Non-invasive prenatal testing is an emerging form of prenatal genetic testing that provides information about the genetic constitution of a foetus without the risk of pregnancy loss as a direct result of the test procedure. As with other prenatal tests, information from NIPT can help to make a decision about termination of pregnancy, plan contingencies for birth or prepare parents to raise a child with a genetic condition. NIPT can also be used by women and couples to test purely ‘for (...) information’. Here, no particular action is envisaged following the test; it is motivated entirely by an interest in the result. The fact that NIPT can be performed without posing a risk to the pregnancy could give rise to an increase in such requests. In this paper, we examine the ethical aspects of using NIPT ‘purely for information’, including the competing interests of the prospective parents and the future child, and the acceptability of testing for ‘frivolous’ reasons. Drawing on several clinical scenarios, we claim that arguments about testing children for genetic conditions are relevant to this debate. In addition, we raise ethical concerns over the potential for objectification of the child. We conclude that, in most cases, using NIPT to test for adult-onset conditions, carrier status or non-serious traits presenting in childhood would be unacceptable. (shrink)

Empirical evidence suggests that some health professionals believe consent procedures for the emerging technology of non-invasive prenatal diagnosis (NIPD) should become less rigorous than those currently used for invasive prenatal testing. In this paper, we consider the importance of informed consent and informed choice procedures for protecting autonomy in those prenatal tests which will give rise to a definitive result. We consider whether there is anything special about NIPD that could sanction a change to consent procedures for prenatal diagnosis or (...) otherwise render informed decision-making less important. We accept the claim that the absence of risk of miscarriage to some extent lessens the gravity of the decision to test compared with invasive methods of testing. However, we also claim that the definitive nature of the information received, and the fact that the information can lead to decisions of great significance, makes NIPD an important choice. This choice should only be made by means of a rigorous and appropriately supported decision-making process (assuming that this is what the pregnant woman wants). We conclude that, on balance, consent procedures for NIPD should mirror those for invasive testing, albeit without the need to emphasise procedure-related risk. (shrink)

Recent scientific advances mean the widespread introduction of non-invasive prenatal diagnosis (NIPD) for chromosomal aneuploidies may be close at hand, raising the question of how NIPD should be introduced as part of antenatal care pathways for pregnant women. In this paper, the authors examine the ethical implications of three hypothetical models for using NIPD for aneuploidy in state-funded healthcare systems and assess which model is ethically preferable. In comparing the models, the authors consider their respective timings; how each model would (...) fit with current screening and diagnostic tests offered to pregnant women; the implications of offering NIPD at different stages of pregnancy; and the potential for each model to support reproductive autonomy and informed decision-making. The authors conclude by favouring a model that would be offered at 11–13 weeks gestation, alongside existing combined screening, provided that this is accompanied by measures to maximise informed decision-making, for example, provision of adequate pretest and post-test counselling. (shrink)

In exploring skilled performance in Contact Improvisation, we utilize an enactive ethnographic methodology combined with an interdisciplinary approach to examine the question of how skill develops in CI. We suggest this involves the development of subtleties of awareness of intra- and interkinaesthetic attunement, and a capacity for interkinaesthetic negative capability—an embodied interpersonal ‘not knowing yet’—including an ease with being off balance and waiting for the next shift or movement to arise, literally a ‘playing with’ balance, falling, nearly falling, momentum and (...) gravity. We draw on insights from an interdisciplinary approach, including from a developmental perspective concerning the experience of dyadic interpersonal embodied skill development in both infancy and CI. Building on Ravn and Høffding’s definition of expertise in improvisation as an “oscillatory process of assuming and relinquishing agency” we propose that a key aspect of expertise in CI involves oscillation between levels and processes of interkinaesthetic sense of agency. These interdisciplinary insights also elucidate limitations within current conceptualisations of sense of agency, including the relationship between sense of agency and sense of control. (shrink)

