That there is a heritable or familial component of susceptibility to chronic non‐communicable diseases such as type 2 diabetes, obesity and cardiovascular disease is well established, but there is increasing evidence that some elements of such heritability are transmitted non‐genomically and that the processes whereby environmental influences act during early development to shape disease risk in later life can have effects beyond a single generation. Such heritability may operate through epigenetic mechanisms involving regulation of either imprinted or non‐imprinted genes but (...) also through broader mechanisms related to parental physiology or behaviour. We review evidence and potential mechanisms for non‐genomic transgenerational inheritance of ‘lifestyle’ disease and propose that the ‘developmental origins of disease’ phenomenon is a maladaptive consequence of an ancestral mechanism of developmental plasticity that may have had adaptive value in the evolution of generalist species such as Homo sapiens. BioEssays 29: 145–154, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

When attempting to answer the question, in the context of clinical healthcare, one might be tempted to leap to either of two rather obvious, but seemingly contradictory conclusions. On the one hand, we might have a general impression of religion not making much of a distinctive and clear difference, at least in the actions and outcomes of most cases of clinical interaction. Those of us in the bioethics world of discourse are likely to think only of the less common cases (...) of Christian Scientists, Jehovah's Witnesses, Orthodox Jews, or certain religious groups who seem to the majority of the population to hold especially sectarian, if not beliefs about medical matters. The so-called mainstream religious groups do not get much attention because they largely don't cause much trouble ; they have learned to bracket their religious commitments from at least any professional settings ; or they don't hold views entailing consequences any different from those of most nonbelieving, generally upright individuals. Furthermore, although religious believers may have some distinctive views, these views don't often noticeably manifest themselves in distinctive or significant ways. (shrink)

Conducting or overseeing research in correctional settings requires knowledge of specific federal rules and regulations designed to protect the rights of individuals in incarceration. To investigate the extent to which relevant groups possess this knowledge, using a 10-item questionnaire, we surveyed 885 IRB prisoner representatives, IRB members and chairs with and without experience reviewing HIV/AIDS correctional protocols, and researchers with and without correctional HIV/AIDS research experience. Across all groups, respondents answered 4.5 of the items correctly. Individuals who have overseen or (...) conducted correctional research had the highest scores; however, even these groups responded correctly only to slightly more than half of the items. These findings emphasize the need for ongoing training in federal guidelines governing correctional research, particularly for those individuals who are embarking on this type of research. (shrink)

Debates over health care have focused for so long on economics that the proper goals for medicine seem to be taken for granted; yet problems in health care stem as much from a lack of agreement about the goals and priorities of medicine as from the way systems function. This book asks basic questions about the purposes and ends of medicine and shows that the answers have practical implications for future health care delivery, medical research, and the education of medical (...) students. The Hastings Center coordinated teams of physicians, nurses, public health experts, philosophers, theologians, politicians, health care administrators, social workers, and lawyers in fourteen countries to explore these issues. In this volume, they articulate four basic goals of medicine — prevention of disease, relief of suffering, care of the ill, and avoidance of premature death — and examine them in light of the cultural, political, and economic pressures under which medicine functions. In reporting these findings, the contributors touch on a wide range of diverse issues such as genetic technology, Chinese medicine, care of the elderly, and prevention and public health. The Goals of Medicine clearly demonstrates the importance of clarifying the purposes of medicine before attempting to change the economic and organizational systems. It warns that without such examination, any reform efforts may be fruitless. (shrink)

The biotechnology industry's intellectual property claims contribute to a subtle but not insignificant encroachment of commodification within health care. Drawing on the conceptual framework of Margaret Jane Radin, I argue that patent claims on human biological materials may commodify that with which our personhood and individuality is intertwined but that such commodification is broad and incomplete. Patents on nonhuman biological organisms contribute to a more materialistic understanding of them but do not significantly change our relationship to them. The systemic effects (...) of biotechnology's commodification within health care are various and may compromise the goal of good health. The morally problematic aspects of patent claims entail certain obligations to inhibit commodification from becoming more egregious, but on balance, those aspects are currently insufficient to justify denying the benefits the patent system promotes. (shrink)

Theories of consciousness have a long and controversial history. One well-known proposal — integrated information theory — has recently been labeled as ‘pseudoscience’, which has caused a heated open debate. Here we discuss the case and argue that the theory is indeed unscientific because its core claims are untestable even in principle.

