing a model from the field of leisure (5) screens will be seen as toys. Combination of two, three, four or even five categories is possible, depending from the “situation” in Erving Goffman’s meaning, i.e., the encounter of a technical apparatus, of a kind of image and of a type of gaze. (shrink)

The yeast two‐hybrid system is a genetic method that detects protein‐protein interactions. One application is the detection by library screening of new interactors of a protein of known function. In the August issue of Nature Genetics, Fromont‐Racine et al.1 showed for the first time that the construction of the protein interaction map of a complex pathway, such as that of the mRNA splicing machinery, is now possible, because of the combination of recent technical improvements elaborated in several laboratories. (...) With a yeast cell mating procedure that increases screen efficiency, they used their complex yeast genomic library of 5 × 106 clones to test 700 × 106 interactions against 15 proteins. They identified and classified 170 potential interactors, including approximately 70 proteins of previously unknown function. More than 25% of the interactors are probably biologically relevant. The achievements of Fromont‐Racine et al. have opened the way to the systematic analysis of the protein interaction networks of the 6,000 open reading frames‐yeast proteome. This task requires, however, automation of the library screens and creation of a two‐hybrid library database. BioEssays 20:1–5, 1998. © 1998 John Wiley & Sons, Inc. (shrink)

New-born screening programs for congenital disorders and chronic disease are expanding worldwide and children “at risk” are identified by nationwide tracking systems at the earliest possible stage. These practices are never neutral and raise important social and ethical questions. An emergent concern is that a reflexive professionalism should interrogate the ever earlier interference in children’s lives. The Flemish community of Belgium was among the first to generalize the screening for hearing loss in young children and is an interesting (...) case to study the public justification of early interventions for families with deaf children. This article uses a critical lens to study the archive of the government child healthcare organization in Flanders in order to uncover underlying constructions of childhood, deafness, and preventive health. We focus on two interrelated themes. The first is the notion of exclusion of the human factor through the mediation of technology. The second is the idea of deafness as endangering a healthy development, an impairment that can nevertheless be treated if detected early enough. It is argued that, since deafness cannot be viewed as a life-threatening condition, the public interest which is implicitly defended is not the rescue of deaf children rather the exclusion of otherness. (shrink)

Technology as a system -- The digital technological system -- The technological structures of perception -- The life and death of the virtual -- Digital ontophany -- The (digital) design of experience.

