How children seek knowledge and evaluate claims may depend on their understanding of the source of knowledge. What shifts in their understandings about why scientists might disagree and how claims about the state of the world are justified? Until about the age of 41/2, knowledge is seen as self-evident. Children believe that knowledge of reality comes directly through our senses and what others tell us. They appeal to these external sources in order to know. The attainment of Theory of Mind (...) (ToM) at this age is commonly seen as the significant shift in development in understanding disagreements in knowledge claims. Children attaining ToM understand that someone exposed to incorrect or incomplete information might have false beliefs. Disagreement, then, is still attributed to objective sources of knowledge. The current study examines the later developing Interpretive Theory of Mind (iToM) as the basis for children’s understanding of how people with access to the same information might disagree and what this means for how to provide justification for a knowledge claim. Fourteen 2nd graders with the most iToM responses to four tasks and 14 with the fewest iToM responses were selected from a larger sample of 91. In analyses of interviews about a story in which two experts make different claims about a scientific phenomenon, those in the high iToM group noted subjective perspective and processes as the source of disagreement and suggested the need for investigation as the means to knowing. In contrast, those in the low iToM group mostly could not explain the source of disagreement and held that knowledge is acquired from external sources. A comparison of the interviews regarding the science story 2 years later allows for a qualitative description of the development. Those in the low iToM group showed more general recognition of subjective and constructive processes in knowing whereas those in the high iToM group identified interpretive processes and the relativity of perspectives with implications for how observations were conducted and interpreted. Only those in the high iToM group referred to the importance of evidence as a basis for knowledge claims at either point in the study. (shrink)

Unlike most Western nations, Israel does not recognize full separation of church and state but seeks instead a gentle fusion of Jewish and democratic values. Inasmuch as important religious norms such as sanctity of life may clash with dignity, privacy, and self-determination, conflicts frequently arise as Israeli lawmakers, ethicists, and healthcare professionals attempt to give substance to the idea of a Jewish-democratic state. Emerging issues in Israeli bioethics—end-of-life treatment, fertility, genetic research, and medical ethics during armed conflict—highlight this conflict (...) vividly. (shrink)

Recently in Israel, a woman was mistakenly implanted with an embryo that is genetically related to another couple. Unfortunately, this case is not an isolated occurrence, as other cases of embryo mix-ups have been reported in several countries, including the USA, China, the UK and various other countries within the European Union. Cases of mixed-up embryos are ethically and legally complex: the woman who carried the pregnancy and the woman who is genetically related to the resulting child—both of whom (...) endured emotionally and physically demanding infertility treatments—along with their partners, may be unwilling to relinquish parental rights over the child.This article explores four possible approaches, found in numerous common law jurisdictions, which can be used to address cases involving embryo mix-ups. Our analysis reveals several avenues through which legal parentage can be established. It can be done through gestation and the marital presumption, genetic connections, by adhering to the principle of the best interests of the child, or by recognising multiple individuals as legal parents. We review the advantages and disadvantages of each approach, but we have one clear recommendation: resolving embryo mix-up cases should be done proactively through the establishment of legislation and guidelines, rather than relying on post hoc individual court decisions. Such legislation and guidelines should guarantee the consistency of values throughout diverse reproductive contexts and mandate that fertility clinics and medical professionals provide individuals with comprehensive information regarding the potential risks associated with assisted reproductive treatments. (shrink)

In an Israeli qualitative study with adolescent cancer survivors and parents who had considered fertility preservation, practically all participants could not recall any discussions with healthcare providers about plans for cryopreserved biological materials in the case of death. This finding is surprising given recent court struggles in Israel over the posthumous use of cryopreserved sperm. In interviews with these adolescent survivors and their parents, intended future use of cryopreserved biological materials is directed for affected individuals’ reproductive purposes later in (...) life, with hardly any consideration of others' use of these materials for posthumous reproduction. To avoid future ethical and legal quagmires, healthcare professionals should have frank discussions with adolescents and their parents about what to do with such materials in the case of death. This paper discusses the socio-cultural and legal Israeli context and considers the ethical implications of using minors’ biological materials for posthumous assisted reproduction in Israel. (shrink)