We examined attitudes as one potential influence on the behavioral intentions of three stakeholder groups commonly in conflict. Business managers (n = 97), government environmental regulators (n = 69), and active members of pro-environmental groups (n = 49) were surveyed to assess the differences among these groups in their attitudes toward property rights, environmental regulation, and technology. We compared the influence of these attitudes and stakeholder group affiliation on intentions to engage in pro-environmental behavior. The attitudes measures explained a significant (...) amount of the variance in behavioral intention, even after group membership was controlled. Theoretical implications of these findings for stakeholder theory are discussed along with some practical applications of these findings for stakeholder negotiations and management practices. (shrink)

The UK government has recently committed to adopting a new policy—dubbed ‘Martha’s Rule’—which has been characterised as providing patients the right to rapidly access a second clinical opinion in urgent or contested cases. Support for the rule emerged following the death of Martha Mills in 2021, after doctors failed to admit her to intensive care despite concerns raised by her parents. We argue that framing this issue in terms of patient rights is not productive, and should be avoided. Insofar as (...) the ultimate goal of Martha’s Rule is the provision of a clinical service that protects patient safety, an approach that focuses on the obligations of the health system—rather than the individual rights of patients—will better serve this goal. We outline an alternative approach that situates rapid clinical review as part of a suite of services aimed at enhancing and protecting patient care. This approach would make greater progress towards addressing the difficult systemic issues that Martha’s Rule does not, while also better engaging with the constraints of clinical practice. (shrink)

Engaging the thought of the Danish thinker Søren Kierkegaard, I challenge a tendency within the analytic tradition of philosophy on the subject of meaning in life. Taking as a starting point Kierkegaard's insights about meaning in life, the striving needed to attain an imagined ideal self, and his paradoxical conception of the perfection available to human life, I claim that meaning in life is a function of an individual's striving for an ideal self. This continuous effort to achieve myself is (...) marked by suffering, an indispensable part of Kierkegaard's project of identity formation. The imagined grasp of a possible ideal self is essential to this process but insufficient for it because the imagination can only ever glimpse a kind of static perfection, not the lived perfection that only results from willed actualization of an ideal self. The meaning of a human life, then, consists in the suffering that results from a struggle to actualize the ideal I aspire to become in the process of identity formation. I contrast this view with a tendency shared by many contemporary analytic philosophers of meaning in life, for whom meaning in life is constituted by achievement of valued goods, without much attention to one's relation to the process of achieving them. In that respect, I will focus on the position of Iddo Landau. After clearing a number of his misconceptions about Kierkegaard's philosophy, I claim that, for a life to be meaningful, valued goods in life must be complemented by a conscious enactment of the process of the formation of one's identity that includes striving to attain a kind of perfection. I conclude that Kierkegaard's paradoxical account of perfectionism makes him more of an ally to Landau than an opponent. (shrink)

Early life adversity, such as child maltreatment or child poverty, engenders problems with emotional and behavioral regulation. In the quest to understand the neurobiological sequelae and mechanisms of risk, the amygdala has been of major focus. While the basic functions of this region make it a strong candidate for understanding the multiple mental health issues common after ELA, extant literature is marked by profound inconsistencies, with reports of larger, smaller, and no differences in regional volumes of this area. We believe (...) integrative models of stress neurodevelopment, grounded in “allostatic load,” will help resolve inconsistencies in the impact of ELA on the amygdala. In this review, we attempt to connect past research studies to new findings with animal models of cellular and neurotransmitter mediators of stress buffering to extreme fear generalization onto testable research and clinical concepts. Drawing on the greater impact of inescapability over unpredictability in animal models, we propose a mechanism by which ELA aggravates an exhaustive cycle of amygdala expansion and subsequent toxic-metabolic damage. We connect this neurobiological sequela to psychosocial mal/adaptation after ELA, bridging to behavioral studies of attachment, emotion processing, and social functioning. Lastly, we conclude this review by proposing a multitude of future directions in preclinical work and studies of humans that suffered ELA. (shrink)

