For over thirty years Susan Wolf has been writing about moral and nonmoral values and the relation between them. This volume collects Wolf's most important essays on the topics of morality, love, and meaning, ranging from her classic essay "Moral Saints" to her most recent "The Importance of Love.".

Background: Genomic analysis may reveal both primary and secondary findings with direct relevance to the health of probands’ biological relatives. Researchers question their obligations to return findings not only to participants but also to family members. Given the social value of privacy protection, should researchers offer a proband’s results to family members, including after the proband’s death? Methods: Preferences were elicited using interviews and a survey. Respondents included probands from two pancreatic cancer research resources, plus biological and nonbiological family members. (...) Hypothetical scenarios based on actual research findings from the two cancer research resources were presented; participants were asked return of results preferences and justifications. Interview transcripts were coded and analyzed; survey data were analyzed descriptively. Results: Fifty-one individuals (17 probands, 21 biological relatives, 13 spouses/partners) were interviewed. Subsequently, a mailed survey was returned by 464 probands, 1,040 biological family members, and 399 spouses/partners. This analysis highlights the interviews, augmented by survey findings. Probands and family members attribute great predictive power and lifesaving potential to genomic information. A majority hold that a proband’s genomic results relevant to family members’ health ought to be offered. While informants endorse each individual’s choice whether to learn results, most express a strong moral responsibility to know and to share, particularly with the younger generation. Most have few concerns about sharing genetic information within the family; rather, their concerns focus on the health consequences of not sharing. Conclusions: Although additional studies in diverse populations are needed, policies governing return of genomic results should consider how families understand genomic data, how they value confidentiality within the family, and whether they endorse an ethics of sharing. A focus on respect for individual privacy—without attention to how the broad social and cultural context shapes preferences within families—cannot be the sole foundation of policy. (shrink)

Large-scale sequencing tests, including whole-exome and whole-genome sequencing, are rapidly moving into clinical use. Sequencing is already being used clinically to identify therapeutic opportunities for cancer patients who have run out of conventional treatment options, to help diagnose children with puzzling neurodevelopmental conditions, and to clarify appropriate drug choices and dosing in individuals. To evaluate and support clinical applications of these technologies, the National Human Genome Research Institute and National Cancer Institute have funded studies on clinical and research sequencing under (...) the Clinical Sequencing Exploratory Research program as well as studies on return of results. Most of these studies use sequencing in real-world clinical settings and collect data on both the application of sequencing and the impact of receiving genomic findings on study participants. They are occurring in the context of controversy over how to obtain consent for exome and genome sequencing. (shrink)

Advanced biopreservation technologies using subzero approaches such as supercooling, partial freezing, and vitrification with reanimating techniques including nanoparticle infusion and laser rewarming are rapidly emerging as technologies with potential to radically disrupt biomedicine, research, aquaculture, and conservation. These technologies could pause biological time and facilitate large-scale banking of biomedical products including organs, tissues, and cell therapies.

Data are lacking with regard to participants' perspectives on return of genetic research results to relatives, including after the participant's death. This paper reports descriptive results from 3,630 survey respondents: 464 participants in a pancreatic cancer biobank, 1,439 family registry participants, and 1,727 healthy individuals. Our findings indicate that most participants would feel obligated to share their results with blood relatives while alive and would want results to be shared with relatives after their death.

This concise anthology collects important historical and contemporary readings on the central ethical theories, including Divine Command Theory, Consequentialism, Deontology, Virtue Ethics, and Feminist Ethics. Each section includes two or three of the most important contributions to the field, together with brief introductions from the editors. This new third edition offers expanded coverage of meta-ethics through the addition of thought-provoking readings from Susan Wolf, Gilbert Harman, and others. The number of selections from women authors has also increased.

What does it mean to claim Jesus as Lord over the principalities and powers in a world where oppression, terror, and death so often seem to have the last word? Jesus' “answer” is not an intellectual explanation but a charge and a benediction, to guide believers and empower them to persevere.

