Delivering high quality genomics-informed care to patients requires accurate test results whose clinical implications are understood. While other actors, including state agencies, professional organizations, and clinicians, are involved, this article focuses on the extent to which the federal agencies that play the most prominent roles — the Centers for Medicare and Medicaid Services enforcing CLIA and the FDA — effectively ensure that these elements are met and concludes by suggesting possible ways to improve their oversight of genomic testing.

Peer review is a widely accepted instrument for raising the quality of science. Peer review limits the enormous unstructured influx of information and the sheer amount of dubious data, which in its absence would plunge science into chaos. In particular, peer review offers the benefit of eliminating papers that suffer from poor craftsmanship or methodological shortcomings, especially in the experimental sciences. However, we believe that peer review is not always appropriate for the evaluation of controversial hypothetical science. We argue that (...) the process of peer review can be prone to bias towards ideas that affirm the prior convictions of reviewers and against innovation and radical new ideas. Innovative hypotheses are thus highly vulnerable to being “filtered out” or made to accord with conventional wisdom by the peer review process. Consequently, having introduced peer review, the Elsevier journal Medical Hypotheses may be unable to continue its tradition as a radical journal allowing discussion of improbable or unconventional ideas. Hence we conclude by asking the publisher to consider re-introducing the system of editorial review to Medical Hypotheses. (shrink)

The success of deep brain stimulation (DBS) for movement disorders and the improved understanding of the neurobiologic and neuroanatomic bases of psychiatric diseases have led to proposals to expand current DBS applications. Recent preclinical and clinical work with Alzheimer's disease and obsessive-compulsive disorder, for example, supports the safety of stimulating regions in the hypothalamus and nucleus accumbens in humans. These regions are known to be involved in addiction and overeating associated with obesity. However, the use of DBS targeting these areas (...) as a treatment modality raises common ethical considerations, which include informed consent, coercion, enhancement, threat to personhood, and manipulation of the reward center. Pilot studies for both of these conditions are currently investigational. If these studies show promise, then there is a need to address the ethical concerns related to the initiation of clinical trials including the reliability of preclinical evidence, patient selection, study design, compensation for participation and injury, cost-effectiveness, and the need for long-term follow-up. Multidisciplinary teams are necessary for the ethical execution of such studies. In addition to establishing safety and efficacy, the consideration of these ethical issues is vital to the adoption of DBS as a treatment for these conditions. We offer suggestions about the pursuit of future clinical trials of DBS for the treatment of addiction and overeating associated with obesity and provide a framework for addressing ethical concerns related to treatment. (shrink)

Alexis de Tocqueville asserted that America had no truly great literature, and that American writers merely mimicked the British and European traditions of the eighteenth and nineteenth centuries. This new edited collection masterfully refutes Tocqueville's monocultural myopia and reveals the distinctive role American poetry and prose have played in reflecting and passing judgment upon the core values of American democracy. The essays, profiling the work of Mark Twain, F. Scott Fitzgerald, John Updike, Edith Wharton, Walt Whitman, Henry James, Willa Cather, (...) Walker Percy, and Tom Wolfe, reveal how America's greatest writers have acted as society's most ardent cheerleaders and its most penetrating critics. Christine Dunn Henderson's exciting new work offers literature as a portal through which to view the philosophical principles that animate America's political order and the mores which either reinforce or undermine them. (shrink)

This paper argues that the current discourse on epistemic injustice in social epistemology itself perpetuates epistemic injustice, namely hermeneutic injustice with regards to class and classism. The main reason is that debates on epistemic injustice have foremost focussed on issues related to gender, race, and disability while mostly ignoring class issues. I suggest that this is due to (largely unwarranted) fears about looming class reductionism. More importantly, this is omission is not innocuous, but problematic insofar as it has an unlikely (...) ally in neoliberal propaganda which features as one main goal stifling class consciousness. While this “allyship” is unwitting, this presents grounds for the discourse of epistemic injustice to consider re-centring class issues and classism. (shrink)

This paper argues that the current discourse on epistemic injustice in social epistemology itself perpetuates epistemic injustice, namely hermeneutic injustice with regards to class and classism. The main reason is that debates on epistemic injustice have foremost focussed on issues related to gender, race, and disability while mostly ignoring class issues. I suggest that this is due to (largely unwarranted) fears about looming class reductionism. More importantly, this is omission is not innocuous, but problematic insofar as it has an unlikely (...) ally in neoliberal propaganda which features as one main goal stifling class consciousness. While this “allyship” is unwitting, this presents grounds for the discourse of epistemic injustice to consider re-centring class issues and classism. (shrink)

