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.

Contemporary public art is still in the process of defining its artistic and legal identity. Indeed to juxtapose the terms public and art is a paradox. Art is often said to be the individual inquiry of the sculptor or painter, the epitome of self-expression and vision that may challenge conventional wisdom and values. The term public encompasses a reference to the community, the social order, self-negation: hence the paradox of linking the private and the public in a single concept. A (...) goal of any general or jurisprudential theory concerning government sponsorship or ownership of art in the public context must reconcile, through state institutions and law, this tension between art’s subjectivity with hits potential for controversy and government’s need to promote the public good.This essay critically examines and discusses existing contemporary legal doctrine and its failure to accommodate or even adequately define the issues and competing values at stake in the public art context. Such failure may be attributed in part to the fact that neither legal theory nor art policy have been inspired by the vision of or located in the broader context of a sociopolitical public realm. Barbara Hoffman practices arts and entertainment law in New York and is counsel to the College Art Association. She is a former professor of constitutional law at the University of Puget Sound, and she has served as chair of the Public Art Committee of the Art Law Committee of the Association of the Bar of the City of New York, and president of the Washington Volunteer Lawyers for the Arts. (shrink)

Everyone agrees that law is a constituent of social reality. Law seems to be a system by which conduct is governed and guided. Its usefulness consists, in part, on its ability to govern and guide conduct in its characteristic way. If laws guides the conduct of lay law subjects, then it must be (really) possible for the content of the laws governing their conduct to be known by them under standard social conditions. Moreover, if some degree of efficacy in guiding (...) and governing the conduct of lay law subjects is an existence condition for a legal system, then in existing legal systems enough of the content of directive law is epistemically accessed by enough law subjects so that they can apply it to their situations and correctly determine the act-tokens required of them. In this chapter, I argue that these modest epistemic reflections have important implications for a theory of legal content that have been largely ignored. Holistic theories of legal content, such as Greenberg’s and Dworkin’s, are inconsistent with an adequate account of epistemic access. After demonstrating the same problem in two mainstream non-holistic theories of legal content -- the view that legal content is set entirely by official interpretive conventions, and the view that legal content is set entirely by official intentions – I propose a theory of legal content that meets the epistemic access challenge. On my approach, law is, at its core, centered upon the understandings of law subjects. (This view is meant to exempt constitutional provisions.) More precisely, the legal content of statutes and judicial decisions is built around, and preserves, a core of understandings and meaning-assignments that is the province of anyone with sufficient linguistic ability and relevant socialization. The details of this view are, roughly: (1) in the case of judicial decisions in a common law system, the social salience of the example the decision sets concerning behavior sets the default legal content; (2) in the case of statutory directives, the set of socially salient applications (behavior in situations) sets the default legal content. I say `default’ because my account of legal content is a two-stage account beginning with the default content and permitting a second stage in which considerations from other sources can operate on the default. Yet if a certain amount of efficacy in guiding lay law subjects’ behavior is a requirement for the existence of a legal system, there must be a core of legal content undistorted from its default social salience by a second stage operation. There is and must be a `law of the street’. -/- . (shrink)

The paper considers the legal tools that have been developed in German pharmaceutical regulation as a result of the precautionary attitude inaugurated by the Contergan decision. These tools are the notion of “well-founded suspicion”, which attenuates the requirements for safety intervention by relaxing the requirement of a proved causal connection between danger and source, and the introduction of the reversal of proof burden in liability norms. The paper focuses on the first and proposes seeing the precautionary principle as an instance (...) of the requirement that one should maximise expected utility. In order to maximise expected utility certain probabilities are required and it is argued that objective Bayesianism offers the most plausible means to determine the optimal decision in cases where evidence supports diverging choices. (shrink)

International Studies in the Philosophy of Science, Volume 25, Issue 1, Page 83-86, March 2011.