This paper is the companion to “Assessment of Information on Public Health Law Best Practices for Obesity Prevention and Control,” and the fourth of four action papers produced as part of the National Summit on Legal Preparedness for Obesity Prevention and Control, convened June 2008 by the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, and the American Society for Law, Medicine Ethics. The four action papers present options to address gaps in the four core elements of (...) public health legal preparedness as outlined in the relevant companion papers. The four core elements are: laws and legal authorities; legal competencies for public health professionals to apply those laws and authorities; coordination of law-based efforts across jurisdictions and sectors, and information on public health law best practices. (shrink)

Race and Pedagogy identifies persistent, institutional racism as the cause of the lower rates of high school graduation among African Americans, Hispanics, and Native Americans in the United States. Adams and Buffington-Adams provide a retrospective look at their own and other teachers’ efforts to acknowledge the limitations of their own cultural lenses in order to identify, examine, and fix the failings of the current educational system.

Carpendale & Lewis's theoretical reconstruction of the “theory of mind” problem offers new hope but still has far to go. The study of atypical development may provide some useful insights for dealing with the work ahead. In particular I discuss three issues – the boundary problem, the question of end states, and the issue of the centrality of triadic interaction.

In New Testament times, Job was considered a model of “steadfastness.” Job persevered by looking ahead to God's salvation. New Testament authors similarly portrayed Jesus as one who stood fast in time of trial, even unto death, thereby breaking the power of sin and strengthening Christians to standfast in their own trials.

This chapter argues that the objection that Socrates makes against diviners, poets, and rhapsodies having knowledge is an example of what has come to be known as an opacity objection: that is, some aspect of what would be required for them to know is unrecognised by them. This chapter contends that the opacity is of a different kind than what contemporary epistemologists have considered, and claims that Socrates’ specific version should have a place in contemporary theory of knowledge.

The original, prescientific Western belief that the mantis is a pious, helpful creature became a widely held explanation for the mantid's unique resting posture, and for one of its cryptic displays. This belief was a characteristic part of a broader discourse about nature in which ancient authority, religious beliefs, and superstition, but few original observations, mixed freely. Gradually, the belief in mantid gentleness and piousness became a commonplace through the continual retelling of the myths and superstitions surrounding this fascinating insect.By (...) the seventeenth century, a growing interest in observation had begun to replace blind reliance on established wisdom and ancient authority. However, the various young sciences to which the period gave rise did not progress equally, and neither did the subdisciplines within each scientific field; biology, especially entomology, was particularly slow to free itself from past beliefs and contemporary superstitions. In the specific case of the praying mantis, the situation may have been at its worst.Early observers of nature found evidence that seemed, at first, to disconfirm the well-established belief that mantids are gentle creatures. These few observers, faced with startling firsthand information about mantid voraciousness, created a new characterization of mantids as merciless predators and then often juxtaposed the two images in their descriptions. However, it was not until the beginning of the nineteenth century that the two characterizations-gentleness versus cruelty— became reconciled.An amalgamation of these seemingly mutually exclusive characterizations was achieved by an interesting accommodation of each to the other. That is, while it could no longer be maintained that mantids are simply gentle insects, neither could it be accepted that they are all cruelty and viciousness. The melding of the two characterizations yielded a hybrid explanation which claimed that the praying mantis actually hastwo sides to its character! On the one hand, and like other creatures, mantids must nourish themselves, and do so quite reasonably by capturing small insects for food. However, even when “well nourished,” and without “the excuse of hunger,” their other, vicious side may surface; when this happens, the darkest of behaviours, cannibalism, is the result.To understand the remainder of the story one must pause to consider what had happened in the other sciences up to this point. In the mid-seventeenth century, professional scientific societies were established throughout Europe. The societies, and the various journals and periodicals that they produced or encouraged, represented an institutionalization of both science and its special, structured discourse. However, as we have stated, entomology lagged behind; and in the case of some insects, superstitions and anthropomorphisms did not fade from descriptions of their behavior for centuries to come.By the time the new scientific discourse was applied to mantids the creatures were already firmly shackled with a dual personality, and this assumption was never challenged. In fact, it was functionally impossible to disconfirm. Captures of small prey were considered part of the mantid's normal side; captures of large prey were considered part of the mantid's abnormal side. There was no alternative explanation.As luck would have it, by the time that the strictures of scientific discourse had tightened sufficiently to disallow the use of anthropomorphisms in the explanation of insect behavior, another acceptable explanation of mantid cannibalism became immediately available: cannibalism became part of mantid mating behavior. That is, the fundamental explanatory model remained unchanged; it was merely couched in more appropriate terms. The acceptance of this new explanation for cannibalism was virtually immediate and complete. For instance, no one ever asked the following questions: If the headless male remains able to mate as a putative precaution against female cannibalism, for what reason does the headless female remain able to fashion “a perfectly constructed ootheca”? Or: If female-on-male cannibalism plays a role in mating behavior, what role is played by genderindifferent cannibalism, especially that among immature mantids? The latter phenomena were simply ignored — they were just uninteresting artifacts of insect life. However, the grand logic of nature was immediately apparent in the headless male's ability to mate. The ruling theory, to use Chamberlin's term, had been able to accommodate itself to, and assimilate, the new scientific discourse. It remained unscathed.A persistent question posed by several historians of this particular topic has been, Why did not the results of Ken Roeder's experiments debunk the myth that males are regularly cannibalized by the females with which they mate? The reason, which we hope is now clear, is that there were two interdependent ruling theories operating here. If one accepts the argument that mantids' cannibalism is simply a normal part of their prey-catching behavior, then one attacks not only the theory that mantids have two separate predatory strategies, but also the more recent theory that mantids have evolved to be the ideal fly-catching machines. This second theory found its first confirming support in the centuries-old practice of feeding flies to captive mantids. Again, the disconfirming evidence of mantids eating prey of various sizes had no impact on the theory. Confirming observations were accepted: disconfirming observations were seen as anomalies.Additional confirmation of both ruling theories was garnered in experiments done in the mid-twentieth century. These experiments were based on the assumption that the original conceptualizations were correct, and consequently they did not test other hypotheses. The combined strength of the two theories is evidenced especially in the Raus' failure to account for the fact that their empirical observations were at odds with many of the conclusions that they drew, and in the fact that Roeder's work is still used to support the belief in the regularity of mating-related cannibalism despite the fact that Roeder, himself, argued the opposite. with both theories well entrenched, it is virtually impossible to promote an alternative theory of mantid behavior: namely, that mantids are generalized, opportunistic predators that manage to survivein spite of the fact that cannibalism sometimes occurs. (shrink)

