Beauchamp and Childress’ definition of autonomous decision‐making includes the conditions of intentionality, understanding, and non‐control. In genetics, however, a relational conception of autonomy has been increasingly recognized. This article aims to empirically assess aspects of social influence in genetic testing decision‐making and to connect these with principlist and relational theories of autonomy. We interviewed 18 adult genetic counsellees without capacity issues considering predictive genetic testing for cancer predisposition for themselves and two counselling physicians in Switzerland. We conducted a qualitative analysis, (...) building on a grounded theory study about predictive genetic testing decision‐making. We found that some participants agreed to predictive genetic testing predominantly because relatives wanted them to do it, with some even acting contrary to their own convictions. Others, in contrast, based their decision on purely individualistic reasons but expressed difficulties in explaining their decision to their social environment. Healthcare professionals had a critical influence on decision‐making in many cases without being manipulative, as perceived by counsellees. Still, cases of coercion and social pressure occurred within social relationships. In conclusion, predictive genetic testing decision‐making includes relational and individualistic aspects, and both are compatible with autonomous decision‐making. While the principlist and relational notions of autonomy compete on a theoretical level, they are two sides of the same coin when used as analytical lenses for genetic testing decision‐making. Social acceptance of refusal of testing should be improved to mitigate social pressure. Individuals should be encouraged to decide for themselves how much their social environment influences their decision regarding predictive genetic testing. (shrink)

The editors welcome letters from readers, although we cannot guarantee that all will be published. To ensure timeliness, correspondents must respond to an article within seven weeks and not exceed two double‐spaced pages. Letters become the property of the editors and may be edited and shortened at our discretion.

The editors welcome letters from readers, although we cannot guarantee that all will be published. To ensure timeliness, correspondents must respond to an article within seven weeks and not exceed two double‐spaced pages. Letters become the property of the editors and may be edited and shortened at our discretion.

Instruction in peer assessment of complex task performance may cause high cognitive load, impairing learning. A stepwise instructional strategy aimed at reducing cognitive load was investigated by comparing it with a combined instructional strategy in an experiment with 128 secondary school students (mean age 14.0?years; 45.2% male) with the between-subjects factor instruction (stepwise, combined). In the stepwise condition, study tasks in Phase 1 were domain-specific and study tasks in Phase 2 had both domain-specific and peer assessment components. In the combined (...) condition, these two components were present in all tasks in both phases. Final performance (i.e. speed and accuracy in domain-specific skills and peer assessment skills) showed no significant differences, but performance improved more from Phase 1 to Phase 2 in the stepwise condition than in the combined condition. The results suggest that, with complex study tasks, it might be beneficial to teach domain-specific skills before peer assessment skills. (shrink)

Initial responses to questionnaires used to assess participants' understanding of informed consent for malaria vaccine trials conducted in the United States and Mali were tallied. Total scores were analyzed by age, sex, literacy (if known), and location. Ninety-two percent (92%) of answers by United States participants and 85% of answers by Malian participants were correct. Questions more likely to be answered incorrectly in Mali related to risk, and to the type of vaccine. For adult participants, independent predictors of higher scores (...) were younger age and female sex in the United States, and male sex in Mali. Scores in the United States were higher than in Mali (P = 0.005). Despite this difference participants at both sites were well informed overall. Although interpretation must be qualified because questionnaires were not intended as research tools and were not standardized among sites, these results do not support concerns about systematic low understanding among research participants in developing versus developed countries. (shrink)