Some video games are said to be philosophical. Despite video games having received some attention in academic philosophy, that contention has not been sufficiently addressed. This paper investigates in what sense video games might be properly called “philosophical”. To this end, I utilize Wittgenstein’s distinction between saying and showing to get into view how some video games might be properly called philosophical. This leads to two senses of being philosophical: a conventional sense of expressing philosophy through propositions, i.e., through saying, (...) and a sense of being genuinely philosophical by expressing philosophical thought through showing. I argue that the conventional sense is not sufficient to call video games philosophical, leaving the question whether there are video games which satisfy the conditions of being genuinely philosophical. I furthermore contend that there are at least some examples of video games which qualify as being philosophical, e.g., Papers, Please and The Stanley Parable. (shrink)

While shame and embarrassment have received significant attention in philosophy and psychology, cringe (also sometimes called ‘vicarious embarrassment’ and ‘vicarious shame’) has received little thought. This is surprising as the relatively new genre of cringe comedy has seen a meteoric rise since the early 2000s. In this paper, I aim to offer a novel characterization of cringe as a hostile social emotion which turns out to be closer to disgust and horror than to shame or embarrassment, thus disclosing ‘vicarious shame’ (...) and ‘vicarious embarrassment’ to be misnomers. The closing part offers an explanation as to why cringe and cringe comedy in particular have become recently more relevant: cringe allows one to express hostility and disgust (often at other forms of life) in a nonviolent manner which fits perfectly well within the permissible boundaries of tolerance set up in liberal Western democracies since the second half of the 20th century. (shrink)

Two opposed movements of thought threaten philosophy as an autonomous practice from the inside: scientific naturalism and quietism. Naturalism (qua methodological thesis) threatens to turn philosophy into a mere ancilla of the sciences, quietism understood as the prescription to remain silent in philosophy would not countenance any more "positive" philosophy. This book reconstructs naturalism and quietism such that it becomes clear naturalism does have the potential to end philosophy as an autonomous practice and that quietism, correctly understood, does not. To (...) this end, this book provides arguments against the prevailing orthodox status of naturalism and a heterogenous reading of Wittgenstein's metaphilosophical quietism as the rejection of a certain kind of theories in philosophy, namely quasi-scientific theories. (shrink)

Students of culture have been increasingly concerned with the ways in which cultural values are 'inscribed' on the body. These essays go beyond this passive construal of the body to a position in which embodiment is understood as the existential condition of cultural life. From this standpoint embodiment is reducible neither to representations of the body, to the body as an objectification of power, to the body as a physical entity or biological organism, nor to the body as an inalienable (...) centre of individual consciousness. This more sensate and dynamic view is applied by the contributors to a variety of topics, including the expression of emotion, the experience of pain, ritual healing, dietary customs, and political violence. Their purpose is to contribute to a phenomenological theory of culture and self - an anthropology that is not merely about the body, but from the body. (shrink)

BSTRACT Frantz Fanon’s works have been invaluable in the analysis of colonies and the colonized subject’s mentality therein, but an analysis of the colonial power itself has been largely left to the wayside. The aim of this paper is to explicate a key element of Fanon’s theoretical framework, the metropolis/periphery dichotomy, then, using the writings of Huey P. Newton and Stokely Carmichael, among others, show its reversal within the colonial power. I will analyze this reversal in three ways: first, the (...) reversal of the relationship between, and the roles of, the metropolis and periphery; second, the role of police and the differences between the colonial police and the police within the colonial power; and third, the modified role of prisons within the colonial power. (shrink)

This volume contains work by the very best young scholars working in Applied Ethics, gathering a range of new perspectives and thoughts on highly relevant topics, such as the environment, animals, computers, freedom of speech, human enhancement, war and poverty. For researchers and students working in or around this fascinating area of the discipline, the volume will provide a unique snapshot of where the cutting-edge work in the field is currently engaged and where it's headed.

