Noninvasive prenatal testing (NIPT) has become widely available in recent years. While initially used to screen for trisomies 21, 18, and 13, the test has expanded to include a range of other conditions and will likely expand further. This paper addresses the ethical issues that arise from one particularly controversial potential use of NIPT: screening for adult‐onset conditions (AOCs). We report data from our quantitative survey of Australian NIPT users' views on the ethical issues raised by NIPT for AOCs. The (...) survey ascertained support for NIPT for several traits and conditions including AOCs. Participants were then asked about their level of concern around implications of screening for AOCs for the future child and parent(s). Descriptive and comparative data analyses were conducted. In total, 109 respondents were included in data analysis. The majority of respondents expressed support for NIPT screening for preventable (70.9%) and nonpreventable AOCs (80.8%). Most respondents indicated concern around potential harmful impacts associated with NIPT for AOCs, including the psychological impact on the future child and on the parent(s). Despite this, the majority of participants thought that continuation of a pregnancy known to be predisposed to an AOC is ethically acceptable. The implications of these data are critically discussed and used to inform the normative claim that prospective parents should be given access to NIPT for AOCs. The study contributes to a body of research debating the ethical acceptability and regulation of various applications of NIPT as screening panels expand. (shrink)

Over the past decade, non-invasive prenatal testing (NIPT) has been adopted into routine obstetric care to screen for fetal sex, trisomies 21, 18 and 13, sex chromosome aneuploidies and fetal sex determination. It is predicted that the scope of NIPT will be expanded in the future, including screening for adult-onset conditions (AOCs). Some ethicists have proposed that using NIPT to detect severe autosomal AOCs that cannot be prevented or treated, such as Huntington’s disease, should only be offered to prospective parents (...) who intend to terminate a pregnancy in the case of a positive result. We refer to this as the ‘conditional access model’ (CAM) for NIPT. We argue against CAM for NIPT to screen for Huntington’s disease or any other AOC. Next, we present results from a study we conducted in Australia that explored NIPT users’ attitudes regarding CAM in the context of NIPT for AOCs. We found that, despite overall support for NIPT for AOCs, most participants were not in favour of CAM for both preventable and non-preventable AOCs. Our findings are discussed in relation to our initial theoretical ethical theory and with other comparable empirical studies. We conclude that an ‘unconditional access model’ (UAM), which provides unrestricted access to NIPT for AOCs, is a morally preferable alternative that avoids both CAM’s fundamental practical limitations and the limitations it places on parents’ reproductive autonomy. (shrink)

In industries populated by small and medium enterprises, managers' good intentions frequently incur barriers to superior environmental performance (Tilley, Bus Strategy Environ 8:238-248, 1999). During the period when the U.S. wine industry was beginning to promote voluntary adoption of sound environmental practices, we examined managers' attitudes, norms, and perceptions of stakeholder pressures to assess their intentions to implement environmental management programs (EMP). We found that managers within the simple structures of these small and medium firms are responsive to attitudes, norms, (...) and pressures from internal stakeholders and that voluntarily established EMP increased the success of firms' implementation of energy conservation and recycling practices. Applications of our findings to future research on small and medium enterprises as well as direct practical applications of our results are discussed. (shrink)

I offer a reading of the role of freedom in Descartes’ Meditations and other writings that sees freedom’s role in “assenting to ideas” as a matter of psychological possibility, and its role in acti...

R J W Evans: Political Chronology; IntroductionJan Rychlík: Czech-Slovak Relations in Czechoslovakia, 1918-39Eagle Glassheim: Ambivalent Capitalists: The Roots of Fascist Ideology among Bohemian Nobles, 1880-1938Melissa Feinberg: The New 'Woman Question': Gender, Nation, and Citizenship in the First Czechoslovak RepublicRobert B. Pynsent: The Literary Representation of the Czechoslovak 'Legions' in RussiaCatherine Albrecht: Economic Nationalism in the Sudetenland, 1918-38R.J.W. Evans: Hungarians, Czechs and Slovaks: Some Mutual Perceptions, 1900-50Mark Cornwall: 'A Leap into Ice-Cold Water': the Manoeuvres of the Henlein Movement in Czechoslovakia, 1933-8Vít (...) Smetana: Old Wine in New Bottles? British Policy towards Czechoslovakia, 1938-9 and 1947-8Tatjana Tönsmeyer: The German Advisers in Slovakia, 1939-45: Conflict or Co-Operation?Mark Dimond: The Sokol and Czech Nationalism, 1918-48Jiri Kocian: The Czechs versus the Slovaks: Bilateral Relations, 1944-8Zdenk Radvanovský: The Transfer of Czechoslovakia's Germans and its Impact in the Border Region after the Second World WarKeith Robbins: Britain and Munich Reconsidered: A Personal Historical Journey. (shrink)