Despite a large and multifaceted effort to understand the vast landscape of phenotypic data, their current form inhibits productive data analysis. The lack of a community-wide, consensus-based, human- and machine-interpretable language for describing phenotypes and their genomic and environmental contexts is perhaps the most pressing scientific bottleneck to integration across many key fields in biology, including genomics, systems biology, development, medicine, evolution, ecology, and systematics. Here we survey the current phenomics landscape, including data resources and handling, and the progress that (...) has been made to accurately capture relevant data descriptions for phenotypes. We present an example of the kind of integration across domains that computable phenotypes would enable, and we call upon the broader biology community, publishers, and relevant funding agencies to support efforts to surmount today's data barriers and facilitate analytical reproducibility. (shrink)

Pharmacists who refuse to provide certain services or treatment for reasons of conscience have been criticized for failing to fulfil their professional obligations. Currently, individual pharmacists in Great Britain can withhold services or treatment for moral or religious reasons, provided they refer the patient to an alternative source. The most high-profile cases have concerned the refusal to supply emergency hormonal contraception, which will serve as an example in this article.I propose that the pharmacy profession's policy on conscientious objections should be (...) altered slightly. Building on the work of Brock and Wicclair, I argue that conscientious refusals should be acceptable provided that the patient is informed of the service, the patient is redirected to an alternative source, the refusal does not cause an unreasonable burden to the patient, and the reasons for the refusal are based on the core values of the profession. Finally, I argue that a principled categorical refusal by an individual pharmacist is not morally permissible. I claim that, contrary to current practice, a pharmacist cannot legitimately claim universal exemption from providing a standard service, even if that service is available elsewhere. (shrink)

This paper identifies and analyses a novel species of hermeneutical epistemic injustice (HI). Fricker’s traditional account analyses HI in terms of a collective conceptual gap. (Epistemic injustice: power and the ethics of knowing, Oxford University Press, Oxford, 2007). Building on this, Simion’s analysis (in: Bondy P, Carter JA (eds) Well-founded belief: new essays on the epistemic basing relation. Routledge, New York, 2019) suggests the phenomenon is broader, and thus more ubiquitous: specifically, that agents who have been hermeneutically marginalised can be (...) susceptible to HI through failing to ground their social experience in conceptual resources that are already available. This paper advances the literature further and presents a novel strand of the phenomena, where agents both have, and base, their experience on available concepts but are still subject to HI. I argue that this is an important species of HI that should be investigated and accounted for, and I suggest that in virtue of being hermeneutically marginalised, often agents only have available to them defective or oppressive concepts. I further provide a case study of what this can look like online and new concerns social media presents for this kind of HI. CW: Mentions of transphobia, racism, sexism, rape. (shrink)

Research integrity is fundamental to the validity and reliability of scientific findings, and for ethical conduct of research. As part of PRINTEGER (Promoting Integrity as an Integral Dimension of Excellence in Research), this study explores the views of researchers, research managers, administrators, and governance advisors in Estonia, Italy, Norway and UK, focusing specifically on their understanding of institutional and organisational influences on research integrity.A total of 16 focus groups were conducted. Thematic analysis of the data revealed that competition is pervasive (...) and appeared in most themes relating to integrity. The structural frameworks for research such as funding, evaluation and publication were thought to both protect and, more commonly, undermine integrity. In addition, institutional systems, including workload and research governance, shaped participants’ day-to-day work environment, also affecting research integrity. Participants also provided ideas for promoting research integrity, including training, and creating conditions that would be supportive of research integrity.These findings support a shift away from individual blame and towards the need for structural and institutional changes, including organisations in the wider research environment, for example funding bodies and publishing companies. (shrink)

In their analysis of how much fetal genetic information prospective parents should be able to access, Bayefsky and Berkman determine that parents should only be able to access information th...

Dance as a complex human activity is a rich test case for exploring perception in action. In this article, we explore a 4E approach to perception/action in dance, focussing on the intersubjective and ecological aspects of kinaesthetic attunement and their capacity to expand empathic and perceptive experience. We examine the question: what are the ways in which the performance ecology co-created in different dance practices influences empathic and perceptive experience? We adopt an enactive ethnographic and phenomenological approach to explore two (...) distinct dance forms: Contact Improvisation [CI], a duet-system based practice aimed at fostering interkinaesthetic awareness and challenging habits of movement; and Body Weather [BW], an anti-hierarchical movement practice sensitive to the surrounding environment. We argue that through intersubjective kinaesthetic attunement, CI scaffolds the development of perceptive awareness of subtle shifts within ourselves and others, allowing the cultivation of a capacity for flexibly traversing between conscious initiation of action, attuned responding, and the intersection between them. Similarly, we investigate the expansion of perceptive experience through kinaesthetic attunement in BW. We suggest that the capacity for empathy is enhanced in BW through drawing attention to, and perception of, the fullness of a place in a way that we do not typically experience. By focussing on the variations in which embodied perceptual skills are enacted in specific dance forms and the expansion of perceptive experience through kinaesthetic attunement, we stress the potential of the performing arts to cultivate and create new ways of empathic engagement with the world in which we find ourselves. (shrink)

This study examined the role of key causal analysis strategies in forecasting and ethical decision-making. Undergraduate participants took on the role of the key actor in several ethical problems and were asked to identify and analyze the causes, forecast potential outcomes, and make a decision about each problem. Time pressure and analytic mindset were manipulated while participants worked through these problems. The results indicated that forecast quality was associated with decision ethicality, and the identification of the critical causes of the (...) problem was associated with both higher quality forecasts and higher ethicality of decisions. Neither time pressure nor analytic mindset impacted forecasts or ethicality of decisions. Theoretical and practical implications of these findings are discussed. (shrink)

It is unarguable that the implementation and use of noninvasive prenatal testing (NIPT) should be critical and appropriate. After all, decisions that influence when and how to have children have ut...

This chapter sketches some of the difficulties involved in defining analytic and continental philosophy, but begins to elaborate an argument for the centrality of methodology to the 'divide'.

Medical ethics and law (MEL) have a well-established place in medical curricula within the UK, but appropriately assessing MEL in a medical school context can be extremely challenging. The Institute of Medical Ethics convened a working group focused on assessment in 2021, and in this article, we present a summary of the work undertaken by this group. We start by explaining the challenges presented by the assessment of MEL, highlighting the potentially demanding requirements set out by the General Medical Council (...) in the UK. We then explore how MEL is currently assessed in UK medical schools. We go on to consider a number of different forms of assessment and their suitability for assessing ethics and law. Finally, we report the key recommendations from the working group and conclude that we are unconvinced that current approaches to assessing MEL are sufficient to robustly assess the General Medical Council’s learning outcomes. (shrink)

To what degree can language be acquired from linguistic input alone? This question has vexed scholars for millennia and is still a major focus of debate in the cognitive science of language. The complexity of human language has hampered progress because studies of language–especially those involving computational modeling–have only been able to deal with small fragments of our linguistic skills. We suggest that the most recent generation of Large Language Models (LLMs) might finally provide the computational tools to determine empirically (...) how much of the human language ability can be acquired from linguistic experience. LLMs are sophisticated deep learning architectures trained on vast amounts of natural language data, enabling them to perform an impressive range of linguistic tasks. We argue that, despite their clear semantic and pragmatic limitations, LLMs have already demonstrated that human-like grammatical language can be acquired without the need for a built-in grammar. Thus, while there is still much to learn about how humans acquire and use language, LLMs provide full-fledged computational models for cognitive scientists to empirically evaluate just how far statistical learning might take us in explaining the full complexity of human language. (shrink)

This memorial essay on the French historian of philosophy Pierre Hadot (1922–2010) explores his life and work. Starting out from an ecclesiastical background and education, Hadot's interest in mysticism led him to study the late Greek Neoplatonists Plotinus and Porphyry, as well as the Latin Church Fathers. Elected first to the École pratique des hautes études and then to the Collège de France, Hadot developed his most influential idea, that ancient philosophy was not the construction of an abstract system of (...) ideas, but a concrete, lived practice intended to transform the perception and being of the practitioner, and thereby to ensure his or her happiness. Later in his career, Hadot, influenced by German Romanticism and above all by Goethe, turned to study the history of the concept of nature from classical to modern times. The breadth of his interests and the novelty of his approach account for the wide interest in his works, extending to circles that extend far beyond the disciplines of classical studies and the history of philosophy. (shrink)

This important collection of essays details some of the more significant methodological and philosophical differences that have separated the two traditions, as ...