This paper opens a critical conversation about the ethics of international bioethics conferencing and proposes principles that commit to being anti-discriminatory, global, and inclusive. We launch this conversation in the Section, Case Study, with a case example involving the International Association of Bioethics’ (IAB’s) selection of Qatar to host the 2024 World Congress of Bioethics. IAB’s choice of Qatar sparked controversy. We believe it also may reveal deeper issues of Islamophobia in bioethics. The Section, Principles for International Bioethics Conferencing, sets (...) forth and defends proposed principles for international bioethics conferencing. The Section, Applying Principles to Site Selection applies the proposed principles to the case example. The Section, Applying Principles Beyond Site Selection addresses other applications of the proposed principles. The Section, Objections responds to objections. We close (in the Section, Conclusion) by calling for a wider discussion of our proposed principles.One-Sentence Capsule Summary: How should bioethicists navigate the ethics of global bioethics conferencing? (shrink)

The boldest and most unsettling of the major early modern philosophers, Spinoza, had a much greater, if often concealed, impact on the international intellectual scene and on the early Enlightenment than philosophers, historians, and political theorists have conventionally tended to recognize. Europe-wide efforts to prevent the reading public and university students learning about Spinoza, the man and his work, in the years immediately after his death in 1677, dominated much of his early reception owing to the revolutionary implications of his (...) thought for philosophy, religion, practical ethics and lifestyle, Bible criticism, and political theory. Nevertheless, contrary to what has sometimes been maintained, his general impact was immediate, very widespread, and profound. One of the main objectives of the book is to show how early and how deeply Leibniz, Bayle, Arnauld, Henry More, Anne Conway, Richard Baxter, Robert Boyle, Henry Oldenburg, Pierre-Daniel Huet, Richard Simon, and Nicholas Steno, among many others, were affected by and led to wrestle with his principal ideas. (shrink)

Mitochondrial replacement therapy (MRT), also called nuclear genome transfer and mitochondrial donation, is a new technique that can be used to prevent the transmission of mitochondrial DNA diseases. Apart from the United Kingdom, the first country to approve MRT in 2015, Australia became the second country with a clear regulatory path for the clinical applications of this technique in 2021. The rapidly evolving clinical landscape of MRT makes the elaboration and evaluation of the responsible use of this technology a pressing (...) matter. As jurisdictions with less strict or non-existent reproductive laws are continuing to use MRT in the clinical context, the need to address the underlying ethical issues surrounding MRT’s clinical translation is fundamental. (shrink)

Investigators and institutional review boards should integrate plans about the appropriate disclosure of individual genetic results when designing research studies. The ethical principles of beneficence, respect, reciprocity, and justice provide justification for routinely offering certain results to research participants. We propose a result-evaluation approach that assesses the expected information and the context of the study in order to decide whether results should be offered. According to this approach, the analytic validity and the clinical utility of a specific result determine whether (...) it should be offered routinely. Different results may therefore require different decisions even within the same study. We argue that the threshold of clinical utility for disclosing a result in a research study should be lower than the threshold used for clinical use of the same result. The personal meaning of a result provides additional criteria for evaluation. Finally, the context of the study allows for a more nuanced analysis by addressing the investigators' capabilities for appropriate disclosure, participants' alternative access to the result, and their relationship with the investigators. This analysis shows that the same result may require different decisions in different contexts. (shrink)

In 2022, the International Association of Bioethics (IAB) announced that the 17th World Congress of Bioethics would be held in Doha, Qatar. In response to ethical concerns expressed about the Qatar selection, the IAB Board of Directors developed and posted to the IAB website a response using a Q&A format. In this Letter, we (the IAB President and Vice President) address concerns about the ethics of bioethics conferencing raised in a 2023 Letter to the Editor of Bioethics by Van der (...) Graaf et al. We do not represent the Board of Directors, and this Letter expresses solely our own views. (shrink)