The principle of non-directiveness remains an important tenet in genetics. However, the concept has encountered growing criticism over the last two decades. There is an ongoing discussion about its appropriateness for specific situations in genetics, especially in light of recent significant advancements in genetic medicine. Despite the debate surrounding non-directiveness, there is a notable lack of up-to-date international research empirically investigating the issue from the perspective of those who actually do genetic counselling. Addressing this gap, our article delves into the (...) viewpoints and experiences of medical geneticists in Germany and Switzerland. Twenty qualitative interviews were analysed employing reflexive thematic analysis. Participants’ responses revealed substantial uncertainties and divergences in their understanding and application of the concept. It seems to cause distress since many geneticists stated that the principle was difficult to put into clinical practice and was no longer ethically justified given the increasing likelihood of therapeutic implications resulting from genomic testing outcomes. The insights provided by our qualitative empirical study accord with the ongoing theoretical debate regarding the definition, legitimacy, and feasibility of the principle. An adequately nuanced understanding and application of non-directiveness seems crucial to circumvent the risks inherent in the principle, while promoting patient autonomy and beneficence. (shrink)

Recent advances in wireless technologies have led to the development of intelligent, in-vehicle safety applications designed to share information about the actions of nearby vehicles, potential road hazards, and ultimately predict dangerous scenarios or imminent collisions. These vehicle safety communication (VSC) technologies rely on the creation of autonomous, self-organizing, wireless communication networks connecting vehicles with roadside infrastructure and with each other. As the technical standards and communication protocols for VSC technologies are still being developed, certain ethical implications of these new (...) information technologies emerge: Coupled with the predicted safety benefits of VSC applications is a potential rise in the ability to surveil a driver engaging in her everyday activities on the public roads. This paper will explore how the introduction of VSC technologies might disrupt the “contextual integrity” of personal information flows in the context of highway travel and threaten one’s “privacy in public.” Since VSC technologies and their related protocols and standards are still in the developmental stage, the paper will conclude by revealing how close attention to the ethical implications of the remaining design decisions can inform and guide designers of VSC technologies to create innovate safety applications that increase public safety, but without compromising the value of one’s privacy in public. (shrink)

In “Imposing Risks,” Judith Thomson gives a case in which, by turning on her stove, she accidentally causes her neighbor’s death. She claims that both the following are true: (1) she ought not to have caused her neighbor’s death; (2) it was permissible for her to turn her stove on. In this paper it is argued that it cannot be that both (1) and (2) are true, that (2) is true, and that therefore (1) is false. How this is so (...) is explained, and the implications of this position regarding the relation between rights and duties is explored. (shrink)

In biology the idea of matter as something passive has been abandoned in favour of the idea that matter has the capacity of self-activity. In modern physics too matter functions more as an agent, with which the experimenter has a relation, than as passive material which he can handle as he likes. So in both fields of study the antithesis between idealism and materialism has been given up, so that the relation instead of the difference between man and nature became (...) the starting point of scientific inquiry. (shrink)

Related Works: Original Paper: M. Randall Holmes. Strong Axioms of Infinity in NFU. J. Symbolic Logic, Volume 66, Issue 1 , 87--116. Project Euclid: euclid.jsl/1183746361.

Peckham claims that my "behavior" in dealing with the quotations in Natural Supernaturalism is the same, in methodology and validity, as the interpretative behavior of Booth's waiter. But the great bulk of the utterances in my quotations—and no less, of the utterances constituting Peckham's own essay—do not consist of orders, requests, or commands. Instead, they consist of assertions, descriptions, judgments, exclamations, approbations, condemnations, and many other kinds of speech-acts, the meanings of which are not related to my interpretative behavior, even (...) in the indirect way in which the meaning of Booth's order is related to the future behavior of his waiter. M. H. Abrams, author of Natural Supernaturalism and The Mirror and the Lamp and Class of 1916 Professor of English at Cornell University, responds in this essay to Morse Peckham's "The Infinitude of Pluralism" . Morse Peckham, in his Critical Response, was commenting on issues raised by the forum on "The Limits of Pluralism" , to which M. H. Abrams contributed. Previous contributions to Critical Inquiry are "Rationality and Imagination in Cultural History: A Reply to Wayne Booth" and "The Deconstructive Angel". (shrink)

Religious life in Islam in the light of sayings and life of Prophet Muhammad, -632.