Delivering high quality genomics-informed care to patients requires accurate test results whose clinical implications are understood. While other actors, including state agencies, professional organizations, and clinicians, are involved, this article focuses on the extent to which the federal agencies that play the most prominent roles — the Centers for Medicare and Medicaid Services enforcing CLIA and the FDA — effectively ensure that these elements are met and concludes by suggesting possible ways to improve their oversight of genomic testing.

Most people agree that murder is wrong. Yet, within computer games virtual murder scarcely raises an eyebrow. In one respect this is hardly surprising, as no one is actually murdered within a computer game. A virtual murder, some might argue, is no more unethical than taking a pawn in a game of chess. However, if no actual children are abused in acts of virtual paedophilia (life-like simulations of the actual practice), does that mean we should disregard these acts with the (...) same abandon we do virtual murder? In this paper I shall outline several arguments which attempt to permit virtual murder, whilst prohibiting virtual paedophilia. (shrink)

Objective: To assess the opinions and practice patterns of obstetrician-gynaecologists on acceptance and use of free drug samples and other incentive items from pharmaceutical representatives.Methods: A questionnaire was mailed in March 2003 to 397 members of the American College of Obstetricians and Gynecologists who participate in the Collaborative Ambulatory Research Network.Results: The response rate was 55%. Most respondents thought it proper to accept drug samples , an informational lunch , an anatomical model or a well-paid consultantship from pharmaceutical representatives. A (...) third of the respondents thought that their own decision to prescribe a drug would probably be influenced by accepting drug samples. Respondents were more likely to think the average doctor’s prescribing would be influenced by acceptance of the items than theirs would be . Respondents who distributed drug samples to patients indicated doing so because of patients’ financial need and for their convenience and less so as a result of knowledge of the efficacy of the sample product . A third of respondents agreed that interactions with industry should be more strictly regulated.Conclusion: Obstetrician-gynaecologists largely indicated that they would act in accordance with what they think is proper regarding accepting incentive items from pharmaceutical representatives. Although accepting free drug samples was considered to be appropriate more often than any other item, samples were most commonly judged to be influential on prescribing practices. The widely accepted practice of receiving and distributing free drug samples needs to be examined more carefully. (shrink)

I explore options for a plenitudinarian solution to the Paradox of Flexible Origin Essentialism, taking as my unlikely starting point the views of Sarah-Jane Leslie, who holds that if plenitudinarianism is true, then there is in fact no paradox to be solved, only the illusion of one. The first three sections are expository: Sect. 1 on plenitudinarianism, Sect. 2 on the paradox, and Sect. 3 on Leslie’s views about how plenitudinarianism bears on the paradox. In Sect. 4, I reject the (...) contention that there is no paradox and critically explore three options for a plenitudinarian solution. In Sect. 5, I argue that the plenitudinarian ought to endorse a fourth option. In Sect. 6, I consider an objection. I endorse neither plenitudinarianism nor its denial; the main aim of the paper is to argue that for one who does endorse plenitudinarianism, the best solution to the Paradox of Flexible Origin Essentialism is clear. (shrink)

Isaiah Berlin was recognized as Britain's most distinguished historian of ideas. Berlin is particularly associated with the concept of the 'Counter-Enlightenment', comprising those thinkers who in Berlin's view reacted against the Enlightenment's naïve rationalism, scientism and progressivism. Berlin's 'Counter-Enlightenment' has received critical attention, but no-one has yet analysed the understanding of the Enlightenment on which it rests. Isaiah Berlin and the Enlightenment explores the development of Berlin's conception of the Enlightenment, noting its curious narrowness, its ambivalence, and its indebtedness to (...) a specific German intellectual tradition. Contributors to the book examine his comments on individual writers, showing how they were inflected by his questionable assumptions, and arguing that some of the writers he assigned to the 'Counter-Enlightenment' have closer affinities to the Enlightenment than he recognized. By locating Berlin in the history of Enlightenment studies, this book also makes a contribution to defining the historical place of his work and to evaluating his intellectual legacy. (shrink)

A significant portion of recent literature on Nietzsche is devoted to his metaethical views, both critical and positive. This article explores one aspect of his positive metaethics. The specific thesis defended is that Nietzsche is, or is plausibly cast as, a reasons internalist. This, very roughly, is the view that what an agent has normative reason to do depends on that agent's motivational repertoire. Section I sketches some of the metaethical terrain most relevant to Nietzsche's organising ethical project, his “revaluation (...) of all values”, and lays out three “design-requirements” that an adequate account of Nietzsche's metaethical views must satisfy. Section II introduces the basic internalist position. Sections III–IV provide textual support for the internalist reading of Nietzsche, with Section V showing how it meets each of the design-requirements. Section VI concludes by showing how the internalist apparatus also illuminates Nietzsche's views about the process of revaluing values. (shrink)

