Throughout the U.S., state laws require professionals who work with children to report cases of suspected child abuse to child protection services. Both practically and conceptually, however, significant problems arise from a lack of clarity regarding the threshold that has been set for reporting. Specifically, there is no consensus as to what constitutes reasonable suspicion, and little direction for how mandated reporters should gauge their legal and professional responsibilities when they harbor suspicion. In this paper we outline the context of (...) the problem, discuss the nature and scope of its conceptual underpinnings, and offer recommendations for moving towards a concrete, practical solution. (shrink)

What are the moral stakes involved when we will have the same power to engineer our bodies as we do our automobiles? Which specific bioethics problems will put the most pressure on our ethical traditions? What should we do now to prepare for this brave new world? With Greg Loeben, Ronald Munson, and Wade Robison.

Next SectionObjectives To evaluate the adequacy of paediatric informed consent and its augmentation by a supplemental computer-based module in paediatric endoscopy. Methods The Consent-20 instrument was developed and piloted on 47 subjects. Subsequently, parents of 101 children undergoing first-time, diagnostic upper endoscopy performed under moderate IV sedation were prospectively and consecutively, blinded, randomised and enrolled into two groups that received either standard form-based informed consent or standard form-based informed consent plus a commercial (Emmi Solutions, Inc, Chicago, Il), sixth grade level, (...) interactive learning module (electronic assisted consent). Anonymously and electronically, the subjects' anxiety (State Trait Anxiety Inventory), satisfaction (Modified Group Health Association of America), number of questions asked, and attainment of informed consent were assessed (Consent-20). Statistics were calculated using t test, paired t test, and Mann Whitney tests. Results The ability to achieve informed consent, as measured by the new instrument, was 10% in the control form-based consent group and 33% in the electronic assisted consent group (p<0.0001). Electronically assisting form-based informed consent did not alter secondary outcome measures of subject satisfaction, anxiety or number of questions asked in a paediatric endoscopy unit. Conclusions This study demonstrates the limitations of form-based informed consent methods for paediatric endoscopy. It also shows that even when necessary information was repeated electronically in a comprehensive and standardised video, informed consent as measured by our instrument was incompletely achieved. The supplemental information did, however, significantly improve understanding in a manner that did not negatively impact workflow, subject anxiety or subject satisfaction. Additional study of informed consent is required. Clinical trial registration number ClinicalTrials.gov Identifier NCT00899392. (shrink)

Name der Zeitschrift: Semiotica Jahrgang: 2016 Heft: 208 Seiten: 35-47.

Comparative analytical study on two truths according to interpretation of eminent masters Gautama Buddha and Mi-bo Gśen-rab of Bon-po sect; includes their brief biographies.

Buddist literature; explanatory commentaries on Tantra philosophy, and commentary on the Mañjuśrīnāmasaṅgīti (Praise to Manjushri).

GS 341 is one of the most familiar of Nietzsche’s writings. This article proposes a new reading that stands in contrast with most English-language Nietzsche scholarship. The text presents a communication and its reception. A ‘demon’ makes an announcement, and a hearer responds in one way or another. But there is also another narrative altogether, whose conceptual vocabulary comes from a dynamic world-view. In this an interaction of forces leads to a new situation. If the hearer is not crushed by (...) the ‘greatest weight’, there must be an inner force that counteracts its impact. I argue that what Nietzsche calls amor fati is a state that allows our drives to achieve full expression, and so makes possible a collective strength able to withstand the greatest impact. The final sentence refers to a “confirmation and sealing”. What happens is that the demon’s message makes an impression on the receptive hearer. For Nietzsche this is a working metaphor, not a turn of phrase. In a draft from this period he writes: “Let us stamp the image of eternity on our life!” That sudden and forceful act, embodying an evaluative judgement, is the event that GS 341 is all about. (shrink)

In GS, Nietzsche utters for the first time the paradoxical formula that sums up a good deal of his ethical thought: "What does your conscience say?—'You should become who you are'".1 The paradox, of course, lies in the odd juxtaposition of becoming and being: how can one become what one already is? Nietzsche repeats the formula toward the end of the original edition of GS, connecting it explicitly to the idea of self-creation: "We, however, want to become who we are—human (...) beings who are new, unique, incomparable, who give themselves laws, who create themselves!". What exactly such self-creation involves for Nietzsche, how it relates to "who we are," and whether it ultimately coheres as a... (shrink)

Genomic sequencing technologies (GS) pose novel challenges not seen in older genetic technologies, making traditional standards for fully informed consent difficult or impossible to meet. This is due to factors including the complexity of the test and the broad range of results it may identify. Meaningful informed consent is even more challenging to secure in contexts involving significant time constraints and emotional distress, such as when rapid genomic testing (RGS) is performed in neonatal intensive care units. In this article, we (...) propose that informed consent matters not for its own sake, but because obtaining it furthers a range of morally important goals, such as promoting autonomy, well‐being, and trust in medicine. These goals form the basis of a new framework [PROmoting Morally Important Consent Ends (PROMICE)] for assessing the ethical appropriateness of various informed consent models. We illustrate this framework with two examples: (a) a tiered and layered consent model for obtaining consent for GS, and (b) consent for RGS in critically ill newborns. We conclude that appropriately—rather than fully—informed consent provides the correct standard for genomic medicine and research. (shrink)

The importance of GS for understanding Nietzsche’s philosophy cannot be overestimated. While it can be disputed whether or not modern Nietzsche scholarship started with the revaluation of GS—as the editors claim with Giorgio Colli—the work forms an important link between the early and late writings of Nietzsche and especially Z. Klassiker Auslegen—Interpreting Classics—is a series dedicated to interpreting important works of philosophy as a whole through chapters successively discussing the individual chapters of the work. The book at hand consists of (...) two introductions—one for the volume, another one discussing the genesis of the edition of GS—and eight chapters covering each of the preface, the “Prelude in... (shrink)

Genomic sequencing (GS) is increasingly used in paediatric medicine to aid in screening, research and treatment. Some health systems are trialling GS as a first-line test in newborn screening programmes. Questions about what to do with genomic data after it has been generated are becoming more pertinent. While other research has outlined the ethical reasons for storing deidentified genomic data to be used in research, the ethical case for storing data for future clinical use has not been explicated. In this (...) paper, we examine the ethical case for storing genomic data with the intention of using it as a lifetime health resource. In this model, genomic data would be stored with the intention of reanalysis at certain points through one’s life. We argue this could benefit individuals and create an important public resource. However, several ethical challenges must first be met to achieve these benefits. We explore issues related to privacy, consent, justice and equality. We conclude by arguing that health systems should be moving towards futures that allow for the sequential interrogation of genomic data throughout the lifespan. (shrink)

In the preface to GS, Nietzsche famously exclaims, "Those Greeks were superficial—out of profundity!".1 And he attributes one aspect of this profound superficiality to the Greeks' "respect for the bashfulness [Scham] with which nature has hidden behind riddles and iridescent uncertainties". For Nietzsche, both the Greeks' shame and their respect for shame played important and healthy psychological and social roles. So, Nietzsche praises shame in the sense that "care [Scham] for one's reputation" is characteristic of noble types and a "highly (...) resourceful" emotion. However, Nietzsche also sometimes condemns shame. For example, in the last three aphorisms of Book 3 of GS, he makes... (shrink)

Many have claimed that ceteris paribus (CP) laws are a quite legitimate feature of scientific theories, some even going so far as to claim that laws of all scientific theories currently on offer are merely CP. We argue here that one of the common props of such a thesis, that there are numerous examples of CP laws in physics, is false. Moreover, besides the absence of genuine examples from physics, we suggest that otherwise unproblematic claims are rendered untestable by the (...) mere addition of the CP operator. Thus, “CP all Fs are Gs” when read as a straightforward statement of fact, cannot be the stuff of scientific theory. Rather, we suggest that when ``ceteris paribus'' appears in scientific works it plays a pragmatic role of pointing to more respectable claims. (shrink)

The ubiquitous schema ‘All Fs are Gs’ dominates much philosophical discussion on laws but rarely is it shown how actual laws mentioned and used in science are supposed to fit it. After consideration of a variety of laws, including those obviously conditional and those superficially not conditional, I argue that we have good reason to support the traditional interpretation of laws as conditionals of some quantified form with a single object variable. I show how this conclusion impacts on the status (...) of ‘system laws’ and the significance of having only one object variable with regard to the relationship between laws and causal relations. (shrink)

The paper formulates and proves a strengthening of ‘Frege’s Theorem’, which states that axioms for second-order arithmetic are derivable in second-order logic from Hume’s Principle, which itself says that the number of Fs is the same as the number ofGs just in case the Fs and Gs are equinumerous. The improvement consists in restricting this claim to finite concepts, so that nothing is claimed about the circumstances under which infinite concepts have the same number. ‘Finite Hume’s Principle’ also suffices for (...) the derivation of axioms for arithmetic and, indeed, is equivalent to a version of them, in the presence of Frege’s definitions of the primitive expressions of the language of arithmetic. The philosophical significance of this result is also discussed. (shrink)

The neo-Fregean program in the philosophy of mathematics seeks a foundation for a substantial part of mathematics in abstraction principles—for example, Hume’s Principle: The number of Fs D the number of Gs iff the Fs and Gs correspond one-one—which can be regarded as implicitly definitional of fundamental mathematical concepts—for example, cardinal number. This paper considers what kind of abstraction principle might serve as the basis for a neo- Fregean set theory. Following a brief review of the main difficulties confronting the (...) most widely discussed proposal to date—replacing Frege’s inconsistent Basic Law V by Boolos’s New V which restricts concepts whose extensions obey the principle of extensionality to those which are small in the sense of being smaller than the universe—the paper canvasses an alternative way of implementing the limitation of size idea and explores the kind of restrictions which would be required for it to avoid collapse. (shrink)