This paper will examine the effects of gender, age, work experience, academic status and legality on certain ethical decisions. Six scenarios representing ethical dilemmas were presented to both undergraduate and MBA students in an attempt to determine if various demographic factors influenced ethical decision making. While some past studies have suggested that gender has an important effect on ethical decision making, this study does not completely support this conclusion and suggests that age and/or length of work experience should be included (...) in any study of ethical decision making.The legality of the decisions was determined and compared to the reason given by the students for their decisions. In some cases the choice made by a majority of the students was not the one that was supported by the legal authorities which suggests that there may be conflicts between the ethical system of the respondents and the behavior expected of them by society. (shrink)

In June 2015, the Supreme Court of Canada struck down the Criminal Code's prohibition on assisted death. Just over a year later, the federal government crafted legislation to entrench medical assistance in dying (MAiD), the term used in Canada in place of physician‐assisted death. Notably, Canada became the first country to allow nurse practitioners to act as assessors and providers, a result of a strong lobby by the Canadian Nurses Association. However, a legislated approach to assisted death has proven challenging (...) in a number of areas. Although it facilitates a degree of accountability, precision and accessibility, it has also resulted in particular challenges negotiating the diverse perspectives of such a morally contentious act. One of these challenges is the tendency to conflate what is legal and what is moral in a modern liberal constitutionalism that places supreme value on autonomy and choice. Such a conflation tends to render invisible the legal and moral/ethical considerations necessary for nurses and nurse practitioners to remain ethical actors. In this paper, we introduce this conflation and then discuss the process of lawmaking in Canada, including the legalization of MAiD and the contributions of nursing to that legalization. We then engage in a hypothetical dialogue about the legal and moral/ethical implications of MAiD for nursing in Canada. We conclude with an appeal for morally sustainable workspaces that, when implementing MAiD, appropriately balance patient choices and nurses’ moral well‐being. (shrink)

In John Locke's Two Treatises of Government, the state of nature, and more particularly natural man, are created within the tradition of natural law. Several commentators, such as James Tully and Karl Olivecrona, have recognized this legacy in Locke's political thought.1 While providing an analysis of Locke's thought in relation to natural law, such studies, however, have not fully examined the global context within which both the Two Treatises and seventeenth-century natural law developed. Consequently the extent to which natural law (...) theorists, such as Hugo Grotius and Samuel Pufendorf, were influenced by the colonial interests of their particular countries of origin has been largely overlooked. The development of natural law theory, which can be traced back to the time of Cicero and beyond, is transformed during the sixteen hundreds by the need to answer new questions posed, both on sea and land, by the expanding colonial empires of Europe. Thus, in considering the natural law theorists who influenced Locke, it will be necessary to examine how colonialism influenced both the questions which were posed and the answers that were given. (shrink)

The origins of Vico's social theory : Vichian reflections on the Neapolitan Revolt of 1701 and the politics of the metropolis -- Vico's cosmopolitanism : global citizenship and natural law in Vico's pedagogical thought -- Vico's social theory : the conundrum of the Roman metropolis and the struggle of humanity for natural rights -- From social theory to philosophy : Vico's disillusions with the Neapolitan magistracy and the new frontier of philosophy.

Rodolfo Sacco has devoted much of his research to the relations between law and language. His analysis were focused on the problem of legal translation for comparative law research, on mute law, and on the importance of understanding the dynamics of the different languages in Europe today.

In this essay I defend functional explanations in sociobiology against the charge that they are exercises in speculative story-telling. I distinguish proximate and ultimate biological functions, and discuss their role in functional explanations. I characterize functional explanations as a kind of "consequence explanation", and argue that sociobiologists need to justify a "functional fact" in addition to a "consequence law". Two methods used to supply evidence for functional hypotheses, the technique of optimality analyses and the comparative method, are discussed and illustrated (...) with examples. I argue that adequate evidence for hypothesis about the function of a trait can be provided by the method of comparison, but not by optimality analyses. The comparative method contains an inductive phase that provides independent warrant for, and so serves to establish the high probability of, functional hypotheses. Independent warrant cannot be provided by optimality analyses alone: the model-building approach itself mandates the sacrifice of the truth of a hypothesis to its predictive power. I conclude that while the sociobiologist may wish to employ the optimality analysis as a heuristic strategy, reliable functional explanations are better sought through the use of the comparative method. (shrink)

There is a widely held view that legislative intention determines the meaning of a statute. The focus of this article is meaning in the sense of full linguistic content, which may not be the same as legal content. Linguistic intentionalism appears to have its greatest appeal when a statute has a partly implied linguistic meaning. It seems natural to suppose that the part of the meaning that is implied by the explicit wording in the statute is determined by an intention (...) of the legislature—roughly, what the legislature intended to imply. The purpose of this article is to present some new reasons to doubt linguistic intentionalism and to offer an alternative for a particular kind of implied statutory meaning that some philosophers of language call implicitures. Rather than legislative intention, the meaning of implicitures is metaphysically determined by intention-free pragmatic linguistic norms, the grasp of which is part of the language competence of ordinary law subjects. The use of these norms, in combination with certain facts about background social practices and other conventions, generates implicitures that may be inconsistent with actual communicative intentions. These intention-free pragmatic norms, and the implicitures they generate, are explanatorily prior to the fact—if there is such a fact—of what impliciture it is reasonable to infer that the enacting legislature (or the legislators collectively) intended. Reference to legislative linguistic intention (actual or reasonably imputed) is thus explanatorily inert. (shrink)

In this paper I discuss how, given the complexity of biological systems, reliance on theoretical models in the development and testing of biological theories leads to an uncomfortable form of anti-realism. I locate the source of this discomfort in the uniqueness and hence diversity of biological phenomena, in contrast with the simplicity and uniformity of the subject matter of physics. I have argued elsewhere that the use of theoretical models creates an unresolvable tension between the explanatory strength and predictive power (...) of hypotheses, and I review this argument again here. My discussion parallels that of Nancy Cartwright, who claims that the use of ceteris paribus laws in physics creates an antagonism between truth and explanation that requires theoretical models to figure centrally in scientific explanation, thereby precluding realism. I argue instead that in biology it is the use of theoretical models that creates this conflict, and conclude that adequate biological explanation cannot rely on the modeling approach alone. Finally, I claim that if we accept the semantic view of theories, which makes theoretical models an integral part of our conception of theories, we must accept anti-realism as well. (shrink)

In this paper, we present a model of pathos, delineate its operationalisation, and demonstrate its utility through an analysis of natural language argumentation. We understand pathos as an interactional persuasive process in which speakers are performing pathos appeals and the audience experiences emotional reactions. We analyse two strategies of such appeals in pre-election debates: pathotic Argument Schemes based on the taxonomy proposed by Walton et al. (Argumentation schemes, Cambridge University Press, Cambridge, 2008), and emotion-eliciting language based on psychological lexicons of (...) emotive words (Wierzba in Behav Res Methods 54:2146–2161, 2021). In order to match the appeals with possible reactions, we collect real-time social media reactions to the debates and apply sentiment analysis (Alswaidan and Menai in Knowl Inf Syst 62:2937–2987, 2020) method to observe emotion expressed in language. The results point to the importance of pathos analysis in modern discourse: speakers in political debates refer to emotions in most of their arguments, and the audience in social media reacts to those appeals using emotion-expressing language. Our results show that pathos is a common strategy in natural language argumentation which can be analysed with the support of computational methods. (shrink)

Imagine that our world were such that the entities, properties, laws, and relations of fundamental physics did not determine what goes on at the mental level; imagine that duplicating our fundamental physics would fail to duplicate the pleasures, feelings of joy, and experiences of wonder that we know and love; in other words, imagine that the mental realm did not supervene on the physical realm. Would our world, then, be a world in which physicalism is false? A good number of (...) philosophers who ponder such issues—perhaps all philosophers who have hitherto pondered such issues—answer “yes.” The purpose of this paper is to suggest that, despite what physicalists say, they don’t think so, either. What is it that they really think? What is the actual doctrine of physicalism? I conclude withan attempt to uncover that as well. (shrink)

Featuring an impressive roster of contributors, this book will serve as a bold and irreplaceable source of information for legal scholars, lawyers, and ...

In 2005, seven European countries signed the so-called Prüm Treaty to increase transnational collaboration in combating international crime, terrorism and illegal immigration. Three years later, the Treaty was adopted into EU law. EU member countries were now obliged to have systems in place to allow authorities of other member states access to nationally held data on DNA, fingerprints, and vehicles by August 2011. In this paper, we discuss the conditions of possibility for the Prüm network to emerge, and argue that (...) rather than a linear ascent towards technological and political convergence and harmonisation, the story of Prüm is heterogeneous and halting. This is reflected also in the early stages of implementing the Prüm Decision which has proven to be more challenging than it was hoped by the drivers of the Prüm process. In this sense, the Prüm network sits uncomfortably with success stories of forensic science . Instead of telling a story of heroic science, the story of Prüm articulates the European dream: one in which goods, services, and people live and travel freely and securely. (shrink)