There is, to all appearances, a philosophic hostility to fashionable dress. Studying this contempt, this paper examines likely sources in philosophy's suspicion of change; anxiety about surfaces and the inessential; failures in the face of death; and the philosophic disdain for, denial of, the human body and human passivity. If there are feminist concerns about fashion, they should be radically different from those of traditional philosophy. Whatever our ineluctable worries about desire and death, whatever our appropriate anger and impatience with (...) the merely superficial, whatever our genuine need to mark off the serious from the trivial, feminism may be a corrective therapy for philosophy's bad humor and self-deception, as these manifest themselves when the subject turns to beautiful clothes. (shrink)

A humanoid robot named ‘Sophia’ has sparked controversy since it has been given citizenship and has done media performances all over the world. The company that made the robot, Hanson Robotics, has touted Sophia as the future of artificial intelligence. Robot scientists and philosophers have been more pessimistic about its capabilities, describing Sophia as a sophisticated puppet or chatbot. Looking behind the rhetoric about Sophia’s citizenship and intelligence and going beyond recent discussions on the moral status or legal personhood (...) of AI robots, we analyse the performativity of Sophia from the perspective of what we call ‘political choreography’: drawing on phenomenological approaches to performance-oriented philosophy of technology. This paper proposes to interpret and discuss the world tour of Sophia as a political choreography that boosts the rise of the social robot market, rather than a statement about robot citizenship or artificial intelligence. We argue that the media performances of the Sophia robot were choreographed to advance specific political interests. We illustrate our philosophical discussion with media material of the Sophia performance, which helps us to explore the mechanisms through which the media spectacle functions hand in hand with advancing the economic interests of technology industries and their governmental promotors. Using a phenomenological approach and attending to the movement of robots, we also criticize the notion of ‘embodied intelligence’ used in the context of social robotics and AI. In this way, we put the discussions about the robot’s rights or citizenship in the context of AI politics and economics. (shrink)

The revolution in health information technology has enabled the compilation and use of large data sets of health records for genomic and other research. Extensive collections of health records, esp...

Dieser Aufsatz analysiert Leibniz' Begriff der Expression. Er ist eine Vorstudie zu einer umfassenden Untersuchung der Lehre, daß jede einfache Substanz das ganze Weltall ausdrückt. Leibnizens Beispiele und Definitionen von Expression werden besprochen, und dann wird die Analyse des Begriffs in zwei Stufen entwickelt.

“Unconscionable.” “Outrageous.” “Indefensible.” These are just some of the tamer descriptions for the billing practices of most hospitals, and also many physicians, that have recently come to the public's attention. Earlier this year, Time magazine published an extraordinary 24,000‐word exposé—the longest article it has ever published—detailing how even charitable hospitals routinely price‐gouge their patients.1 With characteristic flare for telling details, journalist Steven Brill documented ten‐fold markups of charges over costs at some prominent hospitals for common services like X rays and (...) lab tests, and one‐hundred‐fold mark‐ups on mundane supplies such as gauze pads and generic aspirin. Just as the buzz from Brill's article was abating, the Centers for Medicare & Medicaid Services released a comprehensive data set in May that galvanized local and national media across the country. This news tsunami caught hospital managers flat‐footed and tongue‐tied. Typical responses conceded that hospitals’ pricing practices are based neither on actual cost structures nor rational marketplace dynamics. Instead, hospitals attempted to deflect blame by noting that hardly anyone actually pays list prices, and they characterized their indefensible pricing as a symptom of a broken system that is beyond them to fix. There are two glaring faults in these standard defenses. (shrink)

This chapter contains sections titled: Phenomenology Existentialism The Organization of the Book.

Therehasbeenevidencefortheverybrief,temporalquantizationofperceptualexperienceatregularintervalsbelo w100msforseveraldecades.Webrieflydescribehowearlierstudiesledtotheconceptof“psychologicalmoment”ofbe tween50and60msduration.Accordingtohistoricaltheories,withinthepsychologicalmomentalleventswouldbepro cessedasco-temporal.Morerecently,alinkwithphysiologicalmechanismshasbeenproposed,accordingtowhichthe 50–60mspsychologicalmomentwouldbedefinedbytheupperlimitrequiredbyneuralmechanismstosynchronizeandthe rebyrepresentasnapshotofcurrentperceptualeventstructure.However,ourownexperimentaldevelopmentsalsoid entifyamorefine-scