This paper reports two cases in Hong Kong involving two native Chinese adolescent cancer patients (APs) who were denied their rights to consent to necessary treatments refused by their parents, resulting in serious harm. We argue that the dynamics of the 'AP-physician-family-relationship' and the dominant role Chinese families play in medical decision-making (MDM) are best understood in terms of the tendency to hierarchy and parental authoritarianism in traditional Confucianism. This ethic has been confirmed and endorsed by various Chinese writers from (...) Mainland China and Hong Kong. Rather than giving an unqualified endorsement to this ethic, based more on cultural sentimentalism than rational moral reasoning, we warn that a strong familism in MDM, which deprives 'weak' family members of rights, represents the less desirable elements of this tradition, against which healthcare professionals working in this cultural milieu need to safeguard. Specifically for APs, we suggest that parental authority and family integrity should be re-interpreted in terms of parental responsibility and the enhancement of children's interests respectively, as done in the West. This implies that when parents refuse to consent to necessary treatment and deny their adolescent children's right to consent, doctors, as the only remaining advocates of the APs' interest, have the duty to inform the state, which can override parental refusal to enable the doctors to fulfill their professional and moral obligations. In so doing the state exercises its 'parens patriae' power to defend the defenseless in society and the integrity of the medical profession. (shrink)

Nicolas Malebranche (1638–1715) holds that the senses, imagination, and passions aim at survival and the satisfaction of the body’s needs, rather than truth or the good of the mind. Each of these faculties makes a distinctive and, indeed, an indispensable contribution to the preservation of life. Commentators have largely focused on how the senses keep us alive. By comparison, the imagination and passions have been neglected. In this paper, I reconstruct Malebranche’s account of how the imagination contributes to the preservation (...) of the body by compensating for the limitations of the senses. First, the imagination represents non-actual states of affairs, such as probable or possible future states. Second, the imagination forges new and often helpful associations based on past experiences. Third, the imagination (mis)represents that objects will cause pleasure and pain, thereby imbuing them with emotional significance they would otherwise lack. Together, these features flesh out Malebranche’s view that the imagination is necessary for the preservation of life. (shrink)

Targeted gene alteration (TGA) is a strategy for correcting single base mutations in the DNA of human cells that cause inherited disorders. TGA aims to reverse a phenotype by repairing the mutant base within the chromosome itself, avoiding the introduction of exogenous genes. The process of how to accurately repair a genetic mutation is elucidated through the use of single‐stranded DNA oligonucleotides (ODNs) that can enter the cell and migrate to the nucleus. These specifically designed ODNs hybridize to the target (...) sequence and act as a beacon for nucleotide exchange. The key to this reaction is the frequency with which the base is corrected; this will determine whether the approach becomes clinically relevant or not. Over the course of the last five years, workers have been uncovering the role played by the cells in regulating the gene repair process. In this essay, we discuss how the impact of the cell on TGA has evolved through the years and illustrate ways that inherent cellular pathways could be used to enhance TGA activity. We also describe the cost to cell metabolism and survival when certain processes are altered to achieve a higher frequency of repair. (shrink)

Sredi I︠A︡, MY i ONI -- Na kremnistom puti -- V dialektike gumanizma -- S kli︠u︡chami sovesti.