This essay explores how the scientific community interpreted the discoveries of extinct giant birds during the mid-nineteenth century on the islands of New Zealand and Madagascar. It argues that the Aepyornis of Madagascar was understood through the moa of New Zealand because of the rise of global networks and theories. Indeed, their global connections made giant birds a sensation among the scientific community and together forged theories and associations not possible in isolation. In this way, this paper argues for a (...) closer look at how the creation of science emerged from a world framework that involved multiple sites of discovery and interpretation that continually influenced and reshaped scientific theories. It also stresses the importance of local naturalists in participating in this global exchange of knowledge. (shrink)

It was William Blake's insight that the Christian churches, by inverting the Incarnation and the dialectical vision of Paul, have repressed the body, divided God from creation, substituted judgment for grace, and repudiated imagination, compassion, and the original apocalyptic faith of early Christianity. Blake's prophetic poetry thus contributes to the renewal of Christian ethics by a process of subversion and negation of Christian moral, ecclesiastical, and theological traditions, which are recognized precisely as inversions of Jesus, and therefore as instances of (...) the forms of evil that God-in-Christ overcomes through Incarnation, reversing the Fall. Blake's great epic poems, particularly Milton (1804–08) and Jerusalem (1804–20), embody his heterodox representation of the final coincidence of Christ and Satan through which, at last, all things are made new. (shrink)

Plural predication is a pervasive part of ordinary language. We can say that some people are fifty in number, are surrounding a building, come from many countries, and are classmates. These predicates can be true of some people without being true of any one of them; they are non-distributive predications. However, the apparatus of modern logic does not allow a place for them. Thomas McKay here explores the enrichment of logic with non-distributive plural predication and quantification. His book will (...) be of great interest to philosophers of language, linguists, metaphysicians, and logicians. (shrink)

Frantz Fanon’s works have been invaluable in the analysis of colonies and the colonized subject’s mentality therein, but an analysis of the colonial power itself has been largely left to the wayside. The aim of this paper is to explicate a key element of Fanon’s theoretical framework, the metropolis/periphery dichotomy, then, using the writings of Huey P. Newton and Stokely Carmichael, among others, show its reversal within the colonial power. I will analyze this reversal in three ways: first, the reversal (...) of the relationship between, and the roles of, the metropolis and periphery; second, the role of police and the differences between the colonial police and the police within the colonial power; and third, the modified role of prisons within the colonial power. (shrink)

This paper describes issues associated with integrating the study of Ethical, Legal and Social Issues (ELSI) into ongoing scientific and technical research and describes an approach adopted by the authors for their own work with the center for nanophase materials sciences (CNMS) at the Oak Ridge national laboratory (ORNL). Four key questions are considered: (a) What is ELSI and how should it identify and address topics of interest for the CNMS? (b) What advantages accrue to incorporating ELSI into the CNMS? (...) (c) How should the integration of ELSI into the CNMS take place? (d) How should one judge the effectiveness of the activity? We conclude that ELSI research is not a monolithic body of knowledge, but should be adapted to the question at hand. Our approach focuses on junctures in the R&D continuum at which key decisions occur, avoids topics of a purely ethical nature or advocacy, and seeks to gather data in ways that permit testing the validity of generalization. Integrating ELSI into the CNMS allows dealing with topics firmly grounded in science, offers concrete examples of potential downstream applications and provides access to the scientists using the CNMS and their insights and observations. As well, integration provides the opportunity for R&D managers to benefit from ELSI insights and the potential to modify R&D agendas. Successful integration is dependent on the particular ELSI question set that drives the project. In this case questions sought to identify key choices, information of value to scientists, institutional attributes, key attributes of the CNMS culture, and alternatives for communicating results. The opportunity to consult with scientists on ELSI implications is offered, but not promoted. Finally, ELSI effectiveness is judged by observing the use to which research products are put within the CNMS, ORNL, and the community of external scholars. (shrink)

Researches over many years have examined whether levonorgestrel emergency contraception has a postfertilization effect. In a recent article in the Catholic Health Association’s journal Health Progress, Sandra Reznik, MD, asserts that “levonorgestrel acts to prevent pregnancy before, and only before, fertilization occurs.” A companion article by Ron Hamel, PhD, argues for the moral certainty that Plan B is not an abortifacient. Reznik fails to address the principal model supporting a potential postfertil­ization mechanism of action, specifically, that preovulatory administration of levonorgestrel (...) disrupts the delicate ratio of estrogen and progesterone essential to healthy endometrial development and induces the equivalent of luteal phase insufficiency, thereby jeopardizing implantation. Hamel’s argument for moral certitude is similarly inadequate. This article critically reviews both articles and the sources on which they rely. National Catholic Bioethics Quarterly 10.4 : 741–772. (shrink)

Formal logic may be an inappropriate framework for understanding perception. The responses of neurons at various levels of the sensory hierarchy may be better described in terms of probability than logic. Analysis and modeling of the multisensory responses of neurons in the midbrain provide a case study.

