This paper is intended to stimulate debate amongst stakeholders in the international research community on the topic of returning individual genetic research results to study participants. Pharmacogenetics and disease genetics studies are becoming increasingly prevalent, leading to a growing body of information on genetic associations for drug responsiveness and disease susceptibility with the potential to improve health care. Much of these data are presently characterized as exploratory (non‐validated or hypothesis‐generating). There is, however, a trend for research participants to be permitted (...) access to their personal data if they so choose. Researchers, sponsors, patient advocacy groups, ethics committees and regulatory authorities are consequently confronting the issue of whether, and how, study participants might receive their individual results. Noted international ethico‐legal guidelines and public policy positions in Europe and the United States are reviewed for background. The authors offer ‘Points‐to‐Consider’ regarding returning research results in the context of drug development trials based on their knowledge and experience. These considerations include: the clinical relevance of data, laboratory qualifications, informed consent procedures, confidentiality of medical information and the competency of persons providing results to participants. The discussion is framed as a benefit‐to‐risk assessment to balance the potential positive versus negative consequences to participants, while maintaining the integrity and feasibility of conducting genetic research studies. (shrink)

ABSTRACT This paper is intended to stimulate debate amongst stakeholders in the international research community on the topic of returning individual genetic research results to study participants. Pharmacogenetics and disease genetics studies are becoming increasingly prevalent, leading to a growing body of information on genetic associations for drug responsiveness and disease susceptibility with the potential to improve health care. Much of these data are presently characterized as exploratory (non‐validated or hypothesis‐generating). There is, however, a trend for research participants to be (...) permitted access to their personal data if they so choose. Researchers, sponsors, patient advocacy groups, ethics committees and regulatory authorities are consequently confronting the issue of whether, and how, study participants might receive their individual results. Noted international ethico‐legal guidelines and public policy positions in Europe and the United States are reviewed for background. The authors offer ‘Points‐to‐Consider’ regarding returning research results in the context of drug development trials based on their knowledge and experience. These considerations include: the clinical relevance of data, laboratory qualifications, informed consent procedures, confidentiality of medical information and the competency of persons providing results to participants. The discussion is framed as a benefit‐to‐risk assessment to balance the potential positive versus negative consequences to participants, while maintaining the integrity and feasibility of conducting genetic research studies. (shrink)

The state, by V.I. Lenin.--The revolutionary part played by law and the state; a general doctrine of law, by P.I. Stuchka.--The theory of Petrazhitskii: Marxism and social ideology. Law, our law, foreign law, general law, by M.A. Reisner.--The general theory of law and Marxism, by E.B. Pashukanis.--The right deviation in the Communist Party of Bolsheviks. Political report of the Central (Party) Committee to the XVI Congress, 1930, by J.V. Stalin.-- The Soviet state and the revolution in law, by E.B. Pashukanis.--Socialism (...) and law, by P. Yudin.--The fundamental tasks of the science of Soviet socialist law, by A.Y. Vyshinsky.--Report to the XVIII Party Congress, by J.V. Stalin.--The theory of the state and law, by S.A. Golunskii and M.S. Strogovich.--The Soviet state in the war for the fatherland, by A.Y. Vyshinsky.--The relationship between state and law, by I.P. Trainin. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:TOWARD A THOMISTIC PERSPECTIVE ON ABORTION AND THE LAW IN CONTE:MPORARY AMERICA M. CATHLEEN KAVENY Yale University New Haven, Oonnecticut Introduction W;HEN THE SUPREME COURT handed down its abortion decision Webster v. Reproductive Health Services 1 in the summer of 1989, it was widely prel 109 S. Ct. 3040 (1989). All further citations to Webster will be given parenthetically in the text. To summarize the most significant (...) aspects. of the decision: A. Chief Justice Rehnquist authored an opinion of the Oourt (of the highest precedential value) which was joined by Justices White, Kennedy, Scalia, and O'Connor. The majority found the lower courts to be in error in striking down as unconstitutional the preamble to a Missouri statute which asserted that "the life -0f each human being begins at conception." The opinion of the Court also found that Missouri could constitutionally prohibit the use of public employees and facilities in the performance of abortions not necessary to save the mother's life. B. The Court also upheld the Missouri statute's provision requiring a. doctor to perform viability tests before aborting a fetus the doctor believes is of 20 or more weeks gestational age. In the plurality opinion (of less precedential value than an opinion -0f the Court, since it is not joined by a majority of the justices), Chief Justice Rehnquist, Justice White, and Justice Kennedy argued that since most fetuses are not viable at twenty weeks, the provision would impose substantial restrictions unrelated to the health of the mother upon what are, in fact, simply sec-0nd trimester abortions. Because they believed such restrictions to be in tension with Roe's trimester system, the plurality decided to abandon that system, along with its stipulation that the state's interest in unborn life became compelling only at viability. The plurality contended, however, that Webster presented no occasion for reconsidering Roe's holding, which deemed unconstitutional a statute prohibiting all abortions except those necessary to save the life of the mother. In a concurring opinion, Justice Scalia went further, arguing that the Court should explicitly overrule Roe v. Wade. On the other hand, Justice O'Connor, 848 344 M. CAT'HLEEN KAVENY dieted that this would exaicerbate a dangerously bitter social·struggle. In its 1973 decision Roe v. Wade (410 U.S. 113), the court had e1abo:raJted.a woman's right to abortion, and, in rthe sixteen years that fo11owed it, it ga,V'e that right unwavering support. Webster 'seemed to mark a retl.'eat from that support. The new scope it offered for state regulation of rubortion promised rto ignite gra,ss-roots forvor and a stiate..:by-state battle between those seeking rto maintain the abortion rights est1ab1isihed by Roe and its sequalia and those st:dving to limit the s1oope of these rights in 1 significant ways. Much of the criticism of Webster has fooused narrowly upon how weM the,decision has aiocorided with various views on the morality of abortion. Yet important 1as this issue is, thorough ethicaJ ana:lysis of Webster must address severa1l additional fac~ tors. The ethiicatl aidequacy of positive law, induding judicial interpretations of faw siuch as Webster, must he ev1alruated in terms of whetheir it aidvanices or impedes the common good. The common good requires not only that we consider the moml substance of legal requirements but tha:t we ailso attend to the manner in which law is made, promulgated, ml!d interpreted. Such an analysis is,sorely needed; it should. specify the severa1l factors involved in determining whether any given legal also concurring in the plurality's judgment, maintained that this provision of the statute could be upheld without any reconsideration of Roe, since it co· hered with that decision's recognition of the compelling state interest in viable fetal life. C. Justice Blackmun authored an opinion dissenting from the majority on the issues discussed above, and he was joined by Justices Brennan and Mar· shall. The thrust of his opposition is directed against the plurality's treatment of the viability testing,provisions. Blackmun first suggested that i.f understood according to the canons of proper statutory interpretation, these provisions unconstitutionally restrict the attending physician... (shrink)