Since the 1970s, prenatal testing has been integrated into many health care systems on the basis of two competing and largely irreconcilable rationales. The reproductive autonomy rationale focuses on nondirective counseling and consent as ways to ensure that women's decisions about testing and subsequent care are informed and free of undue pressures. It also represents an easily understandable and ethically convincing basis for widespread access to prenatal testing, since the value of autonomy is well established in Western bioethics and widely (...) recognized by funders of health care. In contrast, the public health rationale approaches prenatal testing as designed to reduce the incidence of certain conditions in the population to reduce the burden of disease. This rationale emphasizes the societal consequences of reproduction and the aggregate impact of women's individual reproductive decisions on the overall health of future populations. In this essay, I argue that, despite what could be seen as a persistent failure to meet the ideals of reproductive autonomy, resisting the public health rationale as a basis for prenatal screening is ethically and pragmatically crucial. I recommend policy mechanisms that can enhance reproductive autonomy at a societal level to support choice at the individual level. (shrink)

Noninvasive prenatal screening using cell-free DNA, which analyzes placental DNA circulating in maternal blood to provide information about fetal chromosomal disorders early in pregnancy and without risk to the fetus, has been hailed as a potential “paradigm shift” in prenatal genetic screening. Commercial provision of cell-free DNA screening has contributed to a rapid expansion of the tests included in the screening panels. The tests can include screening for sex chromosome anomalies, rare subchromosomal microdeletions and aneuploidies, and most recently, the entire (...) fetal genome. The benefits of this screening tool are generally framed, by both providers and commercial laboratories, as enhancing reproductive autonomy and choice by providing an earlier, simpler, and more accurate screening while potentially reducing the need for invasive follow-up testing. The majority of the literature has explored these issues empirically or conceptually from a European or North American vantage point, one that assumes normative priorities such as individual reproductive autonomy and the clinical availability of maternal health care or prenatal screening programs within which cell-free DNA screening is offered. While its implementation has raised both challenges and opportunities, very little is known about real-world experiences and the implications of the rapid introduction of cell-free DNA screening outside of North America and Europe, especially in low- and middle-income countries. To begin addressing this gap in knowledge, we organized a four-day international workshop to explore the ethical, legal, social, economic, clinical, and practical implications of the global expansion of cell-free DNA screening. We describe eight key insights that arose from the workshop. (shrink)

Contains twenty-one of the papers presented at the 3rd Islam and Bioethics International Conference held April 14-16, 2010, in Manavgat, Antalya, Turkey.

Effective July 22, 2011, a new law in the state of Washington requires any donor of sperm or eggs to provide a medical history and identifying information to fertility clinics. It also allows donor‐conceived individuals to request this information from clinics once they reach the age of eighteen. This is a significant legislative milestone and a promising development in a country that has consistently shied away from regulating the infertility industry in any way. What do we as a society owe (...) donor‐conceived individuals in terms of obtaining access to information about their genetic origins? This essay addresses just one of this set of issues: the regulatory changes required to address the medical interests of donor‐conceived individuals, regardless of whether a human right to know one's genetic origins is acknowledged. (shrink)

Bayefsky and Berkman argue in favor of evidence-based policy development for expanded prenatal genetic testing. They propose to identify what kinds of information pregnant persons, their par...

One of the most prominent justifications for the use of germline gene editing (GGE) is that it would allow parents to have a “genetically related child” while preventing the transmission of genetic disorders. However, we argue that since future uses of GGE may involve large-scale genetic modifications, they may affect the genetic relatedness between parents and offspring in a meaningful way: Due to certain genetic modifications, children may inherit much less than 50% of their DNA from each parent. We show (...) that the reduction in genetic relatedness between parents and offspring has three important social and legal implications. First, the desire for a genetically related child may end up not being the strong justification it is currently thought to be for the use of GGE. Second, prospective parents may be reluctant to use GGE because of a potential loss of genetic relatedness. Third, in some jurisdictions, parents who would not pass on “enough” DNA to their child may not be recognized as the child's legal parents. We further argue that the reduction in genetic relatedness challenges current conceptions of genetic parenthood that rely on the quantity of DNA shared with the child or on whether the child was directly derived from the parent's genes. We suggest that genetic parenthood should instead be determined based on the nature of the genetic modifications and whether the child's numerical identity has been preserved after the editing process. (shrink)