There is a long tradition of fruitful interaction between logic and social choice theory. In recent years, much of this interaction has focused on computer-aided methods such as SAT solving and interactive theorem proving. In this paper, we report on the development of a framework for formalizing voting theory in the Lean theorem prover, which we have applied to verify properties of a recently studied voting method. While previous applications of interactive theorem proving to social choice have focused on the (...) verification of impossibility theorems, we aim to cover a variety of results ranging from impossibility theorems to the verification of properties of specific voting methods. In order to formalize voting theoretic axioms concerning adding or removing candidates and voters, we work in a variable-election setting whose formalization makes use of dependent types in Lean. (shrink)

Existing literature on counterproductive work behaviors (CWBs) has focused on the influence that interpersonal and organizational factors have on predicting said behavior. However, more recent studies have begun to explore the dimensionality of CWB in relation to the likelihood of coworkers reporting coworkers’ CWBs. Likelihood of reporting CWB across various types of CWB, and the relationships between self-reported CWB were assessed across two studies. The studies did so utilizing two different measures of CWB and two different measures of CWB reporting, (...) and found very similar results. Results suggest those employees who report one type of CWB behavior would also be more willing to report other types of CWBs, and those who have lower self-reported CWB are more likely to report CWB. (shrink)

Prevention focus is a self-regulatory orientation that serves the need for security, and promotion focus is a self-regulatory orientation that serves the need for growth. From mid-March to early April 2020, did people judge prevention focus to be more useful than promotion focus for responding to COVID-19? Our study tested and showed support for this hypothesis with 401 American and Canadian participants, who we sampled in 100-person waves on the first four Thursdays of the pandemic. For this study, we developed (...) a new measure of the judged usefulness of promotion and prevention focus. Additionally, results showed that the judged usefulness of promotion and prevention focus related positively to support of the psychological needs for autonomy and relatedness, respectively, in responding to COVID-19. Exploratory analyses showed that day-to-day differences in autonomy, competence, and relatedness support and in promotion and prevention focus tended to be small, which is notable given the large-scale changes to social distancing, employment, and media coverage of the virus during this time. Our research could be useful for crafting persuasive advocacy and narrative communications that encourage social distancing to protect others about whom people care most. (shrink)

Numerous major holidays celebrate socially gathering in person. However, in major holidays that happened during the pandemic, desires to nurture relationships and maintain holiday traditions often conflicted with physical distancing and other measures to protect against COVID-19. The current research sought to understand wellbeing during American Thanksgiving in 2020, which happened 8months into the COVID-19 pandemic, after months of physical distancing and stay-at-home orders. American Thanksgiving is a major holiday not limited to any religion. We asked 404 American adults how (...) they spent Thanksgiving Day and to report on their experiences of that day. Predictors of wellbeing that we drew from self-determination theory were satisfaction of the fundamental needs for social connection, for doing what one really wants, and feeling effective. The predictors of wellbeing that we drew from regulatory focus theory were a focus on growth, and a focus on security. We found that feeling socially connected and focusing on growth related most strongly to wellbeing. Additionally, participants who saw even one other person face-to-face reported significantly higher relatedness satisfaction, promotion focus, and wellbeing than those who did not. Our research could help construct persuasive messages that encourage nurturing close relationships at major holidays while remaining safe against the virus. (shrink)

Case-based reasoning has long been used to facilitate instructional effectiveness. Although much remains to be known concerning the most beneficial way to present case material, recent literature suggests that simplifying case material is favorable. Accordingly, the current study manipulated two instructional techniques, incremental case presentation and forecasting outcomes, in a training environment in an attempt to better understand the utility of simplified versus complicated case presentation for learning. Findings suggest that pairing these two cognitively demanding techniques reduces satisfaction and detracts (...) from the effectiveness of the learning approach. Implications regarding the use of instructional techniques in training programs are discussed. (shrink)