In light of scientific advances such as genomics, predictive diagnostics, genetically engineered agriculture, nuclear transfer cloning, and the manipulation of stem cells, the idea that genes carry predetermined molecular programs or blueprints is pervasive. Yet new scientific discoveries—such as rna transcripts of single genes that can lead to the production of different compounds from the same pieces of dna—challenge the concept of the gene alone as the dominant factor in biological development. Increasingly aware of the tension between certain empirical results (...) and interpretations of those results based on the orthodox view of genetic determinism, a growing number of scientists urge a rethinking of what a gene is and how it works. In this collection, a group of internationally renowned scientists present some prominent alternative approaches to understanding the role of dna in the construction and function of biological organisms. Contributors discuss alternatives to the programmatic view of dna, including the developmental systems approach, methodical culturalism, the molecular process concept of the gene, the hermeneutic theory of description, and process structuralist biology. None of the approaches cast doubt on the notion that dna is tremendously important to biological life on earth; rather, contributors examine different ideas of how dna should be represented, evaluated, and explained. Just as ideas about genetic codes have reached far beyond the realm of science, the reconceptualizations of genetic theory in this volume have broad implications for ethics, philosophy, and the social sciences. Contributors. Thomas Bürglin, Brian C. Goodwin, James Griesemer, Paul Griffiths, Jesper Hoffmeyer, Evelyn Fox Keller, Gerd B. Müller, Eva M. Neumann-Held, Stuart A. Newman, Susan Oyama, Christoph Rehmann-Sutter, Sahotra Sarkar, Jackie Leach Scully, Gerry Webster, Ulrich Wolf. (shrink)

Employs philosophy to help illuminate the nature of nursing and provide a holistic view of both nursing and persons.

Current thinking on the development of molecular microbial characterisation techniques in public health focuses mainly on operational issues that need to be resolved before incorporation into daily practice can take place. Notwithstanding the importance of these operational challenges, it is also essential to formulate conditions under which such microbial characterisation methods can be used from an ethical perspective. The potential ability of molecular techniques to show relational patterns between individuals with more certainty brings a new sense of urgency to already (...) difficult ethical issues associated with privacy, consent and a moral obligation to avoid spreading a disease. It is therefore important that professionals reflect on the ethical implications of using these techniques in outbreak management, in order to be able to formulate the conditions under which they may be applied in public health practice. (shrink)

Der siegreiche Zug der technische Zivilisation zerstörte die Harmonie des Menschen und der Umwelt, änderte traditionelle Wertvorstellungen. Der "technische Intellekt" ist nicht befähigt, Konkrete Probleme der menschlichen Geschichte zu lösen. Unter dem Vorwand des Kampfes mit diesem "technischem Intellekt" verstärken sich in der modernen Welt irrationalistlische Tendenzen, welche die Vernunft und die menschliche Rationalität im allgemeinen angreifen. In dieser Situation wächst die Rolle der sozialen Erkenntnis, di dialektisch-materialistische Rationalität verkörpert.