Pickering & Garrod's (P&G's) theory of dialogue production cannot completely explain recent data showing that when interactants in referential communication tasks have different views of a physical space, they accommodate their language to their partner's view rather than mimicking their partner's expressions. Instead, these data are consistent with the hypothesis that interactants are taking the perspective of their conversational partners.

Three and 4-year-old children were tested on matched versions of Zaitchik's (1990) photo task and Wimmer and Perner's (1983) false belief task. Although replicating Zaitchik's finding that false belief and photo task are of equal difficulty, this applied only to mean performance across subjects and no substantial correlation between the two tasks was found. This suggests that the two tasks tap different intellectual abilities. It was further discovered that children's performance can be improved by drawing their attention to the back (...) of the photo but not by drawing attention to the person holding the false belief. Results are interpreted as showing that children's difficulty with the photo task is due to referential confusion about which scene the question refers to (the picture or reality) while the hurdle in the false belief task is to understand that the believer misrepresents reality. (shrink)

How a group G can know that p has been the subject of much investigation in social epistemology in recent years. This paper clarifies and defends a form of non-supervenient, non-summative group knowledge: G can know that p even if none of the members of G knows that p, and whether or not G knows that p does not locally supervene on the mental states of the members of G. Instead, we argue that what is central to G knowing that (...) p is whether G has an epistemic structure that is functioning appropriately in accord with the action-related purposes of the group, and this structure may include non-agential elements such as devices that retain or process information. We argue that recent objections to non-summative group knowledge given by Jennifer Lackey do not in fact succeed in undermining the view, but do help to clarify the nature of non-summative group knowledge. The main upshot of our response to Lackey’s objections is that groups put their knowledge into action in ways that often differ from how individuals do so, and social epistemologists should be careful to notice these differences, especially insofar as groups often structure themselves by employing various epistemically-relevant devices. (shrink)

Jesper Kallestrup has provided an insightful response to our paper, “Epistemic Structure in Non-Summative Social Knowledge”. Kallestrup identifies some important issues pertaining to our non-summative, non-supervenient account of group knowledge which we did not address in our original paper. Here, we develop our view further in light of Kallestrup’s helpful reply.

