A majority opinion seems to have emerged in scholarly analysis of the assortment of technologies that have been given the label “synthetic biology.” According to this view, society should allow the technology to proceed and even provide it some financial support, while monitor­ing its progress and attempting to ensure that the development leads to good outcomes. The near‐consensus is captured by the U.S. Presidential Commission for the Study of Bioethical Issues in its report New Directions: The Ethics of Synthetic Biology (...) and Emerging Technologies, which arguably marked the end of a preliminary round of analysis about the ethical and policy questions raised by synthetic bi­ology. Like a number of other, earlier documents issued by various groups around the world, the re­port called attention to questions about how the technology will be used; whether it might be mis­used; what sorts of accidents might happen along the way; the economic, environmental, and social impacts of the eventual applications; whether the very idea of “synthetic biology” should be trou­bling; and how the debate over all of these ques­tions will be conducted. Also like most similar documents, however, while it called for careful monitoring and oversight of technology, it did not recommend any significant new constraints on its development and use. The commission's stance was that it would be “imprudent either to declare a moratorium on synthetic biology until all risks can be determined and mitigated, or to simply ‘let science rip,’ regardless of the likely risks.”In this report, we will take stock of the current consensus, comment on some of the major points of disagreement, and identify the next steps for the debate. In part I, we offer a brief overview of the research and applications commonly grouped together under the heading of synthetic biology, partly in order to set the stage for the rest of the discussion and partly because we want to highlight some conceptual problems that attend the very la­bel given this field. In parts II, III, and IV, we take up, respectively, three broad classes of concerns that arise in the context of synthetic biology: con­cerns about the intrinsic or inherent value of do­ing synthetic biology, concerns about the concrete harms and benefits of doing synthetic biology, and concerns about justice. Addressing these concerns requires a method for bringing the public's values to bear on policy‐making concerning emerging biotechnologies; in part V, we discuss the chal­lenges in developing such a method. (shrink)

This essay analyzes two types of patient‐experience data to broaden and deepen understanding of trust in health care. Analysis of patients’ open‐ended comments shows a close connection between patients’ feelings of trust and their intent to recommend providers and provider organizations—a global measure to evaluate patients’ perceptions of care experiences. Patients’ comments also reveal the bidirectional building of trust between the patient and the caregiver. Trust gets built when patients perceive their caregivers to trust their knowledge of their bodies as (...) well as when caregivers demonstrate caring behaviors that earn the patients’ trust. Patients’ ratings of a closed‐ended survey item on “confidence in provider” create the greatest differentiation for the global measure of patient experience—whether patients did or did not recommend a practice or provider. The essay also discusses related findings on pre‐visit friction and the use of humor by the caregiver to expand understanding of trust. (shrink)

Book reviewed in this article: Mystical Bedlam: Madness, Anxiety, and Healing in Seventeenth Century England. By Michael MacDonald. Making It Crazy: An Ethnography of Psychiatric Clients in an American Community. By Sue E. Estroff. Mind, Mood, and Medicine: A Guide to the New Biopsychiatry. By Paul H. Wender, M.D. and Donald F. Klein, M.D.

The marketing of health care services raises the prospect that an ethic of strangers will govern relations between providers and patients. A fiduciary model that emphasizes honesty and public accountability, as well as the patient's good and avoiding unnecessary services, can keep marketing consistent with the ethical tradition of medicine.

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

The editors welcome letters from readers, although we cannot guarantee that all will be published. To ensure timeliness, correspondents must respond to an article within seven weeks and not exceed two double‐spaced pages. Letters become the property of the editors and may be edited and shortened at our discretion.

The editors welcome letters from readers, although we cannot guarantee that all will be published. To ensure timeliness, correspondents must respond to an article within seven weeks and not exceed two double‐spaced pages. Letters become the property of the editors and may be edited and shortened at our discretion.

Book reviewed in this article: Artificial Reproduction: A Social Investigation. By R. Snowden, G.D. Mitchell, and E. M. Snowden. Redefining Human Life: Reproductive Technologies and Social Policy. By Robert H. Blank. Reproductive Ethics. By Michael D. Bayles.