The conservation of energy law, a law of physics that states that the total energy of any closed system is always conserved, is a bedrock principle that has achieved both broad theoretical and experimental support. Yet if interactive dualism is correct, it is thought that the mind can affect physical objects in violation of the conservation of energy. Thus, some claim, the conservation of energy grounds an argument for physicalism. Although critics of the argument focus on the implausibility of causation (...) requiring the transference of energy, I argue that even if causation requires the transference of energy, once we accept the other required premises of the argument that lie behind any supposed argument from the conservation of energy the law of the conservation of energy is revealed as irrelevant to the question of whether the mental is physical. (shrink)

The natural rights with which we have been dealing are, however, inseparably connected, in the very person who is their subject, with just as many respectiveduties; and rights as well as duties find their source, their sustenance and their inviolability in the natural law which grants or enjoins them.Since men are social by nature they are meant to live with others and to work for one another’s welfare. A well-ordered human society requires that men recognize and observe their mutual rights (...) and duties. It also demands that each contribute generously to the establishment of a civic order in which rights and duties are more sincerely and effectively acknowledged and fulfilled. (shrink)

Populist-nationalist ideologies pose a threat to women’s rights. This article examines to what extent national institutionalisation of international frameworks promoting women’s rights can weather the misogynistic political climate accompanying the global rise of populist nationalism. The post-2016 situation in the Philippines offers a testing ground for this problem due to the co-existence of President Duterte’s hypermasculinist national leadership with a strong history of institutionalisation of the UN’s Women, Peace and Security (WPS) agenda. Drawing from an analysis of WPS policy and (...) institutions in the Philippines between 2009 and 2019 and from field research and interviews with government agencies, local civil society organisations and international partners, this article argues that the WPS agenda will likely survive in the hostile environment. But it also finds that institutionalisation alone does not guarantee successful implementation. While the WPS agenda may ostensibly remain a national priority under populist-nationalist regimes, its progression has been halted. (shrink)

B. Kowalzig, « Broken Rhythms in Plato's Laws. Materialising Social Time in the Chorus » in A.-E. Peponi, Performance and Culture in Plato's Laws, Cambridge, Cambridge University Press, 2013. Le texte de Barbara Kowalzig est en partie accessible en ligne ici. - Philosophie – Nouvel article.

This article contains an analysis of the concept of hospitality as defined in the thinking of Jacques Derrida, who applies the concept of an unsolvable aporia. Thinking about the ethics of hospitality takes place between the right hospitality described by Kant, and the decision to open up to the Other, revealing the infinite hospitality of ethics. Questions posed by Derrida result from a combination of two different traditions of thought: first, how to reconcile Kantian universal law with the particularity of (...) political thinking, and second, how to introduce unconditional hospitality into a project of global governance. The author traces the efforts made to intersect the Kantian universalism with Lévinas’s ethical vision. She also analyses how this hospitality may refer to the political practice that is governed by general laws. (shrink)

The Nile, one of the longest rivers in the world, has not been subjected to a uniform legal regime yet, despite the pressing needs. The hitherto proposals presented by the riparian states of the lower and upper reaches have not been unanimously accepted. Egypt and Sudan face particular difficult situation since the Nile river is their main source of water supply. It is argued that the lack of necessary coordination among all the States in the basin may in the future (...) lead to significant damage and consequences both in terms of access to water and its quality. This short study critically examines past and present initiatives undertaken to solve one of the most controversial aspects of international law in Africa. (shrink)

Many contemporary philosophers of law agree that a necessary condition for a decision to be legally justified, even in a hard case, is that it coheres with established law. Some, namely Sartorius and Dworkin, have gone beyond that relatively uncontroversial claim and described the role of coherence in legal justification as analogous to its role in moral and scientific justification, on contemporary theories. In this, I argue, they are mistaken. Specifically, coherence in legal justification is sometimes specific to a branch (...) of law, and there is nothing isomorphic to this in the models of moral and scientific justification. Although Dworkin and Sartorius rely on the concept of coherence, they do not explicate it. In the course of examining their views, this essay offers a partial analysis of coherence on their models. Finally, two canons of relevance, governing when global coherence considerations are appropriate to legal justification, are presented. (shrink)

