Whole genome sequencing is quickly becoming more affordable and accessible, with the prospect of personal genome sequencing for under $1,000 now widely said to be in sight. The ethical issues raised by the use of this technology in the research context have received some significant attention, but little has been written on its use in the clinical context, and most of this analysis has been futuristic forecasting. This is problematic, given the speed with which whole genome sequencing technology is likely (...) to be incorporated into clinical care. This paper explores one particular subset of these issues: the implications of adopting this technology in the prenatal context without a good understanding of when and how it is useful. Prenatal whole genome sequencing differs from current prenatal genetic testing practice in a number of ethically relevant ways. Most notably, whole genome sequencing would radically increase the volume and scope of available prenatal genetic data. The wealth of new data could enhance reproductive decision‐making, promoting parents' freedom to make well‐informed reproductive decisions. We argue, however, that there is potential for prenatal whole genome sequencing to alter clinical practice in undesirable ways, especially in the short term. We are concerned that the technology could (1) change the norms and expectations of pregnancy in ways that complicate parental autonomy and informed decision‐making, (2) exacerbate the deleterious role that genetic determinism plays in child rearing, and (3) undermine children's future autonomy by removing the option of not knowing their genetic information without appropriate justification. (shrink)

The cost of health care at the end of life accounts for a high proportion of total health care costs in the United States. The percentage of Medicare payments attributable to patients in their last year of life was 28.3% in 1978 and has remained substantially the same at 25.1% in 2006. This indicates how little progress has been made in containing these costs, though doing so will be important to promote a financially sustainable health care system. These expenditures also (...) highlight the prospect that efforts to reduce health care costs overall are likely to disproportionately affect the care patients receive at the end of life. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Kant and the Capacity to Judge; Sensibility and Discursivity in the Transcendental Analytic of the Critique of Pure Reason by Beatrice LonguenesseMichelle GreerBeatrice Longuenesse. Kant and the Capacity to Judge; Sensibility and Discursivity in the Transcendental Analytic of the Critique of Pure Reason. Translation by Charles T. Wolfe. Princeton, NJ: Princeton University Press, 1998. Pp. xv + 420. Cloth, $59.50.Kant and the Capacity to Judge is a translation (...) of Longuenesse’s Kant et Pouvoir de juger, although Longuenesse has revised and added to the original version. The central argument seeks to demonstrate the essential role played by the logical forms of judgment in the arguments of Kant’s first Critique. Longuenesse emphasizes straight away Kant’s efforts (in the Metaphysical Deduction) to deduce a set of pure concepts from the logical forms of judgment. Against many standard readings, she aims to reveal the very “tight” connection between this attempt and subsequent arguments in the Transcendental [End Page 372] Analytic. That Kant takes the functions of judgment to be relevant to these arguments is hardly a novel claim. The originality of Longuenesse’s work, however, stems both from the central and pervasive role she assigns to the logical forms of judgment, and from the impressive, painstaking effort she makes to sustain the close connection between these forms and Kant’s subsequent arguments. According to Longuenesse, any proper understanding of the arguments of the Transcendental Analytic absolutely depends upon relating these “down to the minutest details of their proofs,” to the role of the logical forms (5).These minute details do not escape Longuenesse in her subsequent elaboration on this original thesis. Given the length and detail of her work, I can only highlight a few of the central points and strategies. One should note from the outset, however, that the detail and the scholarship evinced to support her claims constitute much of what is of value in the book. Many of these “supporting arguments” and discussions, which include efforts to trace Kantian conceptions back to their historical/philosophical origins, stand in their own right as independent contributions to Kant scholarship and interpretation.The work is divided into three parts. The first part is essentially propaedeutic. Longuenesse begins by drawing a distinction between the potential or capacity to judge and judgement itself (i.e., the “actualization” of this judgmental capacity under [externally grounded] sensory stimulation) (7). Taking this distinction as her cue, Longuenesse seeks to reveal the way in which the line of argumentation in the transcendental analytic presents an extended investigation into the formal capacity (ibid). The centrality of the logical forms of judgment is secured early on by assigning them a substantive role in the very presentation of something in intuition “as” an “object.” Insofar as she assigns this role to the logical forms themselves, her account clearly undercuts the primary function of the categories in this regard. Relevant here is Longuenesse’s construal of “appearances” as the intentional correlates of our representational capacities and activities (cf. 20–21). Given this, the problem now motivating the transcendental deduction is how to make sense of the relation between this “internalized” object of (indeterminate) empirical intuition (the appearance) and the object corresponding to intuition which concepts allow one to think in a determinate way (the phenomenon). This ability to think the object in a determinate fashion appears to be the essential contribution made by judgement.These preliminary considerations ground Longuenesse’s efforts (in Part Two) to isolate and examine the discursive activity of judgment. Longuenesse stresses the reflective (and not simply the determinative) role of judgment and its forms. Indeed, she suggests that concepts (not merely empirical concepts, but also the pure concepts of the understanding themselves) are formed by reflecting (through acts of comparison, reflection, and abstraction) on the “sensible given.” Drawing extensively from the Logic, she interestingly argues that the form of judgment itself carries with it some inherent claim to objectivity. Thus, objectivity is folded into the formal activity of judging by being identified as a “normative propensity” inherent in every judgment by virtue of its form alone (87–88). Longuenesse accordingly eschews efforts to downplay the role of the logical use of the... (shrink)

