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.

In lieu of an abstract, here is a brief excerpt of the content:THE CASE FOR SPIRIT CHRISTOLOGY: SOME REFLECTIONS THOMAS WEINANDY, O.F.M., CAP. Greyfriars Hall, University of Oxford IN THE JUNE, 1992, issue of Theological Studies Roger Haight, S.J., of the Weston School of Theology, authored an essay entitled "The Case for Spirit Christology." 1 In the December, 1992, issue of the same journal John Wright, S.J., of the Jesuit School of Theology at Berkeley, wrote a critical response entitled: (...) "Roger Haight's Spirit Christology." 2 While I fully endorse Wright's reservations, here I wish to offer some of my own criticisms as well as expand upon some of his.3 In order for a Spirit Christology to be viable Haight believes that it must fulfill six criteria: 1) It must adequately explain why Christians believe that their salvation is found in Jesus; 2) It must be faithful to the Bible; 3) It must uphold the teaching of the Councils, especially Nicaea and Chalcedon; 4) It must be intelligible and coherent; 5) It must respond to contemporary concerns, specifically the relationship of Jesus to the founders of other 1 Roger Haight, S.J., "The Case for Spirit Christology," Theological Studies 53(1992): 257-287. Hereafter referred to in the text by page numbers. 2 John Wright, S.J., "Roger Haight's Spirit Christology," Theological Studies 53(1992) : 729-735. 3 While this article will focus exclusively on Haight's Spirit Christology, much of what will be said here, by way of criticism, can be applied equally to other expressions of Spirit Christology, since the various forms are quite similar. Haight himself relies heavily upon and substantially agrees with G. W. H. Lampe, " The Holy Spirit and the Person of Christ," in Christ, Faith and History, ed. S. W. Sykes and J. P. Clayton (Cambridge: University Press, 1972) 111-130; and God as Spirit (Oxford: Clarendon, 1977). For other recent examples of Spirit Christology see Haight's footnote 1, p. 257. 173 174 THOMAS WEINANDY, O.F.M., CAP. religions; 6) It must be able to stimulate and empower Christian life (see 260-262). As in Wright's response, I wish to examine I-Iaight's Spirit Christology in light of these criteria. I will begin with an extensive examination of Haight's second criterion-faithfulness to scripture-for it is most central to his whole enterprise. Then, more succinctly, I will address his other criteria. Biblical Revelation and Religious Language The central, and therefore fatal, flaw within Haight's Spirit Christology is that his understanding of '.' God as Spirit," upon which the whole of his Christology is founded, is itself non-biblical. To discern Haight's understanding of " God as Spirit," we must first examine his notion of religious language and the philosophy sustaining it. For Haight, "the medium through which religious experience takes place may be called a symbol, making all religious knowledge symbolic knowledge. A symbol is that through which something else is made present and known; a symbol mediates a perception and knowledge of something other" (263). While the symbol makes the presence of God known, yet, precisely because it is a symbol, God is beyond or transcends what is symbolized. The symbol " both makes God present and points away from itself to a God who is other than itself" (263). Thus the symbolized " is" and " is not" the symbol (263). Haight argues then that the biblical symbol, " the Spirit of God " refers to God and is " materially and numerically identical with God. God as Spirit is God" (266). However, God as Spirit " indicates God at work, as active, and as power, energy, or force that accomplishes something" (266-267). God as Spirit refers not to God as he is immanent in himself, but to God as he is "outside of himself," within the order of time and history. Haight recognizes that the Old Testament also uses " Word" and " Wisdom" as symbols along with " Spirit," but " all of these symbols are basically the same insofar as they point to the same generalized experience of God outside of God's self and im- THE CASE FOR SPIRIT CHRISTOLOGY 175 manent in the world in presence and active power" (267). While Haight acknowledges that these symbolic... (shrink)

Qualitative and quantitative research on the impact of medical and health humanities teaching in baccalaureate education is sparse. This paper reviews recent studies of the impact of medical and health humanities coursework in pre-health professions education and describes a pilot study of baccalaureate students who completed semester-long medical humanities courses in the Division of Medical Humanities & Bioethics at the University of Rochester. The study format was an email survey. All participants were current or former baccalaureate students who had taken (...) one or more courses in literature and narrative in medicine, bioethics, history of medicine, and/or visual arts and healthcare during the past four years. The survey gathered numerical data in several areas: demographic information, career plans, self-reported influence of coursework on educational and career plans, and self-reported influence of coursework on intellectual skills and abilities. It also gathered narrative commentary that elaborated on students’ responses to the numerically-based questions. Notable findings from preliminary analysis of the data include higher scores of self-reported impact of the coursework on specific habits of mind and on preparedness for intended career rather than on gaining admission to future educational programs. Discussion of the results focuses on several potential future directions this type of study might take, including multi-center, longitudinal, and sequential approaches. (shrink)

Who a manager is, as a person of moral character, has been only of tangential interest in social science definitions of management, which have focused on functions, roles, behaviors, and environmental influences. But how do managers themselves speak of managerial excellence? This paper answers this for a particular corporation, based on a three-phased research process that deliberately imposes no descriptive or normative categories, but allows the answer to emerge, listening to what managers themselves say when discussing excellent managers and their (...) behaviors. This approach finds that: (1) virtue ethics and virtue language is fluently used by practicing managers, (2) virtue language is important to understanding managerial excellence, and (3) whereas the set of virtues defining the excellent manager can be expected to be dependent on the societal, industry, and organizational context, such a set of manager virtues can be identified and prioritized within a particular organizational milieu. The implication is that, once an organization's management better understands the meaning of the excellent manager in terms of the virtue language already used by its own employees, it is better equipped to implement a practical ethic of virtues, one helpful toward recognizing and developing excellent managers. Ethics researchers are challenged to increase their understanding of extant virtue language as the basis for a renewed development of virtue ethics theory and applications. (shrink)

This paper proposes that managers add an attention to virtues and vices of human character as a full complement to moral reasoning according to a deontological focus on obligations to act and a teleological focus on consequences (a balanced tripartite approach). Even if the criticisms of virtue ethics cloud its use as a mononomic normative theory of justification, they do not refute the substantial benefits of applying a human character perspective – when done so in conjunction with also-imperfect act-oriented perspectives. (...) An interactive tripartite approach is superior for meeting the complex requirements of an applied ethic. To illustrate how deficiencies of a "strong" virtue ethics formulation can be overcome by a balanced tripartite approach, this paper compares normative leadership paradigms (each based on a combination of virtue, deontology, or consequentialist perspectives) and the dangers inherent in each. The preferred paradigm is servant leadership, grounded in a tripartite ethic. Effective application of such an ethics approach in contemporary organizations requires further empirical research to develop a greater understanding of the moral language actually used. Meeting this challenge will allow academics better to assist practicing managers lead moral development and moral reasoning efforts. (shrink)

After briefly describing the philosophy of personalism this article assesses each of three normative leadership paradigms in terms of five major themes of this phenomenological philosophy. Servant leadership appears to be closest to personalism. The critical ingredient for servant leadership is also personalism’s starting point, i.e. the dignity of each human person. A genuine servant leader works with his followers in building a community of participation and solidarity. However, some claim that servant leaders are subject to manipulation by their followers. (...) If so, and if transformational leaders, when too successful, gain too much power or manipulate using bogus empowerment, a superior approach might be provided by a combination in which a morally tough servant leader adopts certain transforming behaviors of Bass’s altruistic transformational leader. The leader and the followers would focus on a jointly formulated and refined vision, avoiding manipulation by any party through a mutual commitment to participation, solidarity of community, and respect for each person. (shrink)

In the introductory chapter to this collection, the editors point out that, until recently, most Anglophone Spinoza scholarship has been focused on the metaphysics and epistemology of the Ethics. But according to Kisner and Youpa, Spinoza thought that metaphysics and epistemology were significant chiefly because they are required for understanding the more important part of his project—the ethical doctrine developed in the last three parts of the work. Ethica was so-titled because it is a book about ethics.In recent years, the (...) scholarly community has begun to shift its attention to bring itself more in line with Spinoza's intentions—to focus more directly on his ethical views. The volume under review presents... (shrink)

