We have a reason to use information which is available about such genes in our reproductive decision-making; (3) couples should selec.

According to what we call the Principle of Procreative Beneficence, couples who decide to have a child have a significant moral reason to select the child who, given his or her genetic endowment, can be expected to enjoy the most well-being. In the first part of this paper, we introduce PB, explain its content, grounds, and implications, and defend it against various objections. In the second part, we argue that PB is superior to competing principles of procreative selection such as (...) that of procreative autonomy. In the third part of the paper, we consider the relation between PB and disability. We develop a revisionary account of disability, in which disability is a species of instrumental badness that is context- and person-relative. Although PB instructs us to aim to reduce disability in future children whenever possible, it does not privilege the normal. What matters is not whether future children meet certain biological or statistical norms, but what level of well-being they can be expected to have. (shrink)

In order to prevent the rapid spread of COVID-19, governments have placed significant restrictions on liberty, including preventing all non-essential travel. These restrictions were justified on the basis the health system may be overwhelmed by COVID-19 cases and in order to prevent deaths. Governments are now considering how they may de-escalate these restrictions. This article argues that an appropriate approach may be to lift the general lockdown but implement selective isolation of the elderly. While this discriminates against the elderly, there (...) is a morally relevant difference—the elderly are far more likely to require hospitalisation and die than the rest of the population. If the aim is to ensure the health system is not overwhelmed and to reduce the death rate, preventing the elderly from contracting the virus may be an effective means of achieving this. The alternative is to continue to keep everyone in lockdown. It is argued that this is levelling down equality and is unethical. It suggests that in order for the elderly to avoid contracting the virus, the whole population should have their liberty deprived, even though the same result could be achieved by only restricting the liberty of the elderly. Similar arguments may also be applied to all groups at increased risk of COVID-19, such as men and those with comorbidities, the obese and people from ethnic minorities or socially deprived groups. This utilitarian concern must be balanced against other considerations, such as equality and justice, and the benefits gained from discriminating in these ways must be proportionately greater than the negative consequences of doing so. Such selective discrimination will be most justified when the liberty restriction to a group promotes the well-being of that group (apart from its wider social benefits). (shrink)

Recent advances in the Super Linguistics of pictures have laid the Super Semantic foundation for modelling the phenomena of narrative sequencing and co-reference in pictorial and mixed linguistic-pictorial discourses. We take up the question of how one arrives at the pragmatic interpretations of such discourses. In particular, we offer an analysis of: (i) the discourse composition problem: how to represent the joint meaning of a multi-picture discourse, (ii) observed differences in narrative sequencing in prima facie equivalent linguistic vs pictorial discourses, (...) and (iii) the phenomenon of co-referencing across pictures. We extend Segmented Discourse Representation Theory to spell out a formal Super Pragmatics that applies to linguistic, pictorial and mixed discourses, while respecting the particular ‘genius’ of either medium and computing their distinctive pragmatic interpretations. (shrink)

Principles of distributive justice are normative principles designed to guide the allocation of the benefits and burdens of economic activity.

Advocates of paid living kidney donation frequently argue that kidney sellers would benefit from paid donation under a properly regulated kidney market. The poor outcomes experienced by participants in existing markets are often entirely attributed to harmful black-market practices. This article reviews the medical and anthropological literature on the physical, psychological, social, and financial harms experienced by vendors under Iran's regulated system of donor compensation and black markets throughout the world and argues that this body of research not only documents (...) significant harms to vendors, but also provides reasons to believe that such harms would persist under a regulated system. This does not settle the question of whether or not a regulated market should be introduced, but it does strengthen the case against markets in kidneys while suggesting that those advocating such a system cannot appeal to the purported benefits to vendors to support their case. (shrink)

It may soon be possible to generate human organs inside of human-pig chimeras via a process called interspecies blastocyst complementation. This paper discusses what arguably the central ethical concern is raised by this potential source of transplantable organs: that farming human-pig chimeras for their organs risks perpetrating a serious moral wrong because the moral status of human-pig chimeras is uncertain, and potentially significant. Those who raise this concern usually take it to be unique to the creation of chimeric animals with (...) ‘humanised’ brains. In this paper, we show how that the same style of argument can be used to critique current uses of non-chimeric pigs in agriculture. This reveals an important tension between two common moral views: that farming human-pig chimeras for their organs is ethically concerning, and that farming non-chimeric pigs for food or research is ethically benign. At least one of these views stands in need of revision. (shrink)

Numerous high-profile ethics scandals, rising inequality, and the detrimental effects of climate change dramatically underscore the need for business schools to instill a commitment to social purpose in their students. At the same time, the rising financial burden of education, increasing competition in the education space, and overreliance on graduates’ financial success as the accepted metric of quality have reinforced an instrumentalist climate. These conflicting aims between social and financial purpose have created an existential crisis for business education. To resolve (...) this impasse, we draw on the concept of moral self-awareness to offer a system-theoretical strategy for crowding-in a culture of ethics within business schools. We argue that to do so, business schools will need to (1) reframe the purpose of business, (2) reframe the meaning of professional success, and (3) reframe the ethos of business education itself. (shrink)

There is growing concern that a global economic system fueled predominately by financial incentives may not maximize human flourishing and social welfare externalities. If so, this presents a challenge of how to get economic actors to adopt a more virtuous motivational mindset. Relying on historical, psychological, and philosophical research, we show how such a mindset can be instilled. First, we demonstrate that historically, financial self-interest has never in fact been the only guiding motive behind free markets, but that markets themselves (...) are representations of our individual and collective moral identities. Building on this understanding, we review the research on how economic incentives crowd out virtue-oriented concerns. We then introduce the concept of moral self-awareness (MSA), an evolving mindset informed by reflection on moral identity, namely what one’s actions say about oneself given the impacts on others or society that one’s action may effect. MSA comprises three fundamental aspects of virtue-oriented reasoning: pride, shame, and guilt. Finally, we offer a four-stage model anchored in systems theory, yielding ever more refined motivating strategies for maximizing human flourishing and social welfare externalities. (shrink)

There are ethical obligations to conduct research that contributes to generalisable knowledge and improves reproductive health, and this should include embryo research in jurisdictions where it is permitted. Often, the controversial nature of embryo research can alarm ethics committee members, which can unnecessarily delay important research that can potentially improve fertility for patients and society. Such delay is ethically unjustified. Moreover, countries such as the UK, Australia and Singapore have legislation which unnecessarily captures low-risk research, such as observational research, in (...) an often cumbersome and protracted review process. Such countries should revise such legislation to better facilitate low-risk embryo research.We introduce a philosophical distinction to help decision-makers more efficiently identify higher risk embryo research from that which presents no more risks to persons than other types of tissue research. That distinction is between future person embryo research and non-future person embryo research. We apply this distinction to four examples of embryo research that might be presented to ethics committees.Embryo research is most controversial and deserving of detailed scrutiny when it potentially affects a future person. Where it does not, it should generally require less ethical scrutiny. We explore a variety of ways in which research can affect a future person, including by deriving information about that person, and manipulating eggs or sperm before an embryo is created. (shrink)

The International Society for Stem Cell Research (ISSCR) has recently released the 2021 update of its guidelines. The update includes detailed new recommendations on human–animal chimera research. This paper argues that the ISSCR recommendations fail to address the core ethical concerns raised by neurological chimeras—namely, concerns about moral status. In minimising moral status concerns, the ISSCR both breaks rank with other major reports on human–animal chimera research and rely on controversial claims about the grounds of moral status that many people (...) will rightly reject. A more robust framework for regulating human–animal chimera research still needs to be developed. (shrink)

AI researchers have developed sophisticated language models capable of generating paragraphs of 'synthetic text' on topics specified by the user. While AI text generation has legitimate benefits, it could also be misused, potentially to grave effect. For example, AI text generators could be used to automate the production of convincing fake news, or to inundate social media platforms with machine-generated disinformation. This paper argues that AI text generators should be conceptualised as a dual-use technology, outlines some relevant lessons from earlier (...) debates on dual-use life sciences research, and calls for closer collaboration between ethicists and the machine learning community to address AI language models’ dual-use implications. (shrink)

ABSTRACTWhat is John Cage's 4′33″? This paper disambiguates this question into three sub-questions concerning, respectively, the work's ontological nature, the art form to which it belongs, and the genre it is in. We shall see that the work's performances consist of silence, that it is a work of performance art, and that it belongs to the genre of conceptual art. Seeing the work in these ways helps us to understand it better, and promises to assuage somewhat the puzzlement and irritation (...) of those who are at first resistant to its charms. (shrink)

This paper aims to provide a theoretical framework for explaining the subjective character of pain experience in terms of what we will call ‘embodied predictive processing’. The predictive processing (PP) theory is a family of views that take perception, action, emotion and cognition to all work together in the service of prediction error minimisation. In this paper we propose an embodied perspective on the PP theory we call the ‘embodied predictive processing (EPP) theory. The EPP theory proposes to explain pain (...) in terms of processes distributed across the whole body. The prediction error minimising system that generates pain experience comprises the immune system, the endocrine system, and the autonomic system in continuous causal interaction with pathways spread across the whole neural axis. We will argue that these systems function in a coordinated and coherent manner as a single complex adaptive system to maintain homeostasis. This system, which we refer to as the neural-endocrine-immune (NEI) system, maintains homeostasis through the process of prediction error minimisation. We go on to propose a view of the NEI ensemble as a multiscale nesting of Markov blankets that integrates the smallest scale of the cell to the largest scale of the embodied person in pain. We set out to show how the EPP theory can make sense of how pain experience could be neurobiologically constituted. We take it to be a constraint on the adequacy of a scientific explanation of subjectivity of pain experience that it makes it intelligible how pain can simultaneously be a local sensing of the body, and, at the same time, a more global, all-encompassing attitude towards the environment. Our aim in what follows is to show how the EPP theory can meet this constraint. (shrink)

The requirements of rationality are fundamental in practical and theoretical philosophy. Nonetheless, there exists no correct account of what constitutes rational requirements. This paper attempts to provide a correct constitutive account of ‘rationality requires’. I argue that rational requirements are grounded in ‘necessary explanations of subjective incoherence’, as I shall put it. Rationality requires of you to X if and only if your rational capacities, in conjunction with the fact that you not-X, explain necessarily why you have a non-maximal degree (...) of subjective coherence. (shrink)

In this book, Reiss argues in favor of a tight fit between evidence, concept and purpose in our causal investigations in the sciences. There is no doubt that the sciences employ a vast array of techniques to address causal questions such as controlled experiments, randomized trials, statistical and econometric tools, causal modeling and thought experiments. But how do these different methods relate to each other and to the causal inquiry at hand? Reiss argues that there is no "gold standard" in (...) settling causal issues against which other methods can be measured. Rather, the various methods of inference tend to be good only relative to certain interpretations of the word "cause", and each interpretation, in turn, helps to address some salient purpose but not others. The main objective of this book is to explore the metaphysical and methodological consequences of this view in the context of numerous cases studies from the natural and social sciences. (shrink)

Bruineberg and colleagues' critique of Friston blankets relies on what we call the “literalist fallacy”: the assumption that in order for Friston blankets to represent real boundaries, biological systems must literally possess or instantiate Markov blankets. We argue that it is important to distinguish a realist view of Friston blankets from the literalist view of Bruineberg and colleagues’ critique.

In her excellent and comprehensive article, Friesen argues that utilising personal responsibility in healthcare is problematic in several ways: it is difficult to ascribe responsibility to behaviour; there is a risk of prejudice and bias in deciding which behaviours a person should be held responsible for; it may be ineffective at reducing health costs. In this short commentary, I will elaborate the critique of personal responsibility in health but suggest one way in which it could be used ethically. In doing (...) so, I will introduce the concepts of reasonable risk and golden opportunity. I previously argued that it is both difficult to disentangle responsibility and that we risk prejudice and bias in singling out behaviours that are socially disapproved of.1 So I am sympathetic to Friesen’s concerns. I also discussed another way in which ascribing personal responsibility for health is problematic which Friesen does not discuss and which, in my view, is the most concerning and further supports her arguments. It represents a back door assault on liberalism and neutrality towards concepts of the good life. Even if one were to accurately and in an unbiased way divine the personal contribution to disease, the greatest problem would remain: those who voluntarily take on risk would be penalised. That is, such a system would be risk-averse. Those lives which avoided risk would be prioritised, while those who chose to take on risky activities in their conception of the good life would be penalised. Yet risk is necessary, both for the good life, and social progress. Columbus, Edmund Hilary, Florence Nightingale, Ernest Hemingway and countless monumental figures in human history took risks in order to achieve something great. Should we aim for a society of trembling, teetotalling health nuts? Surely that prospect is horrific. It is horrific because it elevates health …. (shrink)

Jeffrey Friedman’s Power Without Knowledge argues forcefully that there are inherent limitations to the predictability of human action, due to a circumstance he calls “ideational heterogeneity.” However, our resources for predicting human action somewhat reliably in the light of ideational heterogeneity have not been exhausted yet, and there are no in-principle barriers to progress in tackling the problem. There are, however, other strong reasons to think that disagreement among epistocrats is bound to persist, such that it will be difficult to (...) decide who has “the right answer” to a given technocratic problem. These reasons have to do with competing visions of the good society, fact/value entanglement, and the fragility of the facts of the social sciences. (shrink)

Stereotypes of social construction suggest that the existence of social constructs is accidental and that such constructs have arbitrary and subjective features. In this paper, I explore a conception of social construction according to which it consists in the collective imposition of function onto reality and show that, according to this conception, these stereotypes are incorrect. In particular, I argue that the collective imposition of function onto reality is typically non-accidental and that the products of such imposition frequently have non-arbitrary (...) and objective features. These conclusions are interesting in and of themselves since they debunk important aspects of our socially constructed conception of social construction. Yet, additionally, they have important implications for the viability of mathematical social constructivism since resistance to such constructivism is frequently grounded in the observation that mathematics is non-accidental, non-arbitrary, and objective. As a secondary focus, I explore these implications in this paper. (shrink)

A popular claim in recent philosophy of mind and action is that events only exist once they are over. This has been taken to have the consequence that many temporal phenomena cannot be understood ‘from the inside’, as they are unfolding, purely in terms of events. However, as I argue here, the claim that events exist only when over is incoherent. I consider two ways of understanding the claim and the notion of existence it involves: one that ties existence to (...) the logic of quantification, and another that assimilates the existence of an event to that of a continuant. The first of these, I argue, cannot be the right way to understand the target claim, as there are serious logical obstacles to regarding this notion of existence as temporally variable. The second, on the other hand, leaves it ultimately mysterious what the existence of an event could amount to. I close with the suggestion that the undeniable temporal asymmetries which parties to the debate are interested in are properly understood in perspectival, not ontological, terms. (shrink)

In this paper I consider, in connection with dementia, two views of the person. One view of the person is derived from Locke and Parfit. This tends to regard the person solely in terms of psychological states and his/her connections. The second view of the person is derived from a variety of thinkers. I have called it the situated-embodied-agent view of the person. This view, I suggest, more readily squares with the reality of clinical experience. It regards the person as (...) embedded in a history and culture. The human person is also an embodied agent. I contend that this view encourages a more appropriate approach towards the ethical issues that arise in dementia and towards people with dementia. (shrink)

Peter Kivy has become convinced that it is impossible for pure, instrumental music to be profound. This is because he takes works of such music to be incapable of meeting what he claims to be two necessary conditions for artistic profundity: that the work denotes something profound, and that the work expresses profound propositions about its profound denotatum. The negative part of this paper argues as follows. Although works of pure, instrumental music do, indeed, fail to meet these conditions, the (...) said conditions are not themselves necessary for artistic profundity. In fact, each is a misinterpretation of a distinct, genuinely necessary condition for a work’s being profound: respectively, that the work has a profound subject matter, and that the work handles its profound subject matter in such a way as to elicit a deeper understanding of it in the suitably situated and prepared appreciator. The positive part of the paper elaborates these genuinely necessary conditions for artistic profundity and then argues that, once they have been disentangled from Kivy’s misconstruals of them, it becomes evident that they can be met by pieces of pure, instrumental music. (shrink)

_The Ethics Toolkit_ provides an accessible and engaging compendium of concepts, theories, and strategies that encourage students and advanced readers to think critically about ethics so that they can engage intelligently in ethical study, thought, and debate. Written by the authors of the popular _The Philosophers’ Toolkit_ ; Baggini is also a renowned print and broadcast journalist, and a prolific author of popular philosophy books Uses clear and accessible language appropriate for use both inside and beyond the classroom Enlivened through (...) the use of real-world and hypothetical examples Cross-referencing of entries helps to connect and contrast ideas Features lists of prominent ethics organizations and useful websites Encourages readers to think critically about ethics and teaches them how to engage intelligently in ethical study, thought, and debate. (shrink)

This paper discusses whether rationality, morality or prudence impose process-requirements upon us. It has been argued that process-requirements fulfil two essential functions within a system of rational, moral or prudential requirements. These functions are considered to prove the existence of process-requirements. First, process-requirements are deemed necessary to ensure that rationality, morality or prudence can guide our deliberations and actions. Second, their existence is regarded as essential for the correctness of our ordinary explanations of why a person possesses a certain degree (...) of morality, rationality or prudence. However, I argue that these two functions are unable to show the existence of process-requirements. Instead, I propose a different essential function for process-requirements: they are necessary for attributing the correct degree of rationality, morality or prudence to a subject who is not entirely rational, moral or prudent. This function, I argue, necessitates the existence of process-requirements. (shrink)

Mary Shelley’sFrankensteinhas captured the public imagination ever since it was first published over 200 years ago. While the narrative reflected 19th-century anxieties about the emerging scientific revolution, it also suggested some clear moral lessons that remain relevant today. In a sense,Frankensteinwas a work of bioethics written a century and a half before the discipline came to exist. This paper revisits the lessons ofFrankensteinregarding the creation and manipulation of life in the light of recent developments in stem cell and neurobiological research. (...) It argues that these lessons are becoming more relevant than ever. (shrink)

This essay criticizes the current approach to epistemic democracy. Epistemic democrats are preoccupied with the question of how a society can best exploit a given stock of knowledge. This article argues that the problem-solving capability of a society depends on two factors rather than one. The quality of decision-making depends both on how a democracy is able to make use of its stock of knowledge and on the size of the knowledge stock. Society’s problem-solving capability over time is therefore a (...) function of its ability to develop its knowledge exploitation mechanisms and the growth rate of its knowledge stock. Based on this enhanced model of social problem-solving, this essay compares two different political ideal types: experimental democracy, as commonly defended by epistemic democrats; and polycentric democracy, a model defended most commonly by political economists. (shrink)

Much disease and disability is the result of lifestyle behaviours. For example, the contribution of imprudence in the form of smoking, poor diet, sedentary lifestyle, and drug and alcohol abuse to ill-health is now well established. More importantly, some of the greatest challenges facing humanity as a whole – climate change, terrorism, global poverty, depletion of resources, abuse of children, overpopulation – are the result of human behaviour. In this chapter, we will explore the possibility of using advances in the (...) cognitive sciences to develop strategies to intentionally manipulate human motivation and behaviour. While our arguments apply also to improving prudential motivation and behaviour in relation to health, we will focus on the more controversial instance: the deliberate targeted use of biomedicine to improve moral motivation and behaviour. We do this because the challenge of improving human morality is arguably the most important issue facing humankind (Persson and Savulescu, forthcoming). We will ask whether using the knowledge from the biological and cognitive sciences to influence motivation and behaviour erodes autonomy and, if so, whether this makes it wrong. (shrink)

