In debates about genetic testing of children, as well as about disclosing unsolicited findings (UFs) of pediatric exome sequencing, respect for future autonomy should be regarded as a prima facie consideration for not taking steps that would entail denying the future adult the opportunity to decide for herself about what to know about her own genome. While the argument can be overridden when other, morally more weighty considerations are at stake, whether this is the case can only be determined in (...) concrete cases. Importantly, when children grow into adolescents, respect for future autonomy will have to give way to respecting their emerging autonomy. When pediatric exome sequencing is done for complex conditions not involving developmental delay, respect for the child’s future or emerging autonomy should be a primary consideration for those charged with deciding on behalf of the child. Building on what Emanuel and Emanuel have termed the ‘deliberative model’ of shared decision making, we argue that if parents fail to give these considerations their due, professionals should actively invite them to do so. Taking a directive stance may be needed in order to make sure that the future or emerging autonomy of the child are duly considered in the decision-making process, but also to help the parents and themselves to shape their respective roles as responsible care-givers. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Vagaries and Vicissitudes of WarRichard W Sams III remember standing in the kitchen of our home on Camp Pendleton—a United States Marine Corps base in Southern California—listening to National Public Radio (NPR) and doing dishes in the fall of 2002. President Bush announced to the world that he was considering a pre-emptive invasion of Iraq on the pretext of Saddam Hussein harboring weapons of mass destruction (WMD). Three (...) months later, as a Navy Family Physician, I deployed with a surgical company in support of Operation Iraqi Freedom. Reflecting on the situation with a like-minded close friend, I was not sure— would this be a just war? A necessary war? In my mind, it did not rise to the level of conscientious objection, yet the rightness of invading another country with all the anticipated death and destruction was not clear.En route to Kuwait, we laid over in Spain. While fixed to a TV in a holding area, I watched the Secretary of State make a case to the United Nations (UN) and the world that removing Hussein from power would protect us from mobile anthrax labs that could kill tens of thousands. I thought to myself, Either he is absolutely right, and we are protecting our country and the rest of the free world, or he is terribly mistaken and we are embarking on a disaster.As we trained, prepared, and waited in our tents to invade, we listened to the news on “Voice of America” with a hand crank radio. Thousands of citizens from nations around the world protested. Pope John Paul II, a man well acquainted with the tragedy of war, even spoke out about the planned invasion. “War is not inevitable. It is always a defeat for humanity.” He admonished our leaders that war needed to be the very last option. As a man of faith, I was troubled by his resolute, thoughtful opposition to the crusade I was embarking on. As the day of the invasion approached, scud missiles flew over our camp and we scurried into bunkers, day and night, with our gas masks donned to protect us from possible WMD attacks. In March, with the announcement of a “shock and awe” missile attack on Hussein’s palace, the invasion commenced.Within a day of flying by helicopter into enemy territory to set up a surgical company, the fog of war set in. A series of mass casualties streamed in from nearby Nasiriya. We received dozens of injured enemy combatants and American soldiers. Most troubling were the civilians. An entire extended family fleeing for their lives stumbled into an Iraqi minefield meant for us: a mother dead, the men with shrapnel wounds, and an aunt lost both of her legs. Then there was the little boy. By doctrine, our leaders reassured us we would not care for children. Yet, out of instinct, the field corpsmen scooped up all injured, including children, and [End Page 170] brought them to us. The five-year-old’s legs were blown to bits. We had no pediatric supplies. The anesthesiologist heroically intubated the child’s tiny airway with a urinary catheter and placed an adult IV. The surgeons corrected the wounds the best they could. Hours later, in futility, we performed chest compressions on his tiny mangled body.A day later, the worst sandstorm in a decade struck the area. We struggled to keep the patient-filled tents erect. A Marine appeared on the scene out of the darkness (you could not see beyond your nose in the storm) exclaiming we were going to condition one—lock and load our weapons due to an imminent threat. As healthcare professionals, Geneva Conventions dictated we were to use weapons only in self-defense. We chambered our 9-millimeter pistols to defend our patients and ourselves while Marines formed a defensive perimeter. I thought to myself, Great I’m gonna be shot up and die during a freaking sandstorm in Iraq. Hours later, we were told to stand down. The threat was not from approaching enemy combatants but from shepherds running from the crossfire. I had a small nervous breakdown, sleep deprived and under duress... (shrink)

During the early years of the COVID-19 pandemic, preclinical and clinical research were sped up and scaled up in both the public and private sectors and in partnerships between them. This resulted in some extraordinary advances, but it also raised a range of issues regarding the ethics, rigour, and integrity of scientific research, academic publication, and public communication. Many of the failures of scientific rigour and integrity that occurred during the pandemic were exacerbated by the rush to generate, disseminate, and (...) implement research findings, which not only created opportunities for unscrupulous actors but also compromised the methodological, peer review, and advisory processes that would usually identify sub-standard research and prevent compromised clinical or policy-level decisions. While it would be tempting to attribute these failures of science and its translation solely to the “unprecedented” circumstances of the COVID-19 pandemic, the reality is that they preceded the pandemic and will continue to arise once it is over. Existing strategies for promoting scientific rigour and integrity need to be made more rigorous, better integrated into research training and institutional cultures, and made more sophisticated. They might also need to be modified or supplemented with other strategies that are fit for purpose not only in public health emergencies but in any research that is sped-up and scaled up to address urgent unmet medical needs. (shrink)

For Alesha to give valid and sufficient consent to a COVID-19 vaccine, she must possess both capacity and competency. Let us consider each in turn.Does Alesha have capacity? Is she approaching her...

In recent years, religious studies has undergone an ethnographic turn. More and more, scholars attend to the social location and significance of religious practice. This approach foregrounds the self-understandings of religious communities and practitioners and raises the question of the relation between ethnography and philosophical analysis. For instance, Saba Mahmood, in The Politics of Piety, draws from ethnographic study so as to critique philosophy’s universalizing claims regarding subjectivity, enabling a recognition of the diverse forms feminist subjectivity and political agency may (...) take within religious traditions and practice.2 Jeffrey Stout’s Blessed are the Organized likewise shifts the terrain of .. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Full Collection of Personal NarrativesZohar Lederman, Ola Ziara, Rachel Coghlan, Oksana Sulaieva, Anna Shcherbakova, Oleksandr Dudin, Vladyslava Kachkovska, Iryna Dudchenko, Anna Kovchun, Lyudmyla Prystupa, Yuliya Nogovitsyna, Ghaiath Hussein, Kathryn Fausch, P. P. Kyaw, Ayesha Ahmad, Richard W Sams II, Handreen Mohammed Saeed, Artem Riga, Ryan C. Maves, Elizabeth Dotsenko, Irina Deyneka, Eva V. Regel, and Vita Voloshchuk• An Unsettling Affair• How We Keep Caring While Walking Through Our Pain• (...) Adjusting Laboratory Practices to the Challenges of Wartime• Why We Stay• A Semi-Personal Story from a Ukrainian NGO Professional (or a Semi-Professional Story from a Ukrainian Person) Living through the War• When Ethics Survives Where People Do Not: A Story From Darfur• Burma’s Healthcare Under Fire: My Experience as an Exiled Medical Professional• When a Conflict Collapses on a Child: An (Aborted) Medical Evacuation of a Hazara Toddler During the Kabul Airport Blast and the Taliban Takeover• The Vagaries and Vicissitudes of War• Providing Care to a Potential Aggressor: An Ethical Dilemma• One Surgeon’s Experience During Armed Conflict in Ukraine• The Limits of Our Obligations• A Liberating Breath• Soldiers of the Invisible Front: How Ukrainian Therapists Are Fighting for the Mental Health of the Nation Under Fire• Stories of Families with Chronically Ill Pediatric Patients during the War in UkraineCopyright © 2023 Johns Hopkins University Press... (shrink)

Proceedings of the II World Congress on Paraconsistency held in Juquey, SP, Brazil, from May 12-19, 2000.

Unlike some other reproductions of classic texts (1) We have not used OCR(Optical Character Recognition), as this leads to bad quality books with introduced typos. (2) In books where there are images such as portraits, maps, sketches etc We have endeavoured to keep the quality of these images, so they represent accurately the original artefact. Although occasionally there may be certain imperfections with these old texts, we feel they deserve to be made available for future generations to enjoy.

Although public interest in sustainability increases and consumer attitudes are mainly positive, behavioral patterns are not univocally consistent with attitudes. This study investigates the presumed gap between favorable attitude towards sustainable behavior and behavioral intention to purchase sustainable food products. The impact of involvement, perceived availability, certainty, perceived consumer effectiveness (PCE), values, and social norms on consumers’ attitudes and intentions towards sustainable food products is analyzed. The empirical research builds on a survey with a sample of 456 young consumers, using (...) a questionnaire and an experimental design with manipulation of key constructs through showing advertisements for sustainable dairy. Involvement with sustainability, certainty, and PCE have a significant positive impact on attitude towards buying sustainable dairy products, which in turn correlates strongly with intention to buy. Low perceived availability of sustainable products explains why intentions to buy remain low, although attitudes might be positive. On the reverse side, experiencing social pressure from peers (social norm) explains intentions to buy, despite rather negative personal attitudes. This study shows that more sustainable and ethical food consumption can be stimulated through raising involvement, PCE, certainty, social norms, and perceived availability. (shrink)

v. 1. Nicomachean ethics. Politics. The Athenian Constitution. Rhetoric. On Poetics.--v. 2. Logic.--v. 3. Physics. Metaphysics. On the soul. Short physical treaties.--v. 4. On the heavens. On generation and corruption. Meteorology. Biological treatises.

Epidemics that were probably influenza have been reported throughout recorded history. There were 13 fairly severe epidemics during the 18th century and 12 during the 19th century. Probably 8 of these 25 were influenza pandemics. In the 20th century there have been 4 pandemics (1918/19, 1957/58, 1968/69 and 1977) due to the emergence of new subtypes of influenza A virus. The great pandemic of 1918/19 caused an estimated 20 million deaths. Between pandemics usually there have been epidemics of varying severity (...) at intervals of one to three years and a trickle of sporadic cases every winter. The morbidity and mortality rates have varied greatly from epidemic to epidemic and from place to place during the same epidemic. Generally the morbidity has been lowest in people over 60 years of age, but, except for 1918/19, the mortality has been predominantly in old people. The epidemic behaviour of influenza has been so erratic and difficult to understand that there are still a few scientists who consider that extraterrestrial influences operate. These views are not taken seriously by most virologists but there are puzzling aspects of influenza that are not yet understood. (shrink)