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.

In lieu of an abstract, here is a brief excerpt of the content:THE CASE FOR SPIRIT CHRISTOLOGY: SOME REFLECTIONS THOMAS WEINANDY, O.F.M., CAP. Greyfriars Hall, University of Oxford IN THE JUNE, 1992, issue of Theological Studies Roger Haight, S.J., of the Weston School of Theology, authored an essay entitled "The Case for Spirit Christology." 1 In the December, 1992, issue of the same journal John Wright, S.J., of the Jesuit School of Theology at Berkeley, wrote a critical response entitled: (...) "Roger Haight's Spirit Christology." 2 While I fully endorse Wright's reservations, here I wish to offer some of my own criticisms as well as expand upon some of his.3 In order for a Spirit Christology to be viable Haight believes that it must fulfill six criteria: 1) It must adequately explain why Christians believe that their salvation is found in Jesus; 2) It must be faithful to the Bible; 3) It must uphold the teaching of the Councils, especially Nicaea and Chalcedon; 4) It must be intelligible and coherent; 5) It must respond to contemporary concerns, specifically the relationship of Jesus to the founders of other 1 Roger Haight, S.J., "The Case for Spirit Christology," Theological Studies 53(1992): 257-287. Hereafter referred to in the text by page numbers. 2 John Wright, S.J., "Roger Haight's Spirit Christology," Theological Studies 53(1992) : 729-735. 3 While this article will focus exclusively on Haight's Spirit Christology, much of what will be said here, by way of criticism, can be applied equally to other expressions of Spirit Christology, since the various forms are quite similar. Haight himself relies heavily upon and substantially agrees with G. W. H. Lampe, " The Holy Spirit and the Person of Christ," in Christ, Faith and History, ed. S. W. Sykes and J. P. Clayton (Cambridge: University Press, 1972) 111-130; and God as Spirit (Oxford: Clarendon, 1977). For other recent examples of Spirit Christology see Haight's footnote 1, p. 257. 173 174 THOMAS WEINANDY, O.F.M., CAP. religions; 6) It must be able to stimulate and empower Christian life (see 260-262). As in Wright's response, I wish to examine I-Iaight's Spirit Christology in light of these criteria. I will begin with an extensive examination of Haight's second criterion-faithfulness to scripture-for it is most central to his whole enterprise. Then, more succinctly, I will address his other criteria. Biblical Revelation and Religious Language The central, and therefore fatal, flaw within Haight's Spirit Christology is that his understanding of '.' God as Spirit," upon which the whole of his Christology is founded, is itself non-biblical. To discern Haight's understanding of " God as Spirit," we must first examine his notion of religious language and the philosophy sustaining it. For Haight, "the medium through which religious experience takes place may be called a symbol, making all religious knowledge symbolic knowledge. A symbol is that through which something else is made present and known; a symbol mediates a perception and knowledge of something other" (263). While the symbol makes the presence of God known, yet, precisely because it is a symbol, God is beyond or transcends what is symbolized. The symbol " both makes God present and points away from itself to a God who is other than itself" (263). Thus the symbolized " is" and " is not" the symbol (263). Haight argues then that the biblical symbol, " the Spirit of God " refers to God and is " materially and numerically identical with God. God as Spirit is God" (266). However, God as Spirit " indicates God at work, as active, and as power, energy, or force that accomplishes something" (266-267). God as Spirit refers not to God as he is immanent in himself, but to God as he is "outside of himself," within the order of time and history. Haight recognizes that the Old Testament also uses " Word" and " Wisdom" as symbols along with " Spirit," but " all of these symbols are basically the same insofar as they point to the same generalized experience of God outside of God's self and im- THE CASE FOR SPIRIT CHRISTOLOGY 175 manent in the world in presence and active power" (267). While Haight acknowledges that these symbolic... (shrink)