Since the 19th century, innocence has been a hallmark of childhood. The innocence of children is seen as both a sanctity worth defending and a feature that excuses the unavoidable mistakes of adolescence. While beneficial in many settings, notions of childhood innocence are often entangled with values judgements. Inherent in innocence is the notion that that which we are innocent of is undesirable. Further, attributing innocence to some implies the tolerability of blame for others. This has unique implications in a (...) medical setting. This essay explores the implications of espousing the innocence of paediatric patients. Ultimately, because attribution of innocence is both prone to bias and rooted in the same framework as blame, it degrades patient-centred care and compromises the patient–provider relationship. I argue that avoiding such characterisations may allow providers to more effectively promote paediatric health. (shrink)

In Göttliche Gedanken (Godly Thoughts), Andreas Schmidt provides an in-depth discussion of the metaphysics of knowledge and of mind in four early-modern rationalists: Descartes, Malebranche, Spinoza, and Leibniz. His topic overlaps with what is called “philosophy of mind” in contemporary Anglo-American circles, for he is quite interested in the relation between mind and body in these four historical thinkers. But as Schmidt effectively reminds us, the “mind-body problem” looks entirely different when embedded in the conceptual setting of the seventeenth century. (...) In Schmidt’s reading, reflection on mind at that time begins with reflection on knowledge and our capacity to know. What must the mind be in order for us .. (shrink)

The recently published Cambridge Companion to Spinoza contains a fine essay by Pierre- Francois Moreau on Spinoza’s reception and on his influence during the more than three hundred years that have passed since his death. In Moreau’s twenty-five page article we find a brief paragraph on the novelist George Eliot and half a sentence on Ed Curley. There is not another mention, at all, of any other philosopher from an English-speaking land since the seventeenth century – nothing on how Spinoza’s (...) ideas were received in England, North America or Australia. Not a word on any influence that Spinoza might have had on later thinkers in those countries. (shrink)

One thing that becomes apparent in this exchange is that each of the positions emerges based on differences in fundamental philosophical commitments. An existential Thomist has a very well-defined and sufficiently “thick” view of being at the heart of his metaphysical system. Van Inwagen rejects such views of being in favor of a “thin” view. This issue is addressed and clarified. Craig takes issue with the way the term “moderate-realism” has been explicated, whether or not the idea of existence in (...) the intellect is coherent, and whether the Thomistic solution offers any real advantages over nominalist ones. In this response, I continue to demonstrate the cogency and advocate the superiority of Aquinas’s position. (shrink)

On the horizon between metaphysics and philosophy of religion stands the question of God’s relation to various abstracta. Like other contemporary philosophical debates, this one has resulted in a broadly dichotomous stalemate between Platonic realists on the one hand and varieties of nominalism/antirealism on the other. In this paper, I offer Aquinas’s moderaterealism as a true middle ground between realist or nominalist solutions. What Platonists take to be abstracta are actually the result of intellect’s abstractive work on sensible objects. Further, (...) the Christian philosopher should be concerned as much, if not more so, by nominalism than by Platonism. Given the problems associated with either Platonist or nominalist solutions, one should be open to a Thomistic moderate-realist solution to the problem of God and abstracta. (shrink)

Controversy and activism have long been linked to the subject of primate research. Even in the midst of raging ethical debates surrounding fertility treatments, genetically modified foods and stem-cell research, there has been no reduction in the campaigns of activists worldwide. Plying their trade of intimidation aimed at ending biomedical experimentation in all animals, they have succeeded in creating an environment where research institutions, often painted as guilty until proven innocent, have avoided addressing the issue for fear of becoming targets. (...) One area of intense debate is the use of primates in stroke research. Despite the fact that stroke kills more people each year than AIDS and malaria, and less than 5% of patients are candidates for current therapies, there is significant opposition to primate stroke research. A balanced examination of the ethics of primate stroke research is thus of broad interest to all areas of biomedical research. (shrink)

Editors provide a substantive introduction to the history and theories of perfectionism and neutrality, expertly contextualizing the essays and making the collection accessible.