I discuss a puzzle that shows there is a need to develop a new metaphysical interpretation of mathematical theories, because all well-known interpretations conflict with important aspects of mathematical activities. The new interpretation, I argue, must authenticate the ontological commitments of mathematical theories without curtailing mathematicians' freedom and authority to creatively introduce mathematical ontology during mathematical problem-solving. Further, I argue that these two constraints are best met by a metaphysical interpretation of mathematics that takes mathematical entities to be constitutively constructed (...) by human activity in a manner similar to the constitutive construction of the US Supreme Court by certain legal and political activities. Finally, I outline some of the philosophical merits of metaphysical interpretations of mathematical theories of this type. (shrink)

This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

In The Gift Relationship, Richard Titmuss argued that the practice of altruistic blood donation fosters social solidarity while markets in blood erode it. This paper considers the implications of this line of argument for the organ market debate. I defend Titmuss’ arguments against a number of criticisms and respond to claims that Titmuss’ work is not relevant to the context of live donor organ transplantation. I conclude that Titmuss’ arguments are more resilient than many advocates of organ markets suggest, and (...) more relevant to the debate than is commonly appreciated. (shrink)

In the wake of ChatGPT’s release, academics and journal editors have begun making important decisions about whether and how to integrate generative artificial intelligence (AI) into academic publishing. Some argue that AI outputs in scholarly works constitute plagiarism, and so should be disallowed by academic journals. Others suggest that it is acceptable to integrate AI output into academic papers, provided that its contributions are transparently disclosed. By drawing on Taylor’s work on academic norms, this paper argues against both views. Unlike (...) “traditional” forms of plagiarism, use of generative AI can be consistent with the norms that should underlie academic research. In these cases, its use should neither be prohibited nor required to be disclosed. However, some careless uses of generative AI do threaten to undermine the quality of academic research by mischaracterizing existing literature. This, not “AI plagiarism,” is the real concern raised by ChatGPT and related technologies. (shrink)

I argue that pregnant women have a duty to refrain from behaviours or to allow certain acts to be done to them for the sake of their foetus if the foetus has a reasonable chance of living and being in a harmed state if the woman does not refrain from those behaviours or allow those things to be done to her. There is a proviso: that her refraining from acting or allowing acts to be performed upon her does not significantly (...) harm her. This duty does not presuppose that the foetus is a person. It is grounded on principles of respect for the interests of sentient beings and prevention of harm to future individuals. I give an argument for a general duty of easy rescue. (shrink)

I contrast Robert Veatch's recent liberal vision of medical decision‐making with a more rationalist liberal model. According to Veatch, physicians are biased in their determination of what is in their patient's overall interests in favour of their medical interests. Because of the extent of this bias, we should abandon the practice of physicians offering what they guess to be the best treatment option. Patients should buddy up with physicians who share the same values —‘deep value pairing’. The goal of choice (...) is maximal promotion of patient values. I argue that if subjectivism about value and valuing is true, this move is plausible. However, if objectivism about value is true — that there really are states which are good for people regardless of whether they desire to be in them — then we should accept a more rationalist liberal alternative. According to this alternative, what is required to decide which course is best is rational dialogue between physicians and patients, both about the patient's circumstances and her values, and not the seeking out of people, physicians or others, who share the same values. Rational discussion requires that physicians be reasonable and empathic. I describe one possible account of a reasonable physician. (shrink)

Van Inwagen proposes that besides simples only living organisms exist as composite objects. This paper suggests expanding van Inwagen’s ontology by also accepting composite objects in the case that physical bonding occurs (plus some extra conditions). Such objects are not living organ-isms but rather physical bodies. They include (approximately) the complete realm of inanimate ordinary objects, like rocks and tables, as well as inanimate scientific objects, like atoms and mol-ecules, the latter filling the ontological gap between simples and organisms in (...) van Inwagen’s origi-nal picture. We thus propose a compositional pluralism claiming that composition arises if and on-ly if bonding or life occurs. (shrink)

Even though human smuggling is one of the central topics of contention in the political discourse about immigration, it has received virtually no attention from moral philosophy. This article aims...

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)