This paper proposes that managers add an attention to virtues and vices of human character as a full complement to moral reasoning according to a deontological focus on obligations to act and a teleological focus on consequences (a balanced tripartite approach). Even if the criticisms of virtue ethics cloud its use as a mononomic normative theory of justification, they do not refute the substantial benefits of applying a human character perspective – when done so in conjunction with also-imperfect act-oriented perspectives. (...) An interactive tripartite approach is superior for meeting the complex requirements of an applied ethic. To illustrate how deficiencies of a "strong" virtue ethics formulation can be overcome by a balanced tripartite approach, this paper compares normative leadership paradigms (each based on a combination of virtue, deontology, or consequentialist perspectives) and the dangers inherent in each. The preferred paradigm is servant leadership, grounded in a tripartite ethic. Effective application of such an ethics approach in contemporary organizations requires further empirical research to develop a greater understanding of the moral language actually used. Meeting this challenge will allow academics better to assist practicing managers lead moral development and moral reasoning efforts. (shrink)

Who a manager is, as a person of moral character, has been only of tangential interest in social science definitions of management, which have focused on functions, roles, behaviors, and environmental influences. But how do managers themselves speak of managerial excellence? This paper answers this for a particular corporation, based on a three-phased research process that deliberately imposes no descriptive or normative categories, but allows the answer to emerge, listening to what managers themselves say when discussing excellent managers and their (...) behaviors. This approach finds that: (1) virtue ethics and virtue language is fluently used by practicing managers, (2) virtue language is important to understanding managerial excellence, and (3) whereas the set of virtues defining the excellent manager can be expected to be dependent on the societal, industry, and organizational context, such a set of manager virtues can be identified and prioritized within a particular organizational milieu. The implication is that, once an organization's management better understands the meaning of the excellent manager in terms of the virtue language already used by its own employees, it is better equipped to implement a practical ethic of virtues, one helpful toward recognizing and developing excellent managers. Ethics researchers are challenged to increase their understanding of extant virtue language as the basis for a renewed development of virtue ethics theory and applications. (shrink)

After briefly describing the philosophy of personalism this article assesses each of three normative leadership paradigms in terms of five major themes of this phenomenological philosophy. Servant leadership appears to be closest to personalism. The critical ingredient for servant leadership is also personalism’s starting point, i.e. the dignity of each human person. A genuine servant leader works with his followers in building a community of participation and solidarity. However, some claim that servant leaders are subject to manipulation by their followers. (...) If so, and if transformational leaders, when too successful, gain too much power or manipulate using bogus empowerment, a superior approach might be provided by a combination in which a morally tough servant leader adopts certain transforming behaviors of Bass’s altruistic transformational leader. The leader and the followers would focus on a jointly formulated and refined vision, avoiding manipulation by any party through a mutual commitment to participation, solidarity of community, and respect for each person. (shrink)

Williams, Elster and Pears hold that an effort to induce in oneself a belief in the truth of some proposition that one believes to be false can succeed only if one manages, somewhere along the way, to forget that one is engaged in such an effort. Although this view has strong intuitive appeal, it is false, and in this paper it is shown to be false by example.

According to Colerus, Spinoza replied affirmatively when his landlady asked if she "...could be saved in her faith." This paper asks what Spinoza could have meant -- and what his landlady would have thought he meant. She was asking about salvation of a certain kind -- a kind that Spinoza did not in fact believe to be possible. When he talks about salvation in his writings, he has in mind a different kind of salvation -- one that his landlady will (...) certainly not achieve "in her faith." So, when he assured her that she could be saved in her faith was he simply lying to her? This question is explored against the background of the controversies regarding Spinoza's sincerity in the Tractatus Theologico-politicus. (shrink)