Background Noninvasive prenatal testing (NIPT) provides important benefits yet raises ethical concerns. We surveyed Canadian pregnant women and their partners to explore their views regarding pressure to test and terminate a pregnancy, as well as other societal impacts that may result from the routinization of NIPT.Methods A questionnaire was offered (March 2015 to July 2016) to pregnant women and their partners at five healthcare facilities in four Canadian provinces.Results 882 pregnant women and 395 partners completed the survey. 64% of women (...) anticipated feeling no pressure to take the test if it were offered routinely, and 39% were not concerned about routinization leading to increased pressure to terminate a pregnancy of a fetus with Down Syndrome. Regarding other social concerns possibly resulting from routinization, pregnant women were most concerned regarding a reduction in resources available for people with Down Syndrome and their families and least concerned regarding a decrease in the population of people with Down Syndrome.Conclusions Our findings reflect the concerns expressed by pregnant women and their partners, both personal (pressure to test, pressure to terminate) and societal (e.g., regarding potential negative impact on people with disabilities and their families). Even if most women were not concerned about feeling pressured to test due to NIPT routinization, a large minority express concerns that should not be taken lightly. Moreover, a majority of respondents were concerned regarding pressure to terminate pregnancies due to NIPT routinization as well as regarding most societal impacts they were queried on, especially the possible future reduction in resources available for people with DS and their families. Canadian policy-makers should consider these potential negative ramifications of NIPT and ensure that appropriate social policies accompany its implementation. (shrink)

Current advances in assisted reproductive technologies aim to promote the health and well-being of future children. They offer the possibility to select embryos with the greatest potential of being born healthy (eg, preimplantation genetic testing) and may someday correct faulty genes responsible for heritable diseases in the embryo (eg, human germline genome modification (HGGM)). Most laws and policy statements surrounding HGGM refer to the notion of ‘serious’ as a core criterion in determining what genetic diseases should be targeted by these (...) technologies. Yet, this notion remains vague and poorly defined, rendering its application challenging and decision making subjective and arbitrary. By way of background, we begin by briefly presenting two conceptual approaches to ‘health’ and ‘disease’: objectivism (ie, based on biological facts) and constructivism (ie, based on human values). The basic challenge under both is sorting out whether and to what extent social and environmental factors have a role in helping to define what qualifies as a ‘serious’ disease beyond the medical criteria. We then focus on how a human rights framework (eg, right to science and right to the highest attainable health) could integrate the concepts of objectivism and constructivism so as to provide guidance for a more actionable consideration of ‘serious’. Ultimately, it could be argued that a human rights framework, by way of its legally binding nature and its globally accepted norms and values, provides a more universal foundation for discussions of the ethical, legal and social implications of emerging or disruptive technologies. (shrink)

Les progrès scientifiques ont creusé un fossé entre médecine universitaire et médecine pratique. Les relations humaines entre malades et médecins sont allées en s'appauvrissant. Aussi convient-il de réintroduire dans le dialogue thérapeutique le sujet perdu de la médecine, la personne du malade. C'est la seule voie pour parer au danger de déshumanisation qui menace les institutions hospitalières et l'art de guérir tout entier. Le but de ce livre est de combler le fossé entre les deux médecines en proposant une formation (...) psychologique appropriée du praticien. Lucien Israël est agrégé de médecine et de psychiatrie, professeur de Psychiatrie à l'Université de Strasbourg et Chef de service au Centre Hospitalier de Strasbourg. (shrink)

Historical Dictionary of the Enlightenment, Second Edition contains a chronology, an introduction, and an extensive bibliography. The dictionary section has more than 300 cross-referenced entries. This book is an excellent resource for students, researchers, and anyone wanting to know more about the Enlightenment.