Dans cet article je propose d'exprimer et de défendre une conception des pratiques et du domaine de discours mathématiques qui soit sensible, d'une part, au pluralisme des relations entre pratiques inférentielles et intérêts, et d'autre part, à la structure objective et déterminante des concepts mathématiques. J'ébauche tout d'abord une caractérisation générale des pratiques, pour ensuite préciser certains phénomènes propres aux pratiques mathématiques. Suit un recensement des idées qui se dégagent des arguments pluralistes, et de celles qui sont à retenir. Mais (...) je défends par la suite la nécessité d'une forme de réalisme mathématique, qui toutefois ne peut être le réalisme d'objets que prônent les partisans de l'argument d'indispensabilité. Je défends plutôt un réalisme des concepts, soutenu par ce que je baptise l'« argument de la contrainte ». (shrink)

Mere exposure, generally, entails influences of familiarity manipulations on affective dependent variables. Previously (Phaf & Rotteveel, 2005), we have argued that familiarity corresponds intrinsically to positive affect, and have extended the correspondence to novelty and negative affect. Here, we present two experiments that show reverse effects of affective manipulations on perceived familiarity. In Experiment 1 affectively valenced exteroceptive cues of approach and avoidance (e.g., apparent movement) modulated recognition bias of neutral targets. This finding suggests that our correspondence hypotheses can be (...) generalised to an important aspect of emotion, namely approach and avoidance tendencies. In Experiment 2 participants? emotional mood was manipulated within the Jacoby?Whitehouse paradigm and a pattern of results was obtained as if consciousness was manipulated. We interpret the latter results within the affective modulation framework (AMF), which postulates facilitation of nonconscious processing by positive affect and an enhancement of conscious processing by negative affect. (shrink)