Mark Greenberg has made a transcendental attack on a metaphysical position that some notable legal positivists have held -- namely, that law is ultimately grounded in social facts. He has also pressed legal positivism at a point of perceived vulnerability – the failure of such positivists to develop and defend a compelling theory of legal content. Moreover, in his Moral Impact Theory of law, he preserves a necessary connection between legal obligations and good reasons for action that is absent in (...) legal positivism. One of his arguments against legal positivism relies heavily on what he calls "the bindingness hypothesis"—namely, the claim that it is part of the “nature of law” that it is “supposed to operate” so as to “arrange matters” to “reliably ensure” that its legal obligations are genuinely, all-things-considered, binding. I argue that Greenberg’s defense of the bindingness hypothesis fails, and with it, one of his defenses of his Moral Impact Theory of Law. I attack two other defenses: the assertion that the Moral Impact Theory makes it easy to account for our concern with law, with the implication that legal positivism cannot so easily account for that concern; and the claim that his Moral Impact Theory fits appellate practice better than some views. I show that these the arguments for the Moral Impact Theory are inadequate. In response to Greenberg’s further argument that the Moral Impact Theory rescues the idea of legal obligation as genuine obligation, I argue that the Moral Impact Theory does so at a very steep price – one that is not worth paying. (shrink)

The paper addresses charges of risk and loss aversion as well as of irrationality directed against the precautionary principle, by providing an epistemic analysis of its specific role in the safety law system. In particular, I contend that: 1) risk aversion is not a form of irrational or biased behaviour; 2) both risk and loss aversion regard the form of the utility function, whereas PP rather regards the information on which to base the decision; 3) thus PP has formally nothing (...) to do with risk or loss aversion but rather with risk awareness; 4) PP removes a fictional construct in the legal system, according to which any hazard should be ignored and denied until it is scientifically proven; 5) the quandary originates in the tension between current methods of evidence evaluation, and the logic underlying PP which demands for a probabilistic epistemology. (shrink)

The individual right of access to one’s own data is a crucial privacy protection long recognized in U.S. federal privacy laws. Mobile health devices and research software used in citizen science often fall outside the HIPAA Privacy Rule, leaving participants without HIPAA’s right of access to one’s own data. Absent state laws requiring access, the law of contract, as reflected in end-user agreements and terms of service, governs individuals’ ability to find out how much data is being stored and how (...) it might be shared with third parties. Efforts to address this problem by establishing norms of individual access to data from mobile health research unfortunately can run afoul of the FDA’s investigational device exemption requirements. (shrink)

A crucial step in economic development is the depersonalization of business, which enables an enterprise to operate as a separate entity from its owners and managers. Until the emergence of a de iure depersonalization of business in the 19th century, business activities were eminently personal, with managing partners bearing unlimited liability. Roman law even restricted agency. Yet, the Roman legal system developed a form of de facto depersonalized business entity, where depersonalization was achieved by making the fulcrum of the business (...) a non-person: the slave. Although radically different from a legal perspective, this format exhibited all the distinctive features of modern corporations, thereby providing for a functional equivalent of the modern corporate form. The development of the de iure format was hindered by strong cultural, technological and institutional constraints. In contrast, slave-run businesses exhibited features that were largely compatible with these constraints and emerged along the path of least resistance to legal change. The end of slavery and the fall of the Roman Empire closed off this alternative path of legal evolution; consequently, the modern corporate form could only appear once these constraints had been overcome. (shrink)

If well-designed, the results of a Randomised Clinical Trial can justify a causal claim between treatment and effect in the study population; however, additional information might be needed to carry over this result to another population. RCTs have been criticized exactly on grounds of failing to provide this sort of information Evidence, inference and enquiry. Oxford University Press, New York, 2011), as well as to black-box important details regarding the mechanisms underpinning the causal law instantiated by the RCT result. On (...) the other side, so-called In Silico Clinical Trials face the same criticisms addressed against standard modelling and simulation techniques, and cannot be equated to experiments Philosophy of molecular medicine: foundational issues in research and practice, Routledge, New York, 2017; Parker in Synthese 169:483–496, 2009; Parke in Philos Sci 81:516–536, 2014; Diez Roux in Am J Epidemiol 181:100–102, 2015 and related discussions in Frigg and Reiss in Synthese 169:593–613, 2009; Winsberg in Synthese 169:575–592, 2009; Beisbart and Norton in Int Stud Philos Sci 26:403–422, 2012). We undertake a formal analysis of both methods in order to identify their distinct contribution to causal inference in the clinical setting. Britton et al.’s study :E2098–E2105, 2013) on the impact of ion current variability on cardiac electrophysiology is used for illustrative purposes. We deduce that, by predicting variability through interpolation, ISCTs aid with problems regarding extrapolation of RCTs results, and therefore in assessing their external validity. Furthermore, ISCTs can be said to encode “thick” causal knowledge —as opposed to “thin” difference-making information inferred from RCTs. Hence, ISCTs and RCTs cannot replace one another but rather, they are complementary in that the former provide information about the determinants of variability of causal effects, while the latter can, under certain conditions, establish causality in the first place. (shrink)