Since the 19th century, innocence has been a hallmark of childhood. The innocence of children is seen as both a sanctity worth defending and a feature that excuses the unavoidable mistakes of adolescence. While beneficial in many settings, notions of childhood innocence are often entangled with values judgements. Inherent in innocence is the notion that that which we are innocent of is undesirable. Further, attributing innocence to some implies the tolerability of blame for others. This has unique implications in a (...) medical setting. This essay explores the implications of espousing the innocence of paediatric patients. Ultimately, because attribution of innocence is both prone to bias and rooted in the same framework as blame, it degrades patient-centred care and compromises the patient–provider relationship. I argue that avoiding such characterisations may allow providers to more effectively promote paediatric health. (shrink)

"No, your honor. I didn't know who or what he was when I first came across the book -- they don't exactly love him in the synagogue, if you've read the story of his life. I found it in a junkyard in a nearby town, paid a kopek, and left cursing myself for wasting money hard to come by. Later I read through a few pages and kept on going as though there were a whirlwind at my back. As I (...) say, I didn't understand every word but when you're dealing with such ideas you feel as though you were taking a witch's ride. After that I wasn't the same man. That's in a manner of speaking, of course, because I've changed little since my youth.". The speaker is Yakov Bok, the unlikely hero of Bernard Malamud's The Fixer. At this point, early in the novel, Yakov speaks truthfully when he says that he has changed little since his youth. But over the next two and a half years (the time-period covered in the novel), he will undergo profound change and impressive moral growth. He suffers; he learns; he grows. Spinoza's name and ideas appear again and again at crucial moments in the course of the hero's moral development. Yakov Bok's verbal account of Spinoza's ideas is often comically primitive, but his understanding far outstrips his ability to articulate. By the end of the novel, his sufferings have led him to a deep grasp of certain of Spinoza's ethical and political doctrines. (shrink)

In Göttliche Gedanken (Godly Thoughts), Andreas Schmidt provides an in-depth discussion of the metaphysics of knowledge and of mind in four early-modern rationalists: Descartes, Malebranche, Spinoza, and Leibniz. His topic overlaps with what is called “philosophy of mind” in contemporary Anglo-American circles, for he is quite interested in the relation between mind and body in these four historical thinkers. But as Schmidt effectively reminds us, the “mind-body problem” looks entirely different when embedded in the conceptual setting of the seventeenth century. (...) In Schmidt’s reading, reflection on mind at that time begins with reflection on knowledge and our capacity to know. What must the mind be in order for us .. (shrink)

Review of Daniel Cook, Hartmut Rudolph, and Christoph Schulte, editors. _Leibniz und das Judentum_. Studia Leibnitiana Sonderhefte, 34. Stuttgart: Steiner, 2008. Pp. 283.

In the introductory chapter to this collection, the editors point out that, until recently, most Anglophone Spinoza scholarship has been focused on the metaphysics and epistemology of the Ethics. But according to Kisner and Youpa, Spinoza thought that metaphysics and epistemology were significant chiefly because they are required for understanding the more important part of his project—the ethical doctrine developed in the last three parts of the work. Ethica was so-titled because it is a book about ethics.In recent years, the (...) scholarly community has begun to shift its attention to bring itself more in line with Spinoza's intentions—to focus more directly on his ethical views. The volume under review presents... (shrink)

One thing that becomes apparent in this exchange is that each of the positions emerges based on differences in fundamental philosophical commitments. An existential Thomist has a very well-defined and sufficiently “thick” view of being at the heart of his metaphysical system. Van Inwagen rejects such views of being in favor of a “thin” view. This issue is addressed and clarified. Craig takes issue with the way the term “moderate-realism” has been explicated, whether or not the idea of existence in (...) the intellect is coherent, and whether the Thomistic solution offers any real advantages over nominalist ones. In this response, I continue to demonstrate the cogency and advocate the superiority of Aquinas’s position. (shrink)