Despite having been relegated to the realm of superstition during the dominant years of behaviorism, the investigation and discussion of consciousness has again become scientifically defensible. However, attempts at describing animal consciousness continue to be criticized for lacking independent criteria that identify the presence or absence of the phenomenon. William James recognized that mental traits are subject to the same evolutionary processes as are physical characteristics and must therefore be represented in differing levels of complexity throughout the animal kingdom. James's (...) proposals with regard to animal consciousness are outlined and followed by a discussion of 3 classes of animal consciousness derived from empirical research. These classes are presented to defend both James's proposals and the position that a theory of animal consciousness can be scientifically supported. It is argued that by using particular behavioral expressions to index consciousness and by providing empirical tests by which to elicit these behavioral expressions, a scientifically defensible theory of animal consciousness can be developed. 2012 APA, all rights reserved). (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:After Gödel: Platonism and Rationalism in Mathematics and LogicMark C. R. SmithRichard Tieszen. After Gödel: Platonism and Rationalism in Mathematics and Logic. Oxford-New York: Oxford University Press, 2011. Pp. xi + 245. Cloth, $75.00.Tieszen’s new book offers a synthesis and extension of his longstanding project of bringing the method of Husserl’s phenomenology to bear on fundamental questions—both epistemological and ontological—in the philosophy of mathematics. Gödel held Husserl’s philosophy (...) in high regard, and thought that it offered the most promising avenue for an adequate understanding of the foundations of mathematical thought and practice, but Gödel himself did not give a full systematic statement of how phenomenology might carry out that project. Tieszen takes up the task in this book, which is structured around two main guiding themes. The first is to locate the sources of Gödel’s philosophical views—principally [End Page 303] in Plato, Leibniz, and of course Husserl, along with Kant as a sort of backcloth—and the second is to argue that from these materials, a promising rationalism in mathematics and logic can be consistently articulated. Along the way we also encounter a good many of Gödel’s arguments against an array of reductive positions, Hilbert’s formalism and Carnap’s “logical syntax” project among them, as well as arguments against the prospects of a mechanical or purely computational understanding of the human mind. Many of the arguments (both negative and positive) stem from a reflection on the consequences of Gödel’s landmark incompleteness results of 1931.The core of Tieszen’s positive proposals comes in chapters 4, 5, and 6: here is where we meet with “constituted Platonism,” Tieszen’s name for the rationalist, realist synthesis of Husserl’s method and Gödel’s mathematical insights. Methodologically, the starting point is the actual practice of mathematics as a human undertaking, and its conditions of possibility. At the most general level, it is characteristic of thought to be intentional, that is, to be (or try to be) about something, to have a target, to be a bearer of meaning. So it goes for thought about items in sensory awareness, about fictional objects, or about mathematical subject-matter. Concerning the latter, what we encounter in mathematical experience are frequently “phenomena that resist our will, so that we are ‘forced’ in certain directions” (170); what accounts for this resistance to our will are invariants, which have the further characteristics of repeatability—both for a single subject, and among many subjects—and availability for convergence (221), which, I take it, means availability as structures or concepts upon which many independent rational investigators will come to rest. Thinking mathematical thoughts is quite unlike thinking thoughts about fictional items, because fictions are indefinitely plastic in the face of human will. It is also unlike thought about sensory items, in that the intentional objects at issue are not available to outer sense; but from another angle it is more like thought about real material items than imaginary beings, because our mathematical thoughts are exposed to the possibility of error or misrepresentation in various ways. (An elementary example: most people think that 1 is distinct from 0.9999... repeating: this is a misrepresentation, because they are in fact identical.)The phenomenology of mathematical practice is such that we assay various conjectures and proposals about invariants already given to consciousness by previous practice, and discover what further invariant structures or concepts are revealed as necessary constraints upon the various possibilities that we can experimentally float for ourselves. Sometimes our conjectures or intentions are fulfilled, sometimes they are frustrated; but it is the very fact of fulfillment and frustration which points us to a Platonic reality. It is not the noumenal realm of the “naive” Platonist, in Tieszen’s phrase, but nevertheless an objective reality marked off “on the basis of what stabilizes or becomes invariant in our experience, on the basis of what has a history and a sedimentation that permits of further elaboration, development, constraints, surprises, and so on” (101). In something like this way, human reason and consciousness “constitute the meaning of being” of mathematical objects... (shrink)

Interpretive political science focuses on the meanings that shape actions and institutions, and the ways in which they do so. This Handbook explores the implications of interpretive theory for the study of politics. It provides the first definitive survey of the field edited by two of its pioneers. This Handbook is an invaluable resource for students, scholars and practitioners in the areas of international relations, comparative politics, political sociology, political psychology and public administration.

O tema é programa de reavaliação filosófica da retórica da economia proposta por McCloskey. Bento Prado (I e II) argumenta que uma teoria da retórica para a qual “vale tudo” não deveria ser inferida da justa crítica que McCloskey endereça ao positivismo. Em III (M. Julian Cass) são discutidas algumas aporias filosóficas presentes nos textos de McCloskey.

High-frequency oscillations emerged as a neural code for both positive affect and fluent attentional processing from evolutionary simulations with artificial neural networks. Visual 50 Hz flicker, which entrains neural oscillations in the gamma band, has been shown to foster attentional switching, but can it also elicit positive affect? A three-faces display was preceded by a 50, 25, or 0 Hz flicker on the position of the odd-one-out . Participants decided on the gender or on the subjective valence of this neutral (...) target in an approach-avoidance task, which served as an implicit affective measure. Only the detection of 25 Hz flicker, but not of 50 Hz flicker, was above chance . Faces primed by invisible 50 Hz flicker were explicitly evaluated more positively than with 25 Hz or 0 Hz. This gamma flicker also facilitated approach reactions, and inhibited avoidance reactions relative to 25 Hz and 0 Hz flicker in Blocks 1 and 2. Attentional switching was, moreover, enhanced by the 50 Hz flicker. According to the Affect–Gamma hypothesis, also in biological neural networks, high-frequency gamma oscillations may code for positive affect. (shrink)