This study examined the role of temporal orientation and affective frame in the execution of ethical decision-making strategies. In reflecting on a past experience or imagining a future experience, participants thought about experiences that they considered either positive or negative. The participants recorded their thinking about that experience by responding to several questions, and their responses were content-analyzed for the use of ethical decision-making strategies. The findings indicated that a future temporal orientation was associated with greater strategy use. Likewise, a (...) positive affective frame was associated with greater strategy use. Future orientation may permit better strategy execution than a past orientation because it facilitates more objective, balanced contemplation of the reflected-upon situation and minimizes potential self-threat associated with past behavior. A positive affective frame likely improves strategy execution because it facilitates active analysis of the experience. Future directions and implications of these findings are discussed. (shrink)

Case-based instruction has been regarded by many as a viable alternative to traditional lecture-based education and training. However, little is known about how case-based training techniques impact training effectiveness. This study examined the effects of two such techniques: (a) presentation of alternative outcome scenarios to a case, and (b) conducting a structured outcome evaluation. Consistent with the hypotheses, results indicate that presentation of alternative outcome scenarios reduced knowledge acquisition, reduced sensemaking and ethical decision-making strategy use, and reduced decision ethicality. Conducting (...) a structured outcome evaluation had no impact on these outcomes. Results indicate that those who use case-based instruction should take care to use clear, less complex cases with only a singular outcome if they are seeking these types of outcomes. (shrink)

Confidentiality is a cornerstone of the physician-patient relationship. Breaches of confidentiality in the context of genetic testing are of particular concern for a number of reasons. First, genetic testing reveals information not only about a particular patient, but also about his or her family members. Second,genetic testing can label healthy people as “at risk,” subjecting them to possible stigmatization or discrimination by third parties. Third, as genetic testing becomes more widespread and is incorporated into primary care, breaches of confidentiality might (...) inadvertently occur more frequently because primary care providers may not be trained to understand the uniqueness of genetic information. Until now, genetic services have been provided primarily by medical geneticists and genetic counselors. However, with the proliferation of new genetic presymptomatic and carrier tests, primary care physicians are going to become increasingly involved in genetic testing. Currently, little is known about physicians’ attitudes toward disclosure of confidential genetic information to third parties. (shrink)

Collapse is a term that has attracted much attention in social science literature in recent years, but there remain substantial areas of disagreement about how it should be understood in historical contexts. More specifically, the use of the term collapse often merely serves to dramatize long-past events, to push human actors into the background, and to mystify the past intellectually. At the same time, since human societies are complex systems, the alternative involves grasping the challenges that a holistic analysis presents, (...) taking account of the many different levels and paces at which societies function, and developing appropriate methods that help to integrate science and history. Often neglected elements in considerations of collapse are the perceptions and beliefs of a historical society and how a given society deals with change; an important facet of this, almost entirely ignored in the discussion, is the understanding of time held by the individuals and social groups affected by change; and from this perspective ‘collapse’ depends very much on perception, including the perceptions of the modern commentator. With this in mind, this article challenges simplistic notions of ‘collapse’ in an effort to encourage a more nuanced understanding of the impact and process of both social and environmental change on past human societies. (shrink)

The practice of modern craniomaxillofacial surgery has been defined by emergent technologies allowing for the acquisition, storage, utilization, and transfer of massive amounts of sensitive and identifiable patient data. This alone has thrust providers into an unlikely and unprecedented role as the stewards of vast databases of digital information. This data powers the potent surgical tool of virtual surgical planning, a method by which craniomaxillofacial surgeons plan and simulate procedural outcomes in a digital environment. Further complicating this new terrain is (...) the involvement of third‐party contractors—a necessary presence in bringing raw data to bear in the office, virtual space, and operating room. The individual privileges and responsibilities of patients, providers, and vendors towards data are situated within the most recent U.S. court rulings and regulations. This paper offers guidance for overseeing the safe and responsible transfer to third‐party contractors, and provides suggestions for negotiating the trinary relationship between physicians, their patients, and the vendors offering this transformative technology. (shrink)