On the horizon between metaphysics and philosophy of religion stands the question of God’s relation to various abstracta. Like other contemporary philosophical debates, this one has resulted in a broadly dichotomous stalemate between Platonic realists on the one hand and varieties of nominalism/antirealism on the other. In this paper, I offer Aquinas’s moderaterealism as a true middle ground between realist or nominalist solutions. What Platonists take to be abstracta are actually the result of intellect’s abstractive work on sensible objects. Further, (...) the Christian philosopher should be concerned as much, if not more so, by nominalism than by Platonism. Given the problems associated with either Platonist or nominalist solutions, one should be open to a Thomistic moderate-realist solution to the problem of God and abstracta. (shrink)

The recently published Cambridge Companion to Spinoza contains a fine essay by Pierre- Francois Moreau on Spinoza’s reception and on his influence during the more than three hundred years that have passed since his death. In Moreau’s twenty-five page article we find a brief paragraph on the novelist George Eliot and half a sentence on Ed Curley. There is not another mention, at all, of any other philosopher from an English-speaking land since the seventeenth century – nothing on how Spinoza’s (...) ideas were received in England, North America or Australia. Not a word on any influence that Spinoza might have had on later thinkers in those countries. (shrink)

This debate, principally between myself (Nigel Thomas) and Patrick Hayes, the well known computer scientist and Artificial Intelligence researcher, took place through the internet mailing list for the discussion of the scientific study of consciousness, PSYCHE-D (moderated by Patrick Wilken), which is associated with the on-line journal PSYCHE. The discussion touches on the various different senses in which the expression "mental image" may be used, the underlying cognitive mechanisms of imagery, and the relevance of an understanding of imagery to (...) the understanding of conscious thought, and thought in general. As the debate became rather 'unthreaded' on the list, following it through this page may help the reader to better understand what was going on. (shrink)

It has been known for 20 years that the ribosomal protein S6 is rapidly phosphorylated when cells are stimulated to grow or divide. Furthermore, numerous studies have documented that there is a strong correlation between increases in S6 phosphorylation and protein synthesis, leading to the idea that S6 phosphorylation is involved in up‐regulating translation. In an attempt to define a mechanism by which S6 phosphorylation exerts translational control, other studies have focused on characterizing the sites of phosphorylation of this protein (...) and its location within the ribosome. Recent data show that S6 is a protein which may have diverse cellular functions and is essential for normal development, and that it may be involved in the translational regulation of a specific class of messages. (shrink)

Rapid advances in the domain of science and technology are having an unprecedented effect upon the provision of higher education in universities throughout the world, the pace of change often being so fast as to make planning for the development of the “classroom of the future” an extremely difficult task. The Mobile Multimedia University (MMU) project, a collaborative action between four leading UK based research facilities, has been established to investigate these issues. Included amongst its aims is the use of (...) novel research methodologies to determine the factors which will influence the shape and form of future education provision, and thus the distribution of knowledge to society, such as mobility, telecommunications and multimedia services. This paper describes the use of a Delphi survey in predicting the technological trends and innovations which will affect university education in the near future. It describes the theory underpinning the Delphi method, illustrating this with examples of how such a technique has been successfully used in the past. It then details the specific application of the Delphi approach within the current MMU research project, detailing the preliminary results and discussing the implications of these findings for the future of universities and other institutes of higher education. (shrink)

We developed and tested a behavioral version of the Defining Issues Test-1 revised (DIT-1r), which is a measure of the development of moral judgment. We conducted a behavioral experiment using the behavioral Defining Issues Test (bDIT) to examine the relationship between participants’ moral developmental status, moral competence, and reaction time when making moral judgments. We found that when the judgments were made based on the preferred moral schema, the reaction time for moral judgments was significantly moderated by the moral developmental (...) status. In addition, as a participant becomes more confident with moral judgment, the participant differentiates the preferred versus other schemas better particularly when the participant’s abilities for moral judgment are more developed. (shrink)

We explore the issue of media content and corporate social responsibility by considering three questions:1. Why is this issue becoming so salient to a variety of stakeholders across the political spectrum at this time?2. What are the ethical issues that companies and policy makers should be concerned about with regard to media content?3. How can media-related companies and industries either better self-regulate or enhance consumer choice to respond to legitimate concerns about access tocontent?