Encounters with Alphonso Lingis is the first extensive study of this American philosopher who is gaining an international reputation to augment his national one. The distinguished contributors to this volume address most of the central themes found in Lingis's writings—including singularity and otherness, death and eroticism, emotions and rationality, embodiment and the face, excess and the sacred. The book closes with a new essay by Lingis himself.

I wish here to outline a new methodology for the history of philosophy, which is inspired from the practice of scholarship on Wittgenstein; I will call it “selective interpretation.” It is a method by which an historical figure is read so as to make any philosopher sound like they completely agree with one’s own personal stand on philosophical issues. First, I seek to systematize a set of rules which will aid one in reading the text any damn way one pleases. (...) The next section lays out these rules, outlining the necessary tools to read any text exactly as you want it to read. In the rest of the paper, I plan to give a few specific examples of selective interpretation of the early Wittgenstein: reading the Tractatus so that it sounds like David Hume, Immanuel Kant and Arthur Schopenhauer, respectively. I hope that my analysis here will be therapeutic to Wittgenstein scholars. And I hope also to help other historians of philosophy come to understand this daring methodological proposal. (shrink)

There is a close conceptual relation between the notions of religious disenchantment and scientific naturalism. One way of resisting philosophical and cultural implications of the scientific image and the subsequent process of disenchantment can be found in attempts at sketching a reenchanted worldview. The main issue of accounts of reenchantment can be a rejection of scientific results in a way that flies in the face of good reason. Opposed to such reenchantment is scientific naturalism which implies an entirely disenchanted worldview. (...) However, one of the main problems of scientific naturalism are placement problems. A reenchanted worldview does have the conceptual resources to avoid placement problems, yet seems to throw out the baby with the bathwater. A dilemma results: the Scylla of an undesirable scientific naturalism and the Charybdis of a rampant, seemingly prescientific reenchanted worldview. In this article I argue that there is a safe middle passage between these two options, i.e. the recently proposed liberal naturalism which allows for a moderate normative reenchantment. Liberal naturalism lets us have it both ways: avoiding the placement problems while retaining a necessary and reasonable adherence to science, thereby avoiding both an all-too restrictive scientific naturalism. (shrink)

Henri de Lubac's treatment of the relationship between nature and grace helped the Catholic Church to move beyond the antagonisms that had defined its relationship with the modern nation-state. In critiquing de Lubac, some recent scholarship has presented an interpretation of Aquinas that is remarkably similar to the problems associated with the neo-Scholastic method. These approaches indicate that in order for late modern democratic states to achieve their connatural ends of justice and the common good, they must directly advert to (...) revealed knowledge and Church teaching. This essay proposes an alternative correction to de Lubac that both maintains a distinction between nature and grace and facilitates a capacity for Christians to engage in a nuanced dialogue of affirmation and critique of the human goods sought by late modern political and legal institutions. In the conclusion, this nature-grace distinction is used to analyze the way the US Catholic Bishops have engaged in moral, political, and legal debates over the Patient Protection and Affordable Care Act. (shrink)

The Ethics Code of the American Psychological Association is a bedrock of the profession. The contextual factors of society affect the Ethics Code of the APA, resulting in an ever-changing document. The context of the reorganization of the APA after World War II created an initial impetus toward a formalized code. A key contextual feature of the Code's development was the use of the Critical Incident Technique, which was based in the empirical aspirations of the psychological field. This article explores (...) the historical context around the APA's decision to draft an ethics code, reviews its development, and discusses its role for psychologists today. (shrink)

Lookism refers to discrimination based on physical attractiveness or the lack thereof. A whole host of empirical research suggests that lookism is a pervasive and systematic form of social discrimination. Yet, apart from some attention in ethics and political philosophy, lookism has been almost wholly overlooked in philosophy in general and epistemology in particular. This is particularly salient when compared to other forms of discrimination based on race or gender which have been at the forefront of epistemic injustice as a (...) topic of research. This paper argues that lookism is associated with various forms of epistemic injustice. In the specific case of lookism, hermeneutic injustice takes the shape of the taboo of acknowledging that unattractive people are unattractive. This, on the one hand, results in a hampered understanding of one’s own situation insofar as one is deterred from seeing one’s looks as one major factor for one’s social position. On the other hand, this hermeneutic injustice serves as the backdrop of instances of a special kind testimonial injustice in which the ugly person’s burgeoning realization that their looks influence their social standing detrimentally is discounted due to the pejorative nature of ascribing someone the property of being unattractive or ugly. (shrink)