Objective: To examine changes in patients’ desired control of the deep brain stimulator and perception of global life control throughout DBS.Methods: A consecutive cohort of 52 patients with Parkinson’s disease was recruited to participate in a prospective longitudinal study over three assessment points. Semi-structured interviews assessing participants’ desire for stimulation control and perception of global control were conducted at all three points. Qualitative data were coded using content analysis. Visual analog scales were embedded in the interviews to quantify participants’ perceptions (...) of control over time.Results: Participants reported significant increases in their perception of global control over time and significant declines in their desired control of the stimulation. These changes were unrelated to improvements in motor symptoms. Improvements in global control were negatively correlated with a decline in desired stimulation control. Qualitative data indicate that participants have changed, nuanced levels of desired control over their stimulators. Increased global life control following DBS may be attributed to increased control over PD symptoms, increased ability to engage in valued activities, and increased overall self-regulation, while other domains related to global control remained unaffected by DBS.Conclusions: There are few empirical data documenting patients’ desire for stimulation control throughout neuromodulation and how stimulation control is related to other aspects of control despite the growing application of neuromodulation devices to treat a variety of disorders. Our data highlight distinctions in different types of control and have implications for the development of patient-controlled neurostimulation devices. (shrink)

Introduction: conceptual analysis of teaching, by B. P. Komisar and T. W. Nelson.--A concept of teaching, by B. O. Smith.--The concept of teaching, by I. Sheffler.--A topology of the teaching concept, by T. F. Green.--Teaching: act and enterprise, by B. P. Komisar.--Must an education have an aim? By R. S. Peters.--Curriculum as a field of study, by D. Heubner.--Can and should means-ends reasoning be used in teaching? By C. J. B. Macmillan and J. E. McClellan.

Rapid advances in the domain of science and technology are having an unprecedented effect upon the provision of higher education in universities throughout the world, the pace of change often being so fast as to make planning for the development of the “classroom of the future” an extremely difficult task. The Mobile Multimedia University (MMU) project, a collaborative action between four leading UK based research facilities, has been established to investigate these issues. Included amongst its aims is the use of (...) novel research methodologies to determine the factors which will influence the shape and form of future education provision, and thus the distribution of knowledge to society, such as mobility, telecommunications and multimedia services. This paper describes the use of a Delphi survey in predicting the technological trends and innovations which will affect university education in the near future. It describes the theory underpinning the Delphi method, illustrating this with examples of how such a technique has been successfully used in the past. It then details the specific application of the Delphi approach within the current MMU research project, detailing the preliminary results and discussing the implications of these findings for the future of universities and other institutes of higher education. (shrink)

Williams, Elster and Pears hold that an effort to induce in oneself a belief in the truth of some proposition that one believes to be false can succeed only if one manages, somewhere along the way, to forget that one is engaged in such an effort. Although this view has strong intuitive appeal, it is false, and in this paper it is shown to be false by example.

Although conflated in the public mind, science and technology are separate though overlapping enterprises. While technological progress is advancing rapidly, the more philosophically oriented scientific fields are experiencing an epistemological crisis. In the following text, we examine the origins of this epistemological crisis. Although the crisis is multifactorial in origin, with the factors interacting in a nonlinear fashion, several distinct contributors can be identified. These include a decline in confidence in Western culture and a concomitant rise in exaggerated self-criticism, diminution (...) of cause-and-effect relationships, the rise of relative truth, and a transition from an agnostic to an atheistic stance among scientists. (shrink)

Blair equates the constructs of working memory (WM), executive function, and general fluid intelligence (gF). We argue that there is good reason not to equate these constructs. We view WM and gF as separable but highly related, and suggest that the mechanism behind the relationship is controlled attention – an ability that is dependent on normal functioning of the prefrontal cortex. (Published Online April 5 2006).

In this third volume of Speculations, a serial imprint created to explore post-continental philosophy and speculative realism, a wide range of topics are covered, from the philosophy of religion to psychoanalysis to the philosophy of science to gender studies, and in a wide variety of formats (articles, interviews, position pieces, translations, and review essays).

Based on the proceedings of a 1985 conference held in the U.K., this volume embraces most of the important concerns in AI today, emphasizing common techniques and methodologies rather than applications. Topics covered include building efficient computational logic, planning and design, the representation of uncertain knowledge, user modelling, and psychological and philosophical issues. Papers on perception, theorem proving, expert systems, robotics, and data bases are also included. Each section is preceded by an introduction which draws comparisons between various papers.