In lieu of an abstract, here is a brief excerpt of the content:Genetic Testing and Genetic ScreeningPat Milmoe McCarrick (bio)In recent years there has been an enormous expansion in the knowledge that may be gleaned from the testing of an individual's genetic material to predict present or future disability or disease either for oneself or one's offspring. The Human Genome Project, which is currently mapping the entire human gene system, is identifying progressively more genetic sequencing information (see Scope Note (...) 17, The Human Genome Project). Information obtained from genetic testing raises ethical and legal questions about its uses by society. The ethical dilemmas were foreseen two decades ago by bioethicists who asked whether questionable applications could stop "legitimate pursuits" (IV, Gaylin 1972) and whether genetic disease might come to be viewed as "transmissible" in the sense of being contagious (IV, Veatch 1974).Not only has knowledge expanded, but the practice of genetic testing and screening has greatly increased as well. For example, in the case of testing for cystic fibrosis (CF), the U.S. Congress' Office of Technology Assessment (OTA) estimates that instances of screening jumped from 9310 tests in 1991 to 63,000 tests in 1992 (I, OTA [Cystic Fibrosis] 1992). In addition, the OTA estimates that within the next few years, the six million women who become pregnant each year routinely will be informed of available CF carrier tests (I, OTA [Cystic Fibrosis] 1992).Following the recent identification of a gene linked to breast cancer, Dr. Francis Sellers Collins, director of the National Center for Human Genome Research, said that "it is not inconceivable that every woman in America may want to be screened for this gene. The economic, ethical, and counseling issues will be very daunting." Dr. Collins opines that in the near future physical examinations for 18-year-olds will include DNA testing for diseases with genetic components and that physicians, in the interests of preventive medicine, will make risk-based recommendations for a healthy life-style (IV, Breo 1993). The U.S. President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research predicted as early as 1983 that before the end of the century genetic screening and counseling would become major components of both public health and individual medical care (I, U.S. President's Commission 1983). [End Page 333]The OTA defines genetic testing as "the use of specific assays to determine the genetic status of individuals already suspected to be at high risk for a particular inherited condition. The terms genetic test, genetic assay, and genetic analysis are used interchangeably to mean the actual laboratory examination of samples." In contrast, genetic screening usually uses the same assays employed for genetic testing but is distinguished from genetic testing by its target population (I, OTA [Genetic Monitoring] 1990). The National Academy of Sciences (NAS) defines screening as the systematic search of populations for persons with latent, early, or asymptomatic disease (III, NAS 1975). Some of the literature annotated for this Scope Note appears to use the terms "testing" and "screening" interchangeably.Philip Boyle of the Hastings Center points out that the language used to describe genetic variation is important and asks what words should be used: "Defects, flaws, deleterious genes, disorders, or the more neutral conditions? Using words such as normal—and its corollary, abnormal—is likely to foster stigmatization and discrimination" (III, Genetic Grammar, Boyle 1992).Areas of focus in genetic testing include: prenatal diagnosis, newborn screening, carrier screening, forensic screening, and susceptibility screening.Prenatal diagnosis discerns whether a fetus is at risk for various identifiable genetic diseases or traits. Prenatal diagnosis is made using amniotic fluid, fetal cells, and fetal or maternal blood cells obtained during amniocentesis testing; alpha fetoprotein assays or chorionic villus sampling; or ultrasound tomography, which creates fetal images on a screen. Another method, known as fetoscopy, uses a camera on a needle inserted in the uterus to view the fetus. Since prenatal screening began in 1966 (I, U.S. President's Commission 1983), the number of metabolic defects and genetic disorders that can be diagnosed prenatally has expanded greatly. There is also discussion of requiring testing for parents who are participating in an in vitro fertilization program and are at genetic... (shrink)

Africa is a continent in transition amidst a revival of cultural practices. Over previous years the continent was robbed of the benefits of medical advances by unfounded cultural practices surrounding its cultural heritage. In a fast moving field like genetic screening, discussions of social and policy aspects frequently need to take place at an early stage to avoid the dilemma encountered by Western medicine. This paper, examines the potential challenges to genetic screening in Africa. It discusses how cultural (...) practices may affect genetic screening. It views genomics science as a culture which is trying to diffuse into another one. It argues that understanding the existing culture will help the diffusion process. The paper emphasizes the importance of genetic screening for Africa, by assessing the current level of burden of diseases in the continent and shows its role in reducing disease prevalence. The paper identifies and discusses the cultural challenges that are likely to confront genetic screening on the continent, such as the worldview, rituals and taboos, polygyny, culture of son preference and so on. It also discusses cultural practices that may promote the science such as inheritance practices, spouse selection practices and naming patterns. Factors driving the cultural challenges are identified and discussed, such as socialization process, patriarchy, gender, belief system and so on. Finally, the paper discusses the way forward and highlights the ethical considerations of doing genetic screening on the continent. However, the paper also recognizes that African culture is not monolithic and therefore makes a case for exceptions. (shrink)

Introduction: Early recognition of prediabetes may prevent progression to diabetes, yet not all adults are aware of their prediabetes risk. To reach all adults unaware of their risk, additional risk assessment strategies are warranted. Objectives: The objective of this study was to evaluate the potential scope of benefit from prediabetes risk assessment in the dental care setting and to identify characteristics of dental patients likely to unknowingly have prediabetes or diabetes. Methods: Data from 10,472 adults in the National Health and (...) Nutrition Examination Survey from 2013 to 2014 and 2015 to 2016 were analyzed for associations among prediabetes/diabetes risk factors, health care use, and hemoglobin A1C levels according to chi-square tests and multivariate logistic regression. Results: A total of 7.73% of US adults had seen a dentist but not a medical provider in the past 12 mo. The composition of this subpopulation was significantly different from that who saw a medical provider, in ways that might affect their diabetes risk. In addition, 31.27% of this subpopulation would be identified as being at high risk for prediabetes according to the CDC Prediabetes Screening Test, and 15.83% had hemoglobin A1C levels indicative of undiagnosed prediabetes or diabetes. Screening in a dental setting would have the highest odds of identifying someone unaware of his or her diabetes risk among those who were non-White, obese, or ≥45 y old. Conclusion: Extrapolation from this analysis indicates that screening for prediabetes at dental visits has the potential to alert an estimated 22.36 million adults of their risk for prediabetes or diabetes. Incorporating prediabetes or diabetes risk assessment into routine dental visits may enable 1) those with prediabetes to take action to decrease their risk of developing diabetes and 2) those with diabetes to engage in treatment to decrease their risk of diabetes-related complications. Knowledge Transfer Statement: Screening for prediabetes and diabetes during dental visits has the potential to raise patients’ awareness of diabetes risk and prevent prediabetes from progressing to diabetes. For some patients, the dental visit may be the only point of contact with the health care system, which heightens the importance of including diabetes risk assessment for patient well-being. (shrink)