In “The Ethics of Anonymous Gamete Donation: Is There a Right to Know One's Genetic Origins?,” Inmaculada de Melo‐Martín deconstructs the interests the right is supposed to protect. She argues that these interests are not set back or thwarted when one has no access to one's genetic origins. The basis of her argument is that we lack robust empirical evidence that donor‐conceived individuals suffer certain alleged harms, and that even when such harms are present, they do not provide strong enough (...) justification to ground the right.Indeed, the research on the needs, preferences, and well‐being of donor‐conceived individuals is scant. In fact, we lack robust empirical evidence regarding all aspects of donor conception. I argue, however, that the right to know one's genetic origins does not rest on empirical evidence. Some donor‐conceived individuals who are unable to know their genetic origins may suffer great harms. Others may suffer no harm at all. But all are treated wrongly when they are deprived of the ability to access information about their genetic origins. They are deprived of an important aspect of their autonomy: the liberty to choose what meaning they assign to the genetic components of their identity. (shrink)

In recent years, progress in cancer treatment has greatly increased the chances of recovery. Yet, treatment may have irreversible effects on patients’ fertility. In order to protect future fertility, preservation of ovarian tissue may be offered today even to very young girls, involving a surgical procedure that may be performed by minimally invasive laparoscopy, under general anesthesia. However, in the tragic event of a girl’s death, questions may arise regarding the possible use of the preserved ovarian tissue by her parents. (...) Should posthumous reproductive use of ovarian tissue without the girl’s prior consent (due to her young age) be considered a violation of her rights? On the other hand, can it be argued that it is in the interest of a child who died young to leave a genetic trace through posthumous reproduction, because genetic continuity is in the interest of every human being? After presenting the relevant clinical facts, we explore the ethical dimensions of this possible practice through an analysis of the interests of the deceased, her parents, and the child that may be born posthumously. (shrink)

In the United States, people are deeply divided along lines of race, class, political party, gender, sexuality, and religion. Many believe that historical grievances must eventually be left behind in the interest of progress toward a more just and unified society. But too much in American history is unforgivable and cannot be forgotten. How then can we imagine a way to live together that does not expect people to let go of their entrenched resentments? Living with Hate in American Politics (...) and Religion offers an innovative argument for the power of playfulness in popular culture to make our capacity for coexistence imaginable. Jeffrey Israel explores how people from different backgrounds can pursue justice together, even as they play with their divisive grudges, prejudices, and desires in their cultural lives. Israel calls on us to distinguish between what belongs in a raucous “domain of play” and what belongs in the domain of the political. He builds on the thought of John Rawls and Martha Nussbaum to defend the liberal tradition against challenges posed by Frantz Fanon from the left and Leo Strauss from the right. In provocative readings of Lenny Bruce’s stand-up comedy, Philip Roth’s Portnoy’s Complaint, and Norman Lear’s All in the Family, Israel argues that postwar Jewish American popular culture offers potent and fruitful examples of playing with fraught emotions. Living with Hate in American Politics and Religion is a powerful vision of what it means to live with others without forgiving or forgetting. (shrink)

Israel Gottlieb Canz’ im Jahre 1742 erschienene Theologia naturalis thetico-polemica ist die erste von drei Abhandlungen dieses Autors über natürliche Theologie. Diese ist bei ihm als eine Art Vorbereitung für die „theologia sublimior“ (die geoffenbarte Theologie) zu verstehen. Die Theologia naturalis hat bei Canz als eine theologia thetica eine darlegende und beweisende Funktion. Dahinter steht eine programmatische These, nämlich dass sie als alleinige Erlöserin des Menschen von seinen Sünden nicht ausreicht. Vielmehr soll durch sie die Notwendigkeit des Weges zur (...) Versöhnung aufgezeigt werden; den Weg selber zu erforschen steht ihr nicht zu. Canz’ natürliche Theologie ist auch eine theologia polemica. Gleich in der Praefatio präzisiert der Verfasser, dass er die Systeme der Gegner, ihre Argumente usw. darlegen und sie analysieren und diskutieren werde. Dies erfolgt aber im Hinblick auf den eigenen Diskurs bzw. im Ausgang von diesem, der sich in Konformität mit der geoffenbarten Theologie weiß. Canz gehört zur ersten Generation „Wolffscher Theologen“, bewahrt sich aber eine gewisse Unabhängigkeit gegenüber Topoi der Wolffschen Philosophie und geht durchaus eigene Wege. Dies im Einzelnen nachzuweisen, gehört zu den zahlreichen Forschungsdesideraten im Hinblick auf die Philosophie des 18. Jahrhunderts. Israel Gottlieb Canz’s Theologia naturalis thetico-polemica, published in 1742 is the first of three works by this author on natural theology, which in his case should be understood as a kind of preparation for the ‘theologia sublimior’ (revealed theology). In Canz’s work, theologia naturalis has the expository and substantiating function of a theologia thetica. Behind this stands a programmatic thesis, namely that theology alone is not sufficient to redeem mankind from its sins. Instead, the necessity of a path to reconciliation must be demonstrated; it is not the role of theology itself to seek that path. Canz’s natural theology is also a theologia polemica. In the preface the author states that he will explain, analyse and discuss his opponents’ systems, arguments etc. However, he does this with reference to his own discourse, or rather taking that discourse, which is recognised as conforming with revealed theology, as a starting point. Canz belongs to the first generation of ‘Wolffian theologians’, but retains a certain independence from the topoi of Wolffian philosophy and follows paths which are entirely his own. A detailed examination of these is one of the many desiderata for researchers engaging with the philosophy of the 18th century. (shrink)