Qualitative and quantitative research on the impact of medical and health humanities teaching in baccalaureate education is sparse. This paper reviews recent studies of the impact of medical and health humanities coursework in pre-health professions education and describes a pilot study of baccalaureate students who completed semester-long medical humanities courses in the Division of Medical Humanities & Bioethics at the University of Rochester. The study format was an email survey. All participants were current or former baccalaureate students who had taken (...) one or more courses in literature and narrative in medicine, bioethics, history of medicine, and/or visual arts and healthcare during the past four years. The survey gathered numerical data in several areas: demographic information, career plans, self-reported influence of coursework on educational and career plans, and self-reported influence of coursework on intellectual skills and abilities. It also gathered narrative commentary that elaborated on students’ responses to the numerically-based questions. Notable findings from preliminary analysis of the data include higher scores of self-reported impact of the coursework on specific habits of mind and on preparedness for intended career rather than on gaining admission to future educational programs. Discussion of the results focuses on several potential future directions this type of study might take, including multi-center, longitudinal, and sequential approaches. (shrink)

What is knowledge? Why is it valuable? How much of it do we have, and what ways of thinking are good ways to use to get more of it? These are just a few questions that are asked in epistemology, roughly, the philosophical theory of knowledge. This is Epistemology is a comprehensive introduction to the philosophical study of the nature, origin, and scope of human knowledge. Exploring both classic debates and contemporary issues in epistemology, this rigorous yet accessible textbook provides (...) readers with the foundation necessary to start doing epistemology. Organized around 11 key subtopics, and assuming no prior knowledge of the subject, this volume exposes readers to diverse, often contentious perspectives—guiding readers through crucial debates including Hume’s problem of induction, Descartes’ engagement with radical skepticism, rationalist and empiricist evaluations of a priori justification, and many more. The authors avoid complex technical terms and jargon in favor of an easy-to-follow, informal writing style with engaging chapters designed to stimulate student interest and encourage class discussion. Throughout the text, a wealth of up-to-date references and links to online resources are provided to enable further investigation of an array of epistemological topics. A balanced and authoritative addition to the acclaimed This is Philosophy series, This is Epistemology is a perfect primary textbook for philosophy undergraduates, and a valuable resource for general readers with interest in this important branch of philosophy. (shrink)

How are we to make sense of madness and psychosis? For most of us the words conjure up images from television and newspapers of seemingly random, meaningless violence. It is something to be feared, something to be left to the experts. But is madness best thought of as a medical condition? Psychiatrists and the drug industry maintain that psychoses are brain disorders amenable to treatment with drugs, but is this actually so? There is no convincing evidence that the brain is (...) disordered in psychosis, yet governments across the world are investing huge sums of money on mental health services that take for granted the idea that psychosis is an illness to be treated with medication. Although some people who use mental health services find medication helpful, many do not, and resist the idea that their experiences are symptoms of illnesses like schizophrenia. Consequently they are forced into having treatment against their wishes. So, how do we make sense of this situation? Postpsychiatry addresses these questions. It involves an attempt to rethink some of the fundamental assumptions of mental health work, showing how recent developments in philosophy and ethics can help us to clarify some of the dilemmas and conflicts around different understandings of madness. Throughout, the authors examine the conflicting ways in which politicians, academics, and mental health professionals appear to understand madness, and contrast this with voices and experiences that are usually excluded - those of the people who use mental health services. They then examine the power of psychiatry to shape how we understand ourselves and our emotions, before considering some of the basic limitations of psychiatry as science to make madness meaningful. In the final section of the book they draw on evidence from service users and survivors, the humanities and anthropology, to point out a new direction for mental health practice. This new direction emphasises the importance of cultural contexts in understanding madness, placing ethics before technology in responding to madness, and minimising 'therapeutic' coercion. (shrink)