This essay considers the issue of informed consent as it arose in the context of 1960s living kidney donors. In one of the earliest empirical inquiries into informed consent, psychiatrists Carl H. Fellner and John R. Marshall interviewed donors about their decision‐making process and their experience and reflections on donorship. In their much‐cited 1970 paper, the physicians reported that living donors, rather than reaching a reasoned, intellectual, and unemotional decision about donating a kidney (as stipulated in the Ethical Guidelines for (...) Organ Transplantation issued by the American Medical Association's Judicial Council), instead made instantaneous and “irrational” decisions about participation. Fellner and Marshall's studies contributed to the public debate and professional discussion about the moral and ethical dimensions of donorship, even as they challenged the developing consensus on informed consent. (shrink)

Over email a few days after the death of Daniel Callahan, cofounder of The Hastings Center and for many years its director and then president, Joseph Fins, a longtime Hastings colleague, offered this comfort: “[H]enceforth every issue of the Report is a living memorial to Dan the writer, editor, and institution builder.” In the Hastings Center Report's first issue, published in June 1971, Dan stated, “To say that [the work of the Report] must be multi‐disciplinary is only (...) to say the issues [it will address] are as complex as human beings themselves.” This July–August 2019 issue continues the tradition Dan began. An essay by Laura Guidry‐Grimes expands on the importance of interdisciplinary conversations and problem solving—and attends to the complexity of human beings—in recalling a patient who was failed by multiple social institutions. In the lead article, a team of authors led by James Sabin identifies a challenge to conducting ethical research within learning health organizations, where research and care are integrated with the aid of patient data from health insurance providers. (shrink)

I argue that to be compelled to do routine work is to be gravely harmed. Indeed, that pink - collar work is a more serious harm to women than rape. My purpose is to urge politically active feminists and feminist organizations to arrange their priorities accordingly and devote most of their resources to working for the elimination of sex segregation in employment.

It is a thankless task to have to reply to Professor Murray Krieger’s “Retrospective.” Qui s’excuse, s’accuse, and since I cannot ask my readers to embark on their own retrospective of my writings and test them for consistency, I have little chance of restoring my reputation in their eyes. Hence I would have been happier to leave Professor Krieger to his agonizing, if he did not present himself the “spokesman” for a significant body of theorists who appear to have acclaimed (...) my book on Art and Illusion without ever having read it. The followers of this school of criticism—of which Professor Krieger is a prominent member—had apparently convinced themselves that the book lent support to an aesthetics in which the notions of reality and of nature had no place. They thought that I had subverted the old idea of mimesis and that all that remained were different systems of conventional signs which were made to stand for an unknowable reality. True, professor Krieger admits that I never endorsed such an interpretation of my views, and he even concedes that there are passages in Art and Illusion which contradict such an out-and-out relativism, but he wants to convince his readers that these contradictions lead precisely to the ambiguities he now proposes to analyse.If he were right that the book encourages such a misreading, all I could do would be to express my regrets for having failed to make myself sufficiently clear. Luckily I can draw comfort from the fact that unlike these literary critics, the leading archaeologist of this country, Professor Stuart Piggott, had no difficulty at all in discerning my meaning and profiting from my arguments. In his Walter Neurath Memorial Lecture of 1978, entitled Antiquity Depicted: Aspects of Archaeological Illustration, the author did me the honour of taking a statement from my book as his starting point. It is the passage at the end of part I in which I recapitulate the content of the first two chapters:What matters to us is that the correct portrait, like the useful map, is an end product on a long road through schema and correction. It is not a faithful record of a visual experience but the faithful construction of a relational mode.Neither the subjectivity of vision nor the sway of conventions need lead us to deny that such a model can be constructed to any required degree of accuracy. What is decisive here is clearly the word “required.” The form of a representation cannot be divorced from its purpose and the requirements of the society in which the given visual language gains currency.1 1. E. H. Gombrich, Art and Illusion: A Study in the Psychology of Pictorial Representation, A. W. Mellon Lectures in the Fine Arts, 1956 , p. 90. E. H. Gombrich was director of the Warburg Institute and Professor of the History of the Classical Tradition at the University of London from 1959 to 1976. His many influential works include The Story of Art, Art and Illusion, Meditations on a Hobby Horse, The Sense of Order, Ideals and Idols, The Image and the Eye, and, most recently, Tributes. His previous contributions to Critical Inquiry include “The Museum: Past, Present and Future and “Standards of Truth: The Arrested Image and the Moving Eye”. (shrink)

[E.H. Gombrich wrote on May 13, 1975:] . . . I recently was invited to talk about "Art" at the Institution for Education of our University. There was a well-intentioned teacher there who put forward the view that we had no right whatever to influence the likes and dislikes of our pupils because every generation had a different outlook and we could not possibly tell what theirs would be. It is the same extreme relativism, which has invaded our art schools (...) and resulted in the doctrine that art could not possibly be taught because only what has been done already can be taught, and since art is creativity it is not possible to teach it. Q.E.D.—I recently asked my history finalists what "Quod erat demonstrandum" means and they did not know. . . . [Quentin Bell responded on May 15, 1975:] . . . Your teacher at the Institute, is he really a relativist? Isn't he a kind of religious zealot? I used to teach school children. With me there was a much better teacher . One day she came into the room where I had been teaching and found a series of the most surprising and beautiful water colours. "What are these?" said she. I explained that they were copies of Raphael made by eleven and twelve year old children. I would have gone on to explain how interested I was by their resemblance, not to Raphael but rather to Simone Martini, for they had all the shapes beautifully right but none of the internal drawing or the sentiment, but I was checked by her look of horror. "You've made them copy from Raphael?" she said. Her expression was exactly that of someone who had been casually informed that that I had committed a series of indecent assaults upon the brats. And in fact in subsequent conversation it appeared that this was very nearly what she did feel. For her, what she called "self expression" was as precious as virginity. E.H. Gombrich was director of the Warburg Institute and Professor of the History of the Classical Tradition at the University of London from 1959 to 1976. His books include The Story of Art, Art and Illusion, Meditations on a Hobby Horse, Norm and Form, Symbolic Images, The Heritage of Apelles, and In Search of Cultural History. He became a Fellow of the British Academy in 1960, a Commander of the British Empire in 1966, and was knighted in 1972. He is also a trustee of the British Museum and a foreign member of the American Academy of Arts and Sciences and of the American Philosophical Society. His contributions to Critical Inquiry include "Notes and Exchanges" ,"Standards of Truth: The Arrested Image and the Moving Eye" , and, with Quentin Bell, "Canons and Values in the Visual Arts: A Correspondence" . Quentin Bell is professor of the history and theory of art, Sussex University. He has written Virginia Woolf: A Biography, Of Human Finery, Ruskin, Victorian Artists and Bloomsbury. Other contributions to Critical Inquiry are "The Art Critic and the Art Historian" , "Notes and Exchanges" , and "Bloomsbury and 'the Vulgar Passions'". (shrink)

BACKGROUND: Serotonin transporter promoter genotype appears to increase risk for depression in the context of stressful life events. However, the effects of this genotype on measures of stress sensitivity are poorly understood. Therefore, this study examined whether 5-HTTLPR genotype was associated with negative information processing biases in early childhood. METHOD: Thirty-nine unselected seven-year-old children completed a negative mood induction procedure and a Self-Referent Encoding Task designed to measure positive and negative schematic processing. Children were also genotyped for the 5-HTTLPR gene. (...) RESULTS: Children who were homozygous for the short allele of the 5-HTTLPR gene showed greater negative schematic processing following a negative mood prime than those with other genotypes. 5-HTTLPR genotype was not significantly associated with positive schematic processing. LIMITATIONS: The sample size for this study was small. We did not analyze more recently reported variants of the 5-HTTLPR long alleles. CONCLUSIONS: 5-HTTLPR genotype is associated with negative information processing styles following a negative mood prime in a non-clinical sample of young children. Such cognitive styles are thought to be activated in response to stressful life events, leading to depressive symptoms; thus, cognitive styles may index the "stress-sensitivity" conferred by this genotype. (shrink)