Newborn bloodspot screening programs are some of the longest running population screening programs internationally. Debate continues regarding the need for parents to give consent to having their child screened. Little attention has been paid to how meanings of consent-related terminology vary among stakeholders and the implications of this for practice. We undertook semi-structured interviews with parents, healthcare professionals and policy decision makers in two Canadian provinces. Conceptions of consent-related terms revolved around seven factors within two broad domains, decision-making (...) and information attainment. Decision-making comprised: parent decision authority; voluntariness; parent engagement with decision-making; and the process of enacting choice. Information ascertainment comprised: professional responsibilities ; parent responsibilities; and the need for discussion and understanding prior to a decision. Our findings indicate that consent-related terms are variously understood, with substantive implications for practice. We suggest that consent procedures should be explained descriptively, regardless of approach, so there are clear indications of what is expected of parents and healthcare professionals. Support systems are required both to meet the educational needs of parents and families and to support healthcare professionals in delivering information in a manner in keeping with parent needs. (shrink)

Critical congenital heart disease screening is rapidly becoming the standard of care in the United States after being added to the Recommended Uniform Screening Panel in 2011. Newborn screens typically do not require affirmative parental consent. In fact, most states allow parents to exempt their baby from receiving the required screen on the basis of religious or personally held beliefs. There are many ethical considerations implicated with allowing parents to exempt their child from newborn screening for CCHD. (...) Considerations include the treatment of religious exemptions in our current legal system, as well as medical and ethical principles in relation to the rights of infants. Although there are significant benefits to screening newborns for CCHD, when a parent refuses for religious or personal beliefs, in the case of CCHD screening, the parental decision should stand. (shrink)

Definition of the problem The present article focuses on the current international ethical debate on “responsible implementation” of expanded carrier screening to public healthcare systems. Expanded carrier screening is a novel genetic test which aims to provide information to couples about whether both partners carry a genetic variation for the same recessively inherited condition. It was introduced to the market by commercial laboratories in the U.S. in 2010; since about 2015, however, international debates have emerged on how and (...) why to offer the screening as a public health service. Arguments It is shown that, initially, enhancement of couples’ reproductive autonomy, not prevention of recessive disorders, has been established as the ethically well-founded aim and guiding principle of responsible implementation. Recently, however, in 2019, three well-known Dutch bioethicists argued that this aim has been embraced without much reflection and should therefore be replaced with the guiding principle of “responsible parenthood”. According to the latter, autonomous reproductive decision-making of couples or women is morally acceptable solely when carrier screening is done only during pregnancy. Before pregnancy, by contrast, couples are held to have a moral duty to take preventive measures if their future children are at risk of being affected by one of the “worst” recessive conditions. In the present paper, both of these conflicting ethical framings of expanded carrier screening are critically examined. Conclusions While the aim of reproductive autonomy also has problematic aspects, the notion of “responsible parenthood” is much more objectionable since it challenges voluntary participation in carrier screening, argues for directive genetic counseling, limits reproductive self-determination of women and couples, and introduces dubious concepts to the debate. (shrink)

