While Gabriel Watts and Ainsley Newson argue that diagnostic laboratories do not have a general duty to routinely reinterpret genomic variant classifications, they do formulate several restricted duties to actively reinterpret specific types of classifications.1 They place these duties with laboratories, acknowledging that they are setting aside any responsibilities that might arise for clinicians. Here, we will discuss the implications of this obligation for clinicians and the moral tension it may confront them with. We focus in particular on the consequences (...) of the proposed moral obligation to actively reinterpret variant classifications that carry a higher risk of being false positives. Such reclassification is likely to result in ‘downgrades’: previously pathogenic variants (pathogenic/likely pathogenic, P/LP) reclassified to benign (likely benign/benign, LB/B) or uncertain variants (variant of uncertain significance, VUS). Any laboratory policy to actively reinterpret (specific sets of) classifications will confront the clinician with the question whether the person tested should be recontacted on a reinterpretation of previously reported results. As others have pointed out, recontacting in general comes with challenges, since patients may not want to be recontacted or have forgotten about their genetic test.2 3 Recontacting in case of a downgrade, however, is particularly impactful. Previous studies on the psychosocial impact of reclassification on patients …. (shrink)

We study structures on the fields of characteristic zero obtained by introducing operations of raising to power. Using Hrushovski–Fraisse construction we single out among the structures exponentially-algebraically closed once and prove, under certain Diophantine conjecture, that the first order theory of such structures is model complete and every its completion is superstable.

We examined institutional review board policies from the top U.S. research universities to determine how many have policies that define or provide examples of what constitutes a “minor change” to previously approved research. We sought to describe differences among definitions and to ascertain whether funding level, accreditation, public versus private status, and geographic region impact the inclusion of a definition or example of this term. Of the 184 universities that we obtained policies from, 52.2% defined “minor change,” 43.5% gave examples (...) of what would constitute one, and 67.9% provided either a definition or examples. We found that higher funding and accreditation were positively associated with having a definition or giving examples of minor changes, but that public versus private status and geographic region had no significant impact. While our study indicates that most of the top U.S. research institutions define the term “minor change” to previously approved research, we found that the definitions vary considerably. Additional guidance from federal agencies could help promote consistency in institutional policies and ensure uniformity in protections for human research participants. (shrink)

Countries, companies and farming communities are increasingly involved in issues of sharing and protecting plant genetic resources, knowledge and technologies. Intellectual Property Rights and Access and Benefit-Sharing policies currently regulate the transfer and usage of much of this genetic material, information and related production, which is employed in multiple research projects involving public research institutes. Strikingly, not much is known about how these institutes deal with the transfer and usage regulations. And what, furthermore, are their responsibilities while serving a civil (...) society in which there is such a range of diverging interests in and opinions about such regulations? In order to shed more light on these questions, two public research institutes will here be studied, the International Potato Centre in Peru and Wageningen University & Research Centre in the Netherlands. These institutes are both heavily involved in research into genetic resources, knowledge and technologies related to the potato, and work together with a wide spectrum of stakeholders that have a direct interest in the sharing and/or protection of these resources. The two institutes are continuously weighing up the various stakeholder interests in their attempts to strike a balance between policies geared towards sharing and those aimed at protection. It will be argued that public research institutes must dare to share, and that they need to develop new ways of sharing and protecting in order to adhere to their mission and best serve the public interest. (shrink)

In 2004 Orlando Florida was hit with an almost unprecedented series of storms and hurricanes. Within two months, Hurricanes Charley, Frances, and Jeanne hit, and Hurricane Ivan made a near miss. Billions of dollars of damage resulted from these disasters, and several dozen lives were lost. It is tempting, in the case of extreme events, to either regard them as having no need of interpretation (that is, as simply given, material events shared by everyone), or as a kind of rare (...) window on the workings of a community.1 In this paper I want to examine the public construction of the meaning of the hurricane in Orlando, particularly as represented in reports at the time in the major newspaper, the Orlando Sentinel. I am especially interested in placemaking, that is, the ways in which places gain or fail to gain meaning in times of stress. I will suggest that opportunities for place-making were lost in Orlando because of the frame the events around Hurricane Charley were given. Hurricane Frances, though, was treated differently in the Orlando press, and the discourse around the hurricanes of 2004 provides a contrast to the kind of rhetorical response that circulated during the disastrous hurricane season of 2005. In the case of some disasters, community is reinforced, and the skills of place-making are exercised. The reaction to Hurricane Charley in Orlando, on the other hand, tended not to reinforce community, and tended not to contribute to place-making. While it is extremely difficult to measure sense of place or sense of community quantitatively, it is possible to make sense out of the interpretive tools people have at their disposal in a disaster. What comes out of all this, I think, is something I want to call “place-making imagination”. This is analogous to the 1 concept of “moral imagination” in ethics (Johnson). Our moral options extend as far as our imagination will allow. A person might boil the moral universe down to polarized options – fight or flight, kill or be killed, choose A or B – when in fact a more cultivated and aware imagination may have afforded other options, perhaps better ones than either polarized one.. (shrink)

Gesellschaftliche Veränderungen in grossem Massstab, von der Pluralisierung der Gesellschaft, der Digitalisierung, die als Vierte Kulturtechnik bezeichnet wird, bis hin zur Widerfahrnis von Kontingenzen wie Armut und Flüchtlingsströmen oder Umweltkatastrophen, stellen die Verantwortungsfähigkeit des Menschen vor neue Herausforderungen. Es wird dabei deutlich: Humanität und Vernunft, Würde und Freiheit verdanken ihren Gehalt und ihre Gestalt einem die Vernunft selbst übersteigenden Transzendenten, in dem die Vernunft je und je ihres eigenen Grundes ansichtig werden kann. Dass dieses Verhältnis zwischen Vernunft und ihrem transzendenten (...) Grund alle Wissens- und Lebensbereiche durchdringt, zeigen die interdisziplinären Beiträge dieses Bandes, die Fragen der Weltentstehung und Anthropologie, der Logik und Mystik, des Glaubens und des Gottesbildes, des Sinns und der Religion, der Gottesdienstpraxis und der Architektur behandeln. (shrink)