Perhaps the most troublesome medical decisionmaking cases facing state courts concern serious healthcare decisions involving patients with severe or profound retardation. The courts who face this issue encounter a difficult dilemma. A decision to terminate a medical treatment of a dependent, vulnerable person requires considerable solicitude. Allowing a helpless person to die sooner than is medically possible directly conflicts with that person's most basic right – the right to live. However, continuing treatment in the face of terminal illness may not (...) only prolong but also increase intense mental and physical suffering. Perpetuating near torture in the name of protecting a person's life may be equally worrisome. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:LettersMaxwell J. Mehlman, Susan R. Massey, Ronald M. Green, and Fred RosnerPhysicians and the Allocation of Scarce ResourcesMadam: We read with interest Dr. Pellegrino's commentary on our article in the December 1994 issue of the Kennedy Institute of Ethics Journal, and commend him for pointing out so well the different ways that law and ethics approach the issue of physician allocation of scarce resources.We wish to make one (...) clarification. Dr. Pellegrino states that we propose that fiduciary duties be abolished. Quite the contrary, our position is that fiduciary obligations are essential to the maintenance of trust—which we believe to be an efficient as well as an ethical element of the patient-provider relationship. If fiduciary duties are undercut, as we pointed out they are by the Oregon Medicaid legislation, then some other method of promoting trust must be established, and, as we point out in the article, it is difficult to identify what that method could be.Maxwell J. MehlmanandSusan R. MasseyThe Law Medicine CenterArter & HaddenCase Western Reserve UniversityCleveland, OHSchool of LawCleveland, OHReport of the Human Embryo Research PanelMadam: In the December 1994 issue of the Kennedy Institute of Ethics Journal, I reported on the controversy surrounding the work of the NIH Human Embryo Research Panel and the conclusions reached in its report, which was formally presented to NIH Director Harold Varmus on September 27, 1994. At that time, the report was to be reviewed by the Advisory Committee to the Director (ACD) until its next meeting in early December. I am writing to update your readers on the fate of the Panel's report.On the morning of December 2, 1994, following a previous afternoon of animated discussion, the ACD unanimously accepted the Report of the Human Embryo Research Panel. Panel members and members of the NIH staff who were present and had worked for nearly a year on the Report were gratified by this vote of confidence and by the strong support of NIH Director Harold Varmus.We had little time to enjoy this success. Within a matter of hours, the White House issued a press release in which President Clinton thanked the committee for its work and then, in a remark overruling one of the key recommendations in our report, stated: "I do not believe that federal funds should be used to support the creation of human embryos for research purposes, and I have directed that NIH not allocate any resources for such research." [End Page 83]As a Panel member and active participant in that day's events, my initial response was one of shock. I was particularly distressed that the President and his advisors chose a moment so late in the process to make their views known. Why had we worked for months, I asked, without a word of concern from the White House? Although Panel members were guided primarily by our perceptions of the ethical and scientific issues involved, some were close to the political realities of Washington and would have introduced these concerns into the Panel's deliberations.Within a matter of days, my own sense of outrage had diminished. First of all, it was clear that whatever the personal sources of the President's objections to the Panel's recommendations, this high level political intervention was inevitable. Less than a month before, on November 8, with the election of a majority House and Senate, the political environment for embryo research had changed dramatically. The previous June, 32 congressmen, most of them members of a minority Republican party, had signed a letter protesting the Panel's work. Now, one of the signers of that letter, Newt Gingrich, was destined to be Speaker of the House.Second, it became clear that the damage was not total. The President has forbidden NIH to support work involving the deliberate creation of embryos for research. Without exception, members of the Panel had come to the conclusion that some development of "research embryos" must be permitted to reduce the risks of new assisted reproductive technologies, to enhance scientific knowledge, and to develop new therapies for a range of serious diseases. All these... (shrink)

Patients with insufficient financial resources place physicians in a conflict of interest between the patients' needs and the financial interests of the physician, other patients, and society. Not only must physicians act ethically, but they must avoid liability for violating their legal duties to their patients. The traditional rules of contract and malpractice law that govern the patient-physician relationship do not provide satisfactory guidelines. Better answers are found in the rules of fiduciary law, but only with regard to direct conflicts (...) between patients and physicians and only at the risk of reducing patient access to care. Certain types of legislative action can resolve these conflicts by altering the traditional legal rules, but care must be taken to preserve patient-physician trust, which the legal rules were designed to enhance. (shrink)