NCG 4.0 is the latest update of the Network of Cancer Genes, a web-based repository of systems-level properties of cancer genes. In its current version, the database collects information on 537 known (i.e. experimentally supported) and 1463 candidate (i.e. inferred using statistical methods) cancer genes. Candidate cancer genes derive from the manual revision of 67 original publications describing the mutational screening of 3460 human exomes and genomes in 23 different cancer types. For all 2000 cancer genes, duplicability, evolutionary origin, (...) expression, functional annotation, interaction network with other human proteins and with microRNAs are reported. In addition to providing a substantial update of cancer-related information, NCG 4.0 also introduces two new features. The first is the annotation of possible false-positive cancer drivers, defined as candidate cancer genes inferred from large-scale screenings whose association with cancer is likely to be spurious. The second is the description of the systems-level properties of 64 human microRNAs that are causally involved in cancer progression (oncomiRs). Owing to the manual revision of all information, NCG 4.0 constitutes a complete and reliable resource on human coding and non-coding genes whose deregulation drives cancer onset and/or progression. NCG 4.0 can also be downloaded as a free application for Android smart phones. (shrink)

This article follows a previous study that has recently been published in Narrare I Gruppi and explored the reasons for the large numeric gap between the regions of the North and South of Italy, referring to the breast cancer screening program adherence rate sponsored by the Italian Healthcare System, that addresses all women living in Italy ranging in age between 48 and 69 years, and proposes a free mammogram every two years. The effectiveness of cancer early detections has (...) been widely demonstrated by medical research; this kind of diagnosis is particularly important in the case of breast cancer. A diagnosis of this form of cancer at its early phases in 97% of cases allows women to survive at least five years after it. However, the different level of trust women feel for healthcare structures is the discriminating element between the North and South of Italy for their access to the screening program. This topic will be thoroughly analyzed by presenting the results of research aimed at evaluating the mean... (shrink)

The hypothesis that administering a diagnostic test to an asymptomatic population can detect a relevant proportion of prevalent cases in an early phase and therefore improve the chances of curing disease dates back to the sixties and has been tested and applied mainly to neoplastic diseases. Meanwhile, the practice of screening has benefitted from the progress of diagnostic technology and from the development, particularly in Europe, of efficient national health systems.Half a century later, two Swedish researchers, Niklas Juth and (...) Christian Munthe, undertake the task of reexamining various aspects of screening practices in light of the ethical justification of this secondary prevention tool. Their analysis encompasses all public health actions in which the personal benefit is contrasted with collective health considerations. Screening generates such doubts and conflicts, which are inherently ethical.The publication could be split in two parts. The first is a long section, mainly infor .. (shrink)

Persuasive technologies are interactive systems designed to change and shape users’ behaviours towards specific goals. By discussing the case of screen-time management applications, this paper explores how persuasive systems transform self-awareness and the self’s cognitive architecture. Drawing on the notion of tectonoetic awareness, I will illustrate how artefacts enable the transition from the temporal bounded experience characterizing first-person perspective (noetic awareness) to the ability of reflecting on oneself from a third person and temporally extended perspective (autonoetic awareness). I will argue (...) that persuasive systems make possible new modalities of self-recognition and self-projection while they simultaneously affect the sense of agency by interfering with users’ actions and intentions. (shrink)

The introduction of non-invasive prenatal testing in healthcare systems around the world offers an opportunity to reconsider funding policies for prenatal screening. In some countries with universal access healthcare systems, pregnant women and their partners are asked to pay for NIPT. In this paper, we discuss two important rationales for charging women for NIPT: to prevent increased uptake of NIPT and to promote informed choice. First, given the aim of prenatal screening, high or low uptake rates are not (...) intrinsically desirable or undesirable. Using funding policies to negatively affect uptake, however, is at odds with the aim of screening. Furthermore, copayment disproportionally affects those of lower socioeconomic status, which conflicts with justice requirements and impedes equal access to prenatal screening. Second, we argue that although payment models may influence pregnant women’s choice behaviours and perceptions of the relevance of NIPT, the copayment requirement does not necessarily lead to better-informed choices. On the contrary, external influences on women’s personal choices for or against prenatal screening should ideally be avoided. To improve informed decision-making, healthcare systems should instead invest in adequate non-directive, value-focused pretest counselling. This paper concludes that requiring copayments for NIPT in universal access healthcare systems fails to promote reproductive autonomy and is unfair. (shrink)

