The sequencing of the human genome and decreasing costs of sequencing technology have led to the notion of ‘personalized medicine’. This has been taken by some authors to indicate that personalized medicine will provide individualized treatments solely based on one’s DNA sequence. We argue this is overly optimistic and misconstrues the notion of personalization. Such interpretations fail to account for economic, policy and structural constraints on the delivery of healthcare. Furthermore, notions of individualization based on genomic data potentially take us (...) down the road of genetic reductionism obscuring the role of environmental factors in disease and ill health. We propose that one should see personalized medicine as a way of using personal genomic information to stratify individuals into subpopulations and suggest that personalized medicine be seen within a broader idea of personalized healthcare, reflecting healthcare that integrates personal genomic data into cultural, environmental and personal contexts. (shrink)

Background: Expanded newborn screening generates incidental results, notably carrier results. Yet newborn screening programmes typically restrict parental choice regarding receipt of this non-health serving genetic information. Healthcare providers play a key role in educating families or caring for screened infants and have strong beliefs about the management of incidental results. Methods: To inform policy on disclosure of infant sickle cell disorder (SCD) carrier results, a mixed-methods study of healthcare providers was conducted in Ontario, Canada, to understand attitudes regarding result management (...) using a cross-sectional survey (N = 1615) and semistructured interviews (N = 42). Results: Agreement to reasons favouring disclosure of SCD carrier results was high (65.1%–92.7%) and to reasons opposing disclosure was low (4.1%–18.1%). Genetics professionals expressed less support for arguments favouring disclosure (35.3%–78.8%), and more agreement with arguments opposing disclosure (15.7%–51.9%). A slim majority of genetics professionals (51.9%) agreed that a reason to avoid disclosure was the importance of allowing the child to decide to receive results. Qualitatively, there was a perceived “duty” to disclose, that if the clinician possessed the information, the clinician could not withhold it. Discussion: While a majority of respondents perceived a duty to disclose the incidental results of newborn screening, the policy implications of these attitudes are not obvious. In particular, policy must balance descriptive ethics (ie, what providers believe) and normative ethics (ie, what duty-based principles oblige), address dissenting opinion and consider the relevance of moral principles grounded in clinical obligations for public health initiatives. (shrink)

Cognitive Science, Volume 46, Issue 4, April 2022.

Hume's doctrine of natural belief allows that certain beliefs are justifiably held by all men without regard to the quality of the evidence which may be produced in their favour. Examples are belief in an external world and belief in the veracity of our senses. According to R. J. Butler, Hume argues in the Dialogues that belief in God is of this sort. More recently John Hick has argued that for some people it is as natural to believe in God (...) as to believe in an external world. I shall first inquire what Hume understands by reasonable belief and by natural belief. I shall then use the results of this investigation to argue, against Butler, that belief in God is not a natural belief; and against Hick, more briefly, that his thesis is not viable in as far as it depends upon Hume's doctrine of natural belief. These discussions are important to the philosophy of religion since by means of natural beliefs it could be urged that belief in God is something justifiable without reference to reason or evidence: a position which would be of immense value to the theist. (shrink)

One of the standard ways of proving the consistency of additional hypotheses with the basic axioms of an axiom system is by the construction of what may be described as ‘inner models.’ By starting with a domain of individuals assumed to satisfy the basic axioms an inner model is constructed whose domain of individuals is a certain subset of the original individual domain. If such an inner model can be constructed which satisfies not only the basic axioms but also the (...) particular additional hypothesis under consideration, then this affords a proof that if the basic axiom system is consistent then so is the system obtained by adding to this system the new hypothesis. This method has been applied to axiom systems for set theory by many authors, including v. Neumann, Mostowski, and more recently Gödel, who has shown by this method that if the basic axioms of a certain axiomatic system of set theory are consistent then so is the system obtained by adding to these axioms a strong form of the axiom of choice and the generalised continuum hypothesis. Having been shown in this striking way the power of this method it is natural to inquire whether it has any limitations or whether by the construction of a sufficiently ingenious inner model one might hope to decide other outstanding consistency questions, such as the consistency of the negations of the axiom of choice and continuum hypothesis. In this and two following papers we prove some general theorems concerning inner models for a certain axiomatic system of set theory which lead to the result that as far as a fairly large family of inner models are concerned this method of proving consistency has been exhausted, that no essentially new consistency results can be obtained by the use of this kind of model. (shrink)