The social fact thesis, is, roughly, that law is ultimately a matter of social fact. Mark Greenberg and Kevin Toh have launched transcendental arguments against important or interesting general versions of the social fact thesis. Together, they can be read as posing a dilemma for the thesis. Suppose that many correct assertions of law are normative. Then, according to Toh, the considerations in virtue of which they are correct cannot ultimately be social facts, because the derivation of any normative conclusion (...) requires a normative premise. Suppose that correct assertions of law are not normative. Then, according to Greenberg, they cannot state legal facts in virtue of social facts alone, because the very nature of law requires a particular kind of rational connection between determinants of legal facts and legal facts. Social facts cannot meet this demand; (non-legal) normative facts are needed. In short, Greenberg and Toh together claim that the social fact thesis is consistent with neither the existence nor the normativity of law. This essay meets their challenge. (shrink)

In line with the concept of politics developed by ancient Greeks, the political sphere is identified with transparency and overtness. However, it has always been hiding secret actions, conspiracies and collusions. The emergence of the modern model of the state, along with the rationalisation of its structures, enabled the secret equivalents of authority to transform into organisations, i.e. institutions alternative to official organisations, established by law and having specific powers. Rather than talking about actual organisations, the author discusses the process (...) whereby these secret, underground structures turn into organisations that influence the sphere of overt politics. She tries to show that this is a specific kind of game between what is explicit and public and what is concealed and secret. This game is constantly present in political activities, although we seldom realise it. (shrink)

The ancient history of flamenco is pure hypothesis, partly owing to the “ Dark Ages “ which shrouded the folk expression of a large portion of Andalusia from soon after the victory of the Catholic Kings at Granada in 1492 until the emancipation laws of Charles III in 1783. Although flamenco as such is a product of the nineteenth century, the hypothesis may be taken right back to pre-Iberian days when there was a flourishing civilization in the south of Spain, (...) with its capital, Tartessos, more or less where Seville—or Cadiz—is now, perhaps the first Empire in the West. The Iberians inhabited the north and the east but the towns along the Andalusian coast were founded by Phoenicians from Tyre (Cadiz) and Phocaeans from Asia Minor (Málaga). During the Celtic invasions the south was held by Carthage until Andalusia finally became Roman as a result of the Punic wars. (shrink)

The organ donor shortfall in the UK has prompted calls to introduce legislation to allow for presumed consent: if there is no explicit objection to donation of an organ, consent should be presumed. The current debate has not taken in account accepted meanings of presumption in law and science and the consequences for rights of ownership that would arise should presumed consent become law. In addition, arguments revolve around the rights of the competent autonomous adult but do not always consider (...) the more serious implications for children or the disabled. (shrink)

Class action lawsuits and the justice that they are supposed to enforce have become of great concem to legislators in recent years. The traditional ruIes of tort liability cannot completely support the court decisions that have been reached. The rulings, however, are clearly in the interest of giving victims the justice that they are due. Legal scholars, such as Jules Coleman, claim that the conflicts between tort liability and class action justice cannot be reconciled in our legal system. I propose (...) an avenue of analysis whereby the principles of justice that support tort law are preserved as needed for modem issues, yet at the same time address the genuine public policy concems in these class actions. (shrink)

Many countries currently invest in technologies and data infrastructures to foster precision medicine (PM), which is hoped to better tailor disease treatment and prevention to individual patients. But who can expect to benefit from PM? The answer depends not only on scientific developments but also on the willingness to address the problem of structural injustice. One important step is to confront the problem of underrepresentation of certain populations in PM cohorts via improved research inclusivity. Yet, we argue that the perspective (...) needs to be broadened because the (in)equitable effects of PM are also strongly contingent on wider structural factors and prioritization of healthcare strategies and resources. When (and before) implementing PM, it is crucial to attend to how the organisation of healthcare systems influences who will benefit, as well as whether PM may present challenges for a solidaristic sharing of costs and risks. We discuss these issues through a comparative lens of healthcare models and PM-initiatives in the United States, Austria, and Denmark. The analysis draws attention to how PM hinges on—and simultaneously affects—access to healthcare services, public trust in data handling, and prioritization of healthcare resources. Finally, we provide suggestions for how to mitigate foreseeable negative effects. (shrink)