Recent work in experimental philosophy has shown that people are more likely to attribute intentionality, knowledge, and other psychological properties to someone who causes a bad side effect than to someone who causes a good one. We argue that all of these asymmetries can be explained in terms of a single underlying asymmetry involving belief attribution because the belief that one’s action would result in a certain side effect is a necessary component of each of the psychological attitudes in question. (...) We argue further that this belief-attribution asymmetry is rational because it mirrors a belief-formation asymmetry, and that thebelief-formation asymmetry is also rational because it is more useful to form some beliefs than others. (shrink)

Background: Previous research shows that pediatricians inconsistently utilize the ethics consultation service (ECS). Methods: Pediatricians in two suburban, Midwestern academic hospitals were asked to reflect on their ethics training and utilization of ECS via an anonymous, electronic survey distributed in 2017 and 2018, and analyzed in 2018. Participants reported their clinical experience, exposure to formal and informal ethics training, use of formal and informal ethics consultations, and potential barriers to formal consultation. Results: Less experienced pediatricians were more likely to utilize (...) formal ethics consultation and more likely to have formal ethics training. The most commonly reported reasons not to pursue formal ECS consultation were inconvenience and self-reported expertise in pediatric ethics. Conclusions: These results inform ongoing discussions about ethics consultation among pediatricians and the role of formal ethics training in both undergraduate and graduate medical education. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

In a provocative 1974 article entitled “Harvesting the Dead,” Willard Gaylin explored potential uses of “neomorts,” or what are currently referred to as “heart-beating cadavers”—that is, humans determined to be dead by neurological criteria and whose cardiopulmonary function is medically maintained by ventilators, vasopressors, and so forth. Medical research was one of the potential uses Gaylin identified. He pointed out that tests of drugs and medical procedures that would have unacceptable health risks if performed on living human subjects could be (...) performed on neomorts without any health risks. According to Gaylin, the potential benefits of such research could be enormous, including not subjecting patients to ineffective or harmful medical procedures and eliminating delays in providing effective therapies to dying patients. (shrink)

Typically, a refusal to provide a medical service is an instance of conscientious objection only when the medical service is legal, professionally accepted, and clinically appropriate. That is, conscientious objection typically occurs only when practitioners reject prevailing norms or practices. Insofar as refusing to provide antibiotics for a viral infection does not violate prevailing clinical norms, there is no need for the physician in Case 1 to justify his refusal to provide antibiotics by appealing to his conscience.1 By contrast, insofar (...) as emergency contraception is legal and does not violate prevailing norms of good medical practice, the physician in Case 6 cannot justify his refusal to provide EC by... (shrink)

It is argued that the primary aim of institutional management is to protect the moral integrity of health professionals without significantly compromising other important values and interests. Institutional policies are recommended as a means to promote fair, consistent, and transparent management of conscience-based refusals. It is further recommended that those policies include the following four requirements: (1) Conscience-based refusals will be accommodated only if a requested accommodation will not impede a patient’s/surrogate’s timely access to information, counseling, and referral. (2) Conscience-based (...) refusals will be accommodated only if a requested accommodation will not impede a patient’s timely access to health care services offered within the institution. (3) Conscience-based refusals will be accommodated only if the accommodation will not impose excessive burdens on colleagues, supervisors, department heads, other administrators, or the institution. (4) Whenever feasible, health professionals should provide advance notification to department heads or supervisors. Formal review may not be required in all cases, but when it is appropriate, several recommendations are offered about standards and the review process. A key recommendation is that when reviewing an objector’s reasons, contrary to what some have proposed, it is not appropriate to adopt an adversarial approach modelled on military review boards’ assessments of requests for conscientious objector status. According to the approach recommended, the primary function of reviews of objectors’ reasons is to engage them in a process of reflecting on the nature and depth of their objections, with the objective of facilitating moral clarity on the part of objectors rather than enabling department heads, supervisors, or ethics committees to determine whether conscientious objections are sufficiently genuine. (shrink)