Large-screen human-computer interaction technology is reflected in all aspects of daily life. The dynamic gesture tracking algorithm commonly used in recent large-screen interactive technologies demonstrates compelling results but suffers from accuracy and real-time problems. This paper systematically addresses these issues by a switching federated filter method that combines particle filtering and Mean Shifting algorithms based on a 3D sensor. Compared with several algorithms, the results show that the one-hand and two-hand large-screen gesture tracking based on the switched federated filtering algorithm (...) work well, and there is no tracking failure and loss of target. Therefore, the switching federated tracking positioning algorithm can be well applied to the design of human-computer interaction system and provide new ideas for future human-computer interaction. (shrink)

If I told you that screening technologies are iteratively transforming how people experience pregnancy and early parenting, you might take notice. If I mentioned that a new class of newborn patients was being created and that particular forms of parental vigilance were emerging, you might want to know more. If I described how the particular stories told about screening in public, combined with parents’ fierce commitment to safeguarding their children’s health, make it difficult for problematic experiences with (...) class='Hi'>screening to translate into negative opinions about it, you would most likely be intrigued. An extensive qualitative literature documents all these social phenomena, and more, in connection with the spread of prenatal and newborn screening. So why is it, then, that commentators frequently assert that the predicted psychosocial impact of increased screening and testing associated with “the genomic revolution” has been far less severe and worthy of attention than predicted? How can or should social science “evidence” that sits outside adopted measurement conventions be considered? Why is it that summary statements about the psychosocial impact of genomic information often ignore qualitative evidence, or sideline it as relevant only for improving communication among patients, clinicians, and public health systems? This essay addresses such questions, using qualitative research on prenatal and newborn screening as a case study for illustrating the broad methodological, ideological, and dialogical issues at stake. (shrink)

I support Pylyshyn's skepticism that visual imagery reflects a re-activation of the spatial layout of active neurons embedded within a topographical cortical map of visual space. The pickup of visual information via successive eye movements presents one problem and the two visual systems model poses another difficulty.

Since the 1990s, glycated haemoglobin (HbA1C) has been the gold standard for monitoring glycaemic control in people diagnosed as having either type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM). Discussions are underway about diagnosing diabetes mellitus on the basis of HbA1C titres and using HbA1C tests to screen for T2DM. These discussions have focused on the relative benefits for individual patients, with some attention directed towards reduced costs to healthcare systems and benefits to society. We argue that (...) there are strong ethical reasons for adopting HbA1C-based diagnosis and T2DM screening that have not yet been articulated. The rationale includes the differential impact of HbA1C-based diabetic testing on disadvantaged groups, and what we are beginning to learn about HbA1C vis-à-vis population health. Although it is arguable that screening must primarily benefit the individual, using HbA1C to diagnose and screen for T2DM may promote a more just distribution of health resources and lead to advances in investigating, monitoring and tackling the social determinants of health. (shrink)

According to Reichenbach’s principle of common cause, positive statistical correlations for which no straightforward causal explanation is available should be explained by invoking the action of a hidden conjunctive common cause. Hofer-Szabó and Rédei’s notion of a Reichenbachian common cause system is meant to generalize Reichenbach’s conjunctive fork model to fit those cases in which two or more common causes cooperate in order to produce a positive statistical correlation. Such a generalization is proved to be unsatisfactory in the light (...) of a probabilistic conception of causation. Accordingly, an alternative model for systems of multiple common causes is offered, which is capable of emulating the explanatory efficacy of Reichenbachian common cause systems, while overcoming their major conceptual shortcomings at the same time. (shrink)

In the USA, there are missed opportunities to diagnose hepatitis C virus in pregnancy because screening is currently risk-stratified and thus primarily limited to individuals who disclose history of injection drug use or sexually transmitted infection risks. Over the past decade, the opioid epidemic has dramatically increased incidence of HCV and a feasible, well-tolerated cure was introduced. Considering these developments, recent evidence suggests universal HCV screening in pregnancy would be cost-effective and several professional organisations have called for updated (...) national policy. Historically, universal screening has been financially disincentivised on the healthcare system level, particularly since new diagnoses may generate an obligation to provide expensive treatments to a population largely reliant on public health resources. Here, we provide ethical arguments supporting universal HCV screening in pregnancy grounded in obligations to respect for persons, beneficence and justice. First, universal prenatal HCV screening respects pregnant women as persons by promoting their long-term health outside of pregnancy. Additionally, universal screening would optimise health outcomes within current treatment guidelines and may support research on treatment during pregnancy. Finally, universal screening would avoid potential harms of risk-stratifying pregnant women by highly stigmatised substance use and sexual behaviours. (shrink)