Pediatric critical careCritical care refers to the health care of children with life-threatening illness or following major surgery or severe injury. This care is offered in different contexts across the globe. In well-resourced environments, critical careCritical care may be provided in pediatric intensive care units, which provide highly complex medical care with advanced, potentially expensive technological devices aimed primarily at sustaining life; whereas in poorly resourced regions, only primary care may be available for critically ill or injured childrenInjured children. Even (...) where PICU facilities are available, they are a scarce and expensive resource. The knowledge and ability to sustain a critically ill or injured child’sInjured children life, potentially with effects on the child and family’s quality of lifeQuality of life and at the expense of other children’s health care, leads to frequent ethical challenges. Ethical issues related to how best to ensure optimal quality of lifeQuality of life and the fair distribution of scarce resources are common. In-depth knowledge and understanding of the individual patient’s medical, scientific and psychosocial context, through interdisciplinary discussion and collaboration; as well as familiarity with the overriding, relevant ethico-legal policiesPolicy and principles is essential for appropriate decision-makingDecision-making. Truthful communicationCommunication with the family is essential, using a shared decision-makingDecision-making process, and the child’s best interestBest interest must be central to every decision. This chapter presents an overview of the recommended approach to, and important considerations for, ethical decision-makingDecision-making in the PICU, using a hypothetical case example. (shrink)

The question of a new journal and the philosophical debate of 1947 In 1922-43 Soviet philosophers had their own journal titled Pod znamenem marksizma [Under the Banner of Marxism]. It came into being in early 1922 and its third issue contained Lenin's programmatic article "On the Significance of Militant Materialism" [O znachenii voinstvuiushchego materializma]. This journal published many good combative articles in its twenty years. But during the War it fell ill and in mid-1943 ceased to exist. It was not (...) discontinued. No, it simply lacked the strength to appear. Thereafter, we Soviet philosophers did not have our own journal for several years. The lack was felt especially keenly after the end of the Great Patriotic War when philosophical studies developed quickly in our country. A wide discussion of philosophical questions, especially contentious, controversial questions—and there were quite a few of them—became necessary but there was no forum for discussing them. This was also true of the critical analysis of the philosophical literature that was coming out: a rare review appeared from time to time in the existing journals, but it was clearly inadequate and, most importantly, it did not give a comprehensive evaluation of the merits and shortcomings of the published philosophical work. It seemed to us then that an unhealthy situation such as the one involving G. F. Aleksandrov's book The History of Western European Philosophy [Istoriia zapadnoevropeiskoi filosofii], which was not evaluated on its merits and, despite its serious flaws, was praised by admirers of the author's talent, could only arise in the absence of a philosophical journal. Had there been a journal, it could have helped to prevent such stuffy situations from arising in certain sections of the philosophical front. Obviously, this opinion was quite naive: at the time many of us did not understand that if Aleksandrov had had "his" man on the journal, no criticism of his book would have been permitted. We realized this later. (shrink)

It has long become established practice, on the part of the editors of Voprosy filosofii, to hold round table discussions on various pressing problems of philosophy and related disciplines.

We know that the Philosophical Notebooks do not constitute a finished work, but are working digests done by Lenin, not for publication but only for himself, and as a basis for further work on questions of dialectics. This circumstance must always be remembered when one turns to the Philosophical Notebooks. Here are recorded and collected Lenin's remarkable thoughts as they developed upon reading the works of Hegel and other philosophers as well as certain natural scientists, and Lenin's exceedingly valuable plans (...) and notions pertaining to further work on theoretical problems of the materialist dialectic. But, at the same time, the Philosophical Notebooks contain numerous passages copied by Lenin as he did the digests of the philosophical works he read. Moreover, it is sometimes difficult to say for what purpose and toward what end Lenin did this copying: was it in order subsequently to adduce these extracts and quotations in support of his own views and postulates; was it for purposes of criticism — to demonstrate that the propositions of Marxist dialectics were incompatible with them; or was it merely as the roughest kind of material for work he would subsequently do? Many of the copied extracts in the Philosophical Notebooks are accompanied by Lenin's critical remarks, negative and positive, in brief analyses and rather extensive commentaries. But some of them remained open questions for Lenin himself. In such an instance he noted for his own information that it would be necessary to return again to the proposition he had copied, because it was something that he did not fully understand: it seemed to him that at the given point Hegel wished to say this or that; but perhaps that is not the case. (shrink)