The forestry profession has no offical policy on forest aesthetics: Neither foresters nor the public have clear guidelines as to what a socially acceptable, actively managed forest should lookl ike. Hints of an impplicit policy can be found in the Society of American Foresters position statements on timber harvesting and in various recommendations for best management practices found in state, federal, and industrial forestry publications. These implicit policies may send a hypocritical message to the public about the practice, intent, and (...) ethics of forestry. (shrink)

Members of the transforming growth factor beta (TGFβ) family are pleiotropic cytokines with key roles in tissue morphogenesis and growth. TGFβ1, TGFβ2 and TGFβ3 are abundant in mammalian reproductive tissues, where development and cyclic remodelling continue in post‐natal and adult life. Potential roles for TGFβ have been identified in gonad and secondary sex organ development, spermatogenesis and ovarian function, immunoregulation of pregnancy, embryo implantation and placental development. However, better tools must now be employed to map more precisely essential functions and (...) the regulatory networks governing their activity. Gene ablation and transgenic models are expected to provide novel insights into distinct physiological activities for each TGFβ isoform in normal reproductive function and reproductive pathologies. It is also necessary to consider the mechanisms controlling TGFβ activation from latent precursor forms, and receptor and binding protein expression. Smad intracellular signalling circuitry and modulation by environmental stimuli through cross‐talk with other signal transduction pathways will further constrain TGFβ action. This review examines existing evidence for TGFβ1, TGFβ2 and TGFβ3 regulation of male and female reproductive biology, and highlights prospects for future research. BioEssays 24:904–914, 2002. © 2002 Wiley Periodicals, Inc. (shrink)

Drawing on Heidegger’s essay “The Origin on the Work of Art,” I argue that works of art reveal human experience to be simultaneously finite and ecstatic and that art is part of the way our experience unfolds. Secondly, I argue that the dynamic of experience that art enables and in which it is implicated is precisely what historical experience is; this historical character of our experience is also always intersubjective and relational. Next, I turn to “Why Poets?” to analyse Heidegger’s (...) critique of Rilke’s work in terms of the idea that works of art are involved in our self-constitution as historical and relational beings. Reading these two essays together, finally, allows me to conclude by characterising the demands of a distinctly modern experience of interpretation and by identifying the need to question what it means to be a “we” as the defining question of modernity. (shrink)

"_Weaving the World_ is a well-written and lucid overview of Simone Weil's writings on science and mathematics. This book will be of great benefit for anyone who wishes to pursue Weil's thought in depth." —_Eric O. Springsted, President of the American Weil Society_ "_Weaving the World_ is a detailed account of the philosophy of science and knowledge of Simone Weil. It is a very useful contribution to our understanding of one of the deepest and most incandescent thinkers of the twentieth (...) century." —_Martin Andic, University of Massachusetts, Boston_ This clearly written book introduces readers to Simone Weil’s philosophy of science and mathematics. Weil held that, for the ancient Greeks, the ultimate purpose of science and mathematics was the knowledge and love of the divine. Her creative assimilation of this vision led her to a conception of science and mathematics that connects the human person with not only the physical world but also the spiritual and aesthetic aspects of human existence. Vance Morgan sketches an outline of a metaphysical foundation for mathematics and science that, according to Weil, opens the door to a reinvigorated discussion among science, philosophy, art, and religion. (shrink)

In this paper we examine the thesis that the probability of the conditional is the conditional probability. Previous work by a number of authors has shown that in standard numerical probability theories, the addition of the thesis leads to triviality. We introduce very weak, comparative conditional probability structures and discuss some extremely simple constraints. We show that even in such a minimal context, if one adds the thesis that the probability of a conditional is the conditional probability, then one trivializes (...) the theory. Another way of stating the result is that the conditional of conditional probability cannot be represented in the object language on pain of trivializing the theory. (shrink)

A method of developing a relational semantics and relational proof systems for many-valued logics based on finite algebras of truth values is presented. The method is applied to Rosser-Turquette logic, logics based on symmetric Heyting algebras with operators and a Post-style logic.