The principle of common cause asserts that positive correlations between causally unrelated events ought to be explained through the action of some shared causal factors. Reichenbachian common cause systems are probabilistic structures aimed at accounting for cases where correlations of the aforesaid sort cannot be explained through the action of a single common cause. The existence of Reichenbachian common cause systems of arbitrary finite size for each pair of non-causally correlated events was allegedly demonstrated by Hofer-Szabó and Rédei in 2006. (...) This paper shows that their proof is logically deficient, and we propose an improved proof. (shrink)

Alternative cleavage and polyadenylation (APA) can diversify coding and non‐coding regions, but has particular impact on increasing 3′ UTR diversity. Through the gain or loss of regulatory elements such as RNA binding protein and microRNA sites, APA can influence transcript stability, localization, and translational efficiency. Strikingly, the central nervous systems of invertebrate and vertebrate species express a broad range of transcript isoforms bearing extended 3′ UTRs. The molecular mechanism that permits proximal 3′ end bypass in neurons is mysterious, and only (...) beginning to be elucidated. This landscape of neural 3′ UTR extensions, many reaching unprecedented lengths, may help service the unique post‐transcriptional regulatory needs of neurons. A combination of approaches, including transcriptome‐wide profiling, genetic screening to identify APA factors, biochemical dissection of alternative 3′ end formation, and manipulation of individual neural APA targets, will be necessary to gain fuller perspectives on the mechanism and biology of neural‐specific 3′ UTR lengthening. (shrink)

This paper examines the nature of model-based reasoning in the interplay between theory and experiment in the context of biomedical engineering research laboratories, where problem solving involves using physical models. These "model systems" are sites of experimentation where in vitro models are used to screen, control, and simulate specific aspects of in vivo phenomena. As with all models, simulation devices are idealized representations, but they are also systems themselves, possessing engineering constraints. Drawing on research in contemporary cognitive science that construes (...) cognition as occurring in a complex distributed system comprising people and artifacts, I argue that reasoning with model systems is a constraint satisfaction process involving co-construction, manipulation, and revision of mental and physical models. (shrink)

The understanding of emergent, self-organizing phenomena has been immensely deepened in recent years on the basis of simulation-based theoretical research. We discuss these new ideas, and illustrate them using examples from several fields. Our discussion serves to introduce equivalent self-organized phenomena in social interaction. Interaction systems appear to be structured partly by virtue of such emergents. These appear under specific conditions: When cognitive buffering is inadequate relative to the levels of stress persons are subjected to, anxiety-spreading has the potential of (...) pushing their interaction into nonlinear conditions. Arousal in these conditions produces effects on behavior arising from biological sources-indeed, behavior can come under the control of reflex patterns. When this occurs, psychological activity no longer screens off biological controls over behavior. As the direct effects of biological activity spill into interaction, attachment behavior introduced into an interaction system can produce effects that are transmitted beyond dyads to produce global social patterns. These effects illustrate how strong interactions based in biological activity can produce an architecture for social systems. (shrink)

This paper examines potential ethical and legal issues arising during the research, develop- ment and clinical use of a proposed strategy in personalized medicine (PM): using human induced pluripotent stem cell (iPSC)-derived tissue cultures as predictive models of individ- ual patients to inform treatment decisions. We focus on epilepsy treatment as a likely early application of this strategy, for which early-stage stage research is underway. In relation to the research process, we examine issues associated with biological samples; data; health; vulnerable (...) populations; neural organoids; and what level of accuracy justifies using the iPSC-derived neural tissue system. In relation to clinical use, we examine potential uses in pre-natal screening, and effects on clinical decision-making. Although our focus is providing recommendations for researchers developing work in this area, we identify the novel issue of deciding on an acceptable accuracy level for the system. We also emphasize an issue thus far neglected in the ethics of PM: PM tends to represent treatment decisions as though they should be directed solely by biomedical information, but this in itself could be detri- mental to best personalizing treatment decisions in the clinic. (shrink)