Historically associated with military service, conscientious objection has become a significant phenomenon in health care. Mark Wicclair offers a comprehensive ethical analysis of conscientious objection in three representative health care professions: medicine, nursing and pharmacy. He critically examines two extreme positions: the 'incompatibility thesis', that it is contrary to the professional obligations of practitioners to refuse provision of any service within the scope of their professional competence; and 'conscience absolutism', that they should be exempted from performing any action contrary (...) to their conscience. He argues for a compromise approach that accommodates conscience-based refusals within the limits of specified ethical constraints. He also explores conscientious objection by students in each of the three professions, discusses conscience protection legislation and conscience-based refusals by pharmacies and hospitals, and analyzes several cases. His book is a valuable resource for scholars, professionals, trainees, students, and anyone interested in this increasingly important aspect of health care. (shrink)

Those who provide medical care for infants born extremely prematurely, at what is often referred to as borderline viability, have long grown accustomed to working with the parent(s) to reach a deci...

In response to physicians who refuse to provide medical services that are contrary to their ethical and/or religious beliefs, it is sometimes asserted that anyone who is not willing to provide legally and professionally permitted medical services should choose another profession. This article critically examines the underlying assumption that conscientious objection is incompatible with a physician’s professional obligations (the “incompatibility thesis”). Several accounts of the professional obligations of physicians are explored: general ethical theories (consequentialism, contractarianism, and rights-based theories), internal morality (...) (essentialist and non-essentialist conceptions), reciprocal justice, social contract, and promising. It is argued that none of these accounts of a physician’s professional obligations unequivocally supports the incompatibility thesis. (shrink)

A US Department of Health and Human Services Final Rule, Protecting Statutory Conscience Rights in Health Care, and a proposed bill in the British House of Lords, the Conscientious Objection Bill, may well warrant a concern that—to borrow a phrase Daniel Callahan applied to self-determination—conscientious objection in health care has “run amok.” Insofar as there are no significant constraints or limitations on accommodation, both rules endorse an approach that is aptly designated “conscience absolutism.” There are two common strategies to counter (...) conscience absolutism and prevent conscientious objection in medicine from running amok. One, non-toleration, is to decline to accommodate physicians who refuse to provide legal, professionally accepted, clinically appropriate medical services within the scope of their clinical competence. The other, compromise or reasonable accommodation, is to impose constraints on accommodation. Several arguments for non-toleration are critically analyzed, and I argue that none warrants its acceptance. I maintain that non-toleration is an excessively blunt instrument to prevent conscientious objection in medicine from running amok. Instead, I defend a more nuanced contextual approach that includes constraints on accommodation. (shrink)

Unemployment has been at historically high rates for an extended period, and while it has recently improved in certain countries, the unemployment that remains may be becoming structural. Aside from inequality, unemployment is accordingly the problem that is most likely to put critical pressure on our political institutions, disrupt the social fabric of our way of life, and even threaten the continuation of liberalism itself. Despite the obvious importance of the problem of unemployment, however, there has been a curious lack (...) of attention paid to this issue by contemporary non-Marxist political philosophers. Non-Marxists typically view unemployment as a technical matter, and doing something about it a question of means not ends, with the solution to this question depending on the kind of empirical determinations about what causes what that are best left to economists, not political philosophers. But I think this is a mistake. Because work is a major part of our social life, as well as something that for a great many people grounds their sense of who they are and provides the basis of their sense of self-respect, those unable to find work are missing out on a great deal of what makes for a meaningful life, and not just the economic benefits that social cooperation has to offer. Those who are unemployed accordingly have something to complain about, even if we do not let them starve, and the rest of us (or at least the institutions that represent us) may have some sort of moral obligation to take action to increase the number of employment opportunities currently available regardless of any uncertainty surrounding the effects that any actions open to us might have. The nature and extent of this moral obligation is what On Unemployment is dedicated to exploring. (shrink)