In the current career landscape and labor market, career transitions have become a critical aspect of career development and are significant for Human Resource Development research and practice. Our research examines the type of support used during different career transitions and who can provide that support to women in career transition. We investigated four types of social support—emotional, appraisal, informational, and instrumental—and their roles in five types of career transitions: school-to-work transition, upward mobility transition, transition to a new profession, transition (...) to entrepreneurship, career re-entry transition, and transition to retirement. We analyzed 80 journal articles using directed content analysis, cross-tabulation, and nonparametric statistical tests. Instrumental support appears to be the most commonly documented type of social support in this career transition literature. Appraisal support was consistently documented least for each type of career transition. Our results may highlight the importance of personal connections and internal resources in successful career transitions for women. Based on our findings, we offer a model of women's social support network for career transitions and advocate for expanded networks of social support for women anticipating and during career transitions. The results of our study contain insights for how women can be supported in transitioning to the next career experience. We conclude with suggestions for future research. (shrink)

In 1982, without waiting for the findings of the National Hospice Study, Congress passed legislation enabling certified hospices to receive Medicare reimbursement. What emerged is a reimbursement program that differs substantially from the movement that spawned it. Hospices now face many dilemmas, among them shifting the burden of care to the family, determining who controls the course of patient care, and breaking even financially.

This paper presents an extensional account of manyand few that explains data that have previously motivated intensional analyses of these quantifiers :599–620, 2000). The key insight is that their semantic arguments are themselves set intersections: the restrictor is the intersection of the predicates denoted by the N’ or the V’ and the restricted universe, U, and the scope is the intersection of the N’ and V’. Following Cohen, I assume that the universe consists of the union of alternatives to the (...) nominal and verbal predicates, where an alternative to a property ψ is one that shares a pragmatic presupposition with ψ, and a pragmatic presupposition is one that is selected by context from a set of potential presuppositions associated with the sentence. A many/few-quantified sentence is then true iff the proportion of the scope to the restrictor is greater/less than some threshold, n. In addition to explaining various problematic cases from the literature, the analysis shows how the readings of a many/few-quantified sentence can be derived from the same syntactico-semantic structure, it being unnecessary to claim lexical or structural ambiguity. The analysis also provides strong support for the idea that natural language quantification is always purely extensional. (shrink)

Augustine’s first conversion is to the Christian Platonism of his day, which brought along with it a free-will defence to the problem of evil. Formative as this philosophical influence was, however, Augustine’s own experience of sin combines with his sense of God’s sovereignty to lead him to modify the views he inherited in significant ways. This transformation is demonstrated by setting Augustine’s evolving position against that of Gregory of Nyssa.

The primary function of the European Court of Human Rights is to ensure that administrative and judicial processes in member states effectively conform to pan‐European Convention standards (‘constitutional justice’) rather than seeking to provide every deserving applicant with a remedy for a Convention violation (‘individual justice’). But, in order to do so effectively some core elements of the Convention's constitution require more deliberate articulation and more consistent application. In seeking to show how this might be achieved, this article argues that (...) three primary constitutional principles—the judicial protection of Convention rights (the ‘rights’ principle), the democratic pursuit of the public interest (the ‘democracy’ principle), and the principle of priority to rights (the ‘priority’ principle), each exercised according to the rule of law—can be distinguished from a cluster of secondary principles which support them in a variety of ways. An analysis of the Convention's key provisions shows, in particular, how the ‘priority’ principle can, and should, operate to give the Court's decisions greater coherence and constitutional authority. (shrink)