Argument about the ethical possibility of the therapeutic use of embryonic stem cells depends critically on the evaluation of the moral status of the very early embryo. Some assert that at the blastocyst stage it is only potentially human, not yet possessing the full ethical status of personhood, while others assert that from its formation the embryo possesses all the moral rights of a human person. It is shown that a decision on this issue is closely related to how human (...) nature is to be understood. The idea of a person as a dual combination of body and spirit correlates naturally with the assertion of absolute personhood from conception, while an idea of human psychosomatic unity encourages a development picture in which the embryo only grows gradually into personhood. The latter view is seen to be encouraged by new advances in science which emphasise the importance of the concept of information in the discussion of complex systems. Other ethical issues related to human genetics are also briefly reviewed. (shrink)

The influence of age and formal education on the development of moral reasoning in a Spanish sample of students was assessed by using a Spanish translation of Rest's Defining Issues Test. Our results support the hypothesis that moral development is highly related to both variables in our cultural context, although more so with formal education than with age.

The allegedly alternative theories of Phyletic Gradualism and Punctuated Equilibria are examined as regards the nature of their differences. The explanatory value of both models is determined by establishing their actual connection with reality. It is concluded that they are to be considered complementary rather than mutually exclusive at all levels of infraspecific, specific, and supraspecific evolution. So, in order to be described comprehensively, the pathways of evolution require at least two distinct models, each based on a discrete range of (...) real phenomena. [Phyletic Gradualism; Punctuated Equilibria; evolutionary theories; divergence models; additive speciation; microevolution; macroevolution; anagenesis.]. (shrink)

Many attempts have been made at supporting either one of the allegedly complementary divergence models Phyletic Gradualism and Punctuated Equilibria by patterns found in specific fossil sequences. However, assessing each model's connection with reality via such “individual case histories” appears not to constitute a relevant approach. Instead, in order to correctly establish the possible merits of both concepts, the claims of each have to be verified against general evolutionary theory. This is being pointed out herein by analyzing cladogenesis at the (...) specific level as an example. [Phyletic Gradualism; Punctuated Equilibria; evolutionary theory; divergence models; case histories; additive speciation.]. (shrink)

The political distinction between left and right remains ideologically muddled. This was not always so, but an immediate return to the pristine usage is impractical. Putting a theory of social liberty to one side, this essay defends the interpretation of left-wing as personal-choice and right-wing as property-choice. This allows an axis that is north/choice (or state-free) and south/control (or state-ruled). This Political Compass clarifies matters without being tendentious or too complicated. It shows that what is called ‘libertarianism’ is north-wing. A (...) quiz gives the reader’s Political Compass reading. (shrink)

Ever since they were first published, the works of Bernard Mandeville have met with a few careful readers as well as with a larger number of stupid or unscrupulous assailants. Both classes are faithfully recorded at the end of F. B. Kaye's splendid edition of The Fable of the Bees , which has helped to revive interest in Mandeville, and which has moulded the current estimate of his ideas: the treatment of Mandeville in such a work as Basil Willey's Eighteenth (...) Century Background is confessedly based almost entirely on Kaye. My purpose in this paper is to suggest some modifications of the account given by Kaye, and to make claims for Mandeville's importance in one particular field, the relation of ethics to politics. (shrink)

Two problems involving Thucydides and medicine have attracted intense treatment by classical scholars and medical men working separately or in combination. They are, first, the nature of the Athenian Plague which Thucydides describes and, second, the possibility of his having been influenced by the doctrines and outlook of Hippocrates and his followers. It is the purpose of the present paper to reconsider both these problems, to indicate some false assumptions made in the methodology of previous attempts to identify the Plague, (...) and to suggest a somewhat radical revaluation of Thucydides' approach to medical matters compared with that of Hippocrates. (shrink)

The objective of this paper is to stimulate academic debate on embryo and fetal research from the perspective of the drafting of a protocol to the European Convention on Biomedicine. The Steering Committee on Bioethics of the Council of Europe was mandated to draw up such a protocol and for this purpose organised an important symposium on reproductive technologies and embryo research, in Strasbourg from the 16th to the 18th of December 1996.