Consensus is growing among ethicists and lawyers that medical decision making for incompetent patients who were previously competent should be made in accordance with that person's prior wishes and desires. Moreover, this legal and ethical preference for the substituted judgment standard has found its way into the daily practice of medicine. However, what appears on the surface to be an agreement between jurists, bioethicists, and clinicians obscures the very real differences between disciplines regarding the actual implementation of the sub stituted (...) judgment standard. Ethicists and judges have carefully outlined how substituted judgments ought to be made and evaluated. Although differences arise, especially at the state court level, regarding the scope of the substituted judgment standard and its relation to other standards of surrogate decision making, agreement is fairly widespread on the priority of substituted judgment and on the necessity of sufficient evidence being available in order to support a particular substituted judgment. (shrink)

Previous discussions of the evolution of the self have diverged greatly in their estimates of the date at which the capacity for self-thought emerged, the factors that led self-reflection to evolve, and the nature of the evidence offered to support these disparate conclusions. Beginning with the assumption that human self-awareness involves a set of distinct cognitive abilities that evolved at different times to solve different adaptive problems, we trace the evolution of self-awareness from the common ancestor of humans and apes (...) to the beginnings of culture, drawing upon paleontological, anthropological, biological, and psychological evidence. These data converge to suggest that that modern self-thought appeared just prior to the Middle-Upper Paleolithic transition, approximately 60,000 years ago.Recto running head: Evolution of the Self. (shrink)

We show that the fundamental legal structure of a well-written financial contract follows a state-transition logic that can be formalized mathematically as a finite-state machine (specifically, a deterministic finite automaton or DFA). The automaton defines the states that a financial relationship can be in, such as “default,” “delinquency,” “performing,” etc., and it defines an “alphabet” of events that can trigger state transitions, such as “payment arrives,” “due date passes,” etc. The core of a contract describes the rules by which different (...) sequences of events trigger particular sequences of state transitions in the relationship between the counterparties. By conceptualizing and representing the legal structure of a contract in this way, we expose it to a range of powerful tools and results from the theory of computation. These allow, for example, automated reasoning to determine whether a contract is internally coherent and whether it is complete relative to a particular event alphabet. We illustrate the process by representing a simple loan agreement as an automaton. (shrink)

:Academic Medical Centers offer patient care and perform research. Increasingly, AMCs advertise to the public in order to garner income that can support these dual missions. In what follows, we raise concerns about the ways that advertising blurs important distinctions between them. Such blurring is detrimental to AMC efforts to fulfill critically important ethical responsibilities pertaining both to science communication and clinical research, because marketing campaigns can employ hype that weakens research integrity and contributes to therapeutic misconception and misestimation, undermining (...) the informed consent process that is essential to the ethical conduct of research. We offer ethical analysis of common advertising practices that justify these concerns. We also suggest the need for a deliberative body convened by the Association of American Medical Colleges and others to develop a set of voluntary guidelines that AMCs can use to avoid in the future, the problems found in many current AMC advertising practices. (shrink)

Self-produced tactile stimulation usually feels less tickly—is perceptually attenuated—relative to the same stimulation produced externally. This is not true, however, for individuals with schizophrenia. Here, we investigate whether the lack of attenuation to self-produced stimuli seen in schizophrenia also occurs for normal participants following REM dreams. Fourteen participants were stimulated on their left palm with a tactile stimulation device which allowed the same stimulus to be generated by the participant or by the experimenter. The level of self-tickling attenuation did not (...) differ between REM and non-REM sleep awakening conditions, where presence or absence of an accompanying dream was not controlled for. However, for the female participants, when awakening occurred from an REM sleep dream, self-stimulation ratings were higher than for external stimulation, whereas ratings after NREM sleep unaccompanied by a dream were lower for self-stimulation than for external stimulation. These results indicate deficits in self-monitoring and a confusion between self- and externally generated stimulation accompany REM dream formation. (shrink)

What is conscientious objection? -- Should conscientious objectors be accommodated? -- Assessing objectors' beliefs and reasons -- Accommodation and conscientious provision.