A rich literature in public health has demonstrated that health is strongly influenced by a host of environmental factors that can vary according to social, economic, geographic, cultural or physical contexts. Bioethicists should, we argue, recognize this and – where appropriate – work to integrate environmental concerns into their field of study and their ethical deliberations. In this article, we present an argument grounded in scientific research at the molecular level that will be familiar to – and so hopefully more (...) persuasive for – the biomedically-inclined in the bioethics community. Specifically, we argue that the relatively new field of molecular epigenetics provides novel information that should serve as additional justification for expanding the scope of bioethics to include environmental and public health concerns. We begin by presenting two distinct visions of bioethics: the individualistic and rights-oriented and the communitarian and responsibility-oriented. We follow with a description of biochemical characteristics distinguishing epigenetics from genetics, in order to emphasize the very close relationship that exists between the environment and gene expression. This then leads to a discussion of the importance of the environment in determining individual and population health, which, we argue, should shift bioethics towards a Potterian view that promotes a communitarian-based sense of responsibility for the environment, in order to fully account for justice considerations and improve public health. (shrink)

Recent findings in epigenetics have been attracting much attention from social scientists and bioethicists because they reveal the molecular mechanisms by which exposure to socioenvironmental factors, such as pollutants and social adversity, can influence the expression of genes throughout life. Most surprisingly, some epigenetic modifications may also be heritable via germ cells across generations. Epigenetics may be the missing molecular evidence of the importance of using preventive strategies at the policy level to reduce the incidence and prevalence of common diseases. (...) But while this “policy translation” of epigenetics introduces new arguments in favor of public health strategies and policy-making, a more “clinical translation” of epigenetics is also emerging. It focuses on the biochemical mechanisms and epigenetic variants at the origin of disease, leading to novel biomedical means of assessing epigenetic susceptibility and reversing detrimental epigenetic variants. In this paper, we argue that the impetus to create new biomedical interventions to manipulate and reverse epigenetic variants is likely to garner more attention than effective social and public health interventions and therefore also to garner a greater share of limited public resources. This is likely to happen because of the current biopolitical context in which scientific findings are translated. This contemporary neoliberal “regime of truth,” to use a term from Michel Foucault, greatly influences the ways in which knowledge is being interpreted and implemented. Building on sociologist Thomas Lemke's Foucauldian “analytics of biopolitics” and on literature from the field of science and technology studies, we present two sociological trends that may impede the policy translation of epigenetics: molecularization and biomedicalization. These trends, we argue, are likely to favor the clinical translation of epigenetics—in other words, the development of new clinical tools fostering what has been called “personalized” or “precision” medicine. In addition, we argue that an overemphasized clinical translation of epigenetics may further reinforce this biopolitical landscape through four processes closely related to neoliberal pathways of thinking: the internalization and isolation of socioenvironmental determinants of health and increased opportunities for commodification and technologicalization of health care interventions. (shrink)