Background Achieving meaningful consent can be challenging, particularly in contexts of diminished literacy, yet is a vital part of participant protection in global health research. Method We explored the challenges and potential solutions of achieving meaningful consent through a qualitative study in a predominantly hill tribe ethnic minority population in northern Thailand, a culturally distinctive population with low literacy. Semi-structured interviews were conducted with 37 respondents who had participated in scrub typhus clinical research, their family members, researchers and other key (...) informants. A thematic analysis was conducted. Results Our analysis identified four interrelated themes surrounding participants’ ability to give consent: varying degrees of research understanding, limitations of using informal translators, issues impacting decisions to join research, and voluntariness of consent. Suggestions for achieving more meaningful consent included the use of formal translators and community engagement with research populations. Conclusions Participant’s agency in decision making to join research should be supported, but research information needs to be communicated to potential participants in a way that they can understand. We found that improved understanding about the study and its potential benefits and harms goes beyond literacy or translation and requires attention to social and cultural factors. (shrink)

Responding to the complicated conditions produced by both the Constantinian Revolution and the collapse of the Roman Empire in the West, Augustine concerned himself not so much with “earthly transitions” as with the only transition that he believed had final significance: the transition of Christ from death to life.

Transnational politics and labor markets are undermining national industrial relations systems in Europe. This article examines the construction industry, where the internationalization of the labor market has gone especially far. To test hypotheses about di ferences between “national systems,” the authors examine the United Kingdom, Finland, and Germany, alongside European-level policy making. Regardless of overall national institutional framework, employers seek to avoid industrial relations rules, while unions attempt to relocalize labor relations. Both use shop-floor, national, and European power resources. The (...) authors argue that comparative industrial relations should take seriously the connection between action at the national and transnational levels. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Figures of Entanglement: Diffractive Readings of Barad, New Materialism, and Rhetorical Theory and Criticism ed. by Christopher N. Gamble and Joshua S. HananSavannah Greer DowningFigures of Entanglement: Diffractive Readings of Barad, New Materialism, and Rhetorical Theory and Criticism. Edited by Christopher N. Gamble and Joshua S. Hanan. Routledge, 2021. xvi + 122 pp. $168 (hardcover), $47.16 (electronic book). ISBN: 9780367903794.Rhetorical scholars have turned to various new materialist (...) frameworks to shift the discipline's historically anthropocentric focus and fully engage matter's rhetoricity. While all such frameworks attempt to challenge "the anthropocentric assumption that nonhuman matter is intrinsically passive or non-agential and thus external to or separable from (human) meaning," Figures of Entanglement enters this burgeoning conversation by centering the unique contributions of Karen Barad (xi, x). Readers may recognize this collection from a 2016 special issue of Review of Communication. Yet, with a new foreword by editors Christopher N. Gamble and Joshua S. Hanan and an afterword by Laurie Gries, this collection makes Barad's distinct approach to matter's rhetoricity even more apparent, underscoring its fruitful potential for new materialist rhetorics invested in ethical, political transformation.In the book's foreword Gamble and Hanan differentiate Barad's per-formative new materialism from "vital" as well as what they refer to as "negative" new materialisms to show the generative potential of Barad's framework and the notion of entanglement (x). Other new materialisms tend to be "inclusionary"—add matter and stir—and fail to complicate "the human" itself and its differences (xiv, xi). First, vital and negative new materialisms maintain a distinction between being and knowing, allowing humans to emerge with a unique capacity to "objectively observe and know the existence of something essential, determinate, and unchanging about [End Page 395] reality that precedes and remains unaffected by both its own activities and our observations of it" (xi). On the contrary, Barad's performative approach suggests that "no aspect of reality—including human thought, meaning, and observation—is in any sense external to matter or ever remains entirely unchanged by matter's ongoing performances" (x). Here, humans are not "outside" of observation, but all observation "human or otherwise" co-constitutes what is observed (xi). Second, failing to interrogate "the human" in an attempt to observe matter's vitality is an ethical flaw that makes other approaches less capable of grappling with difference: they have been charged with "erasing associations between race, gender, and matter" and (re)producing a homogenizing, "Western-colonialist notion of humanness" (xiv). In contrast, Barad's is a "thoroughly relational," performative new materialism (1).Barad's concept of "entanglement" draws attention to the indeterminacy of matter and meaning, but it is accompanied by an ethical imperative to examine how difference, human or otherwise, is produced and the implications of power imbalances that arise through these enactments. For Barad, the notion of entanglement does not dissolve difference; difference is what matters. Indeed, they give us a way of thinking about how performative intra-actions produce difference through material-discursive practices, or apparatuses—differences that may be expected but are not inevitable. Rhetorical scholars are therefore invited to interrogate the production of boundaries that cause harm and reconfigure them, rather than assume the discreteness of boundaries from the start. Gamble and Hanan thus make a convincing case for how Barad's work may contribute to important scholarship in decolonial and critical rhetorics for which vital and negative new materialisms are less equipped.Gamble and Hanan utilize the introduction to show how Barad's per-formative new materialism both "supports and affirms" rhetorical materialism, or rhetoric's materiality, and enriches it (5). Ushered in by Michael Calvin McGee, "standard" rhetorical materialism worked to challenge the centuries-old debate about rhetoric's secondary, supplementary status vis-à-vis philosophy by recognizing rhetoric as part of a "shifting and dynamic material history" (6). Building upon this view, Ronald Walter Greene utilizes Foucault's notion of the apparatus to demonstrate how even the "material history" McGee called our attention to is itself "produced by apparatuses"—history is not "outside" of meaning (6). Instead, rhetoric's materiality is a "publicity effect" produced through technologies of rhetoric and intersecting power... (shrink)

While the focus examines multiple levels and perspectives on care, it will go beyond description and analysis to discuss ethical, intersectional, and life-sustaining ways in which care may be enhanced.

A guide to the everyday decisions about right and wrong faced by physical scientists and research engineers. This book offers the first comprehensive guide to ethics for physical scientists and engineers who conduct research. Written by a distinguished professor of chemistry and chemical engineering, the book focuses on the everyday decisions about right and wrong faced by scientists as they do research, interact with other people, and work within society. The goal is to nurture readers' ethical intelligence so that they (...) know an ethical issue when they see one, and to give them a way to think about ethical problems. After introductions to the philosophy of ethics and the philosophy of science, the book discusses research integrity, with a unique emphasis on how scientists make mistakes and how they can avoid them. It goes on to cover personal interactions among scientists, including authorship, collaborators, predecessors, reviewers, grantees, mentors, and whistle-blowers. It considers underrepresented groups in science as an ethical issue that matters not only to those groups but also to the development of science, and it examines human participants and animal subjects. Finally, the book examines scientifically relevant social issues, including public policy, weapons research, conflicts of interest, and intellectual property. Each chapter ends with discussion questions and case studies to encourage debate and further exploration of topics. The book can be used in classes and seminars in research ethics and will be an essential reference for scientists in academia, government, and industry. (shrink)

This is my response to a book, Globalize Liberation, edited by David Solnit and published in 2004. Media activists James John Bell and Patrick Reinsborough sent me a copy and asked for my thoughts about it; the result turned into an essay of some length, which got a certain amount of exposure and discussion online. Looking at the travails of progressive activism since its publication, I find very little that needs revision, except the tone of relative optimism expressed toward the (...) end. (shrink)

While heredity is predominantly controlled by what deoxyribonucleic acid (DNA) sequences are passed from parents to their offspring, a small but growing number of traits have been shown to be regulated in part by the non‐genetic inheritance of information. Transgenerational epigenetic inheritance is defined as heritable information passed from parents to their offspring without changing the DNA sequence. Work of the past seven decades has transitioned what was previously viewed as rare phenomenology, into well‐established paradigms by which numerous traits can (...) be modulated. For the most part, studies in model organisms have correlated transgenerational epigenetic inheritance phenotypes with changes in epigenetic modifications. The next steps for this field will entail transitioning from correlative studies to causal ones. Here, we delineate the major molecules that have been implicated in transgenerational epigenetic inheritance in both mammalian and non‐mammalian models, speculate on additional molecules that could be involved, and highlight some of the tools which might help transition this field from correlation to causation. (shrink)

Recently, there have been a number of lawsuits in the United States in which families objected to performance of apnoea testing for determination of brain death. The courts reached conflicting determinations in these cases. We discuss the medicolegal complications associated with apnoea testing that are highlighted by these cases and our position that the decision to perform apnoea testing should be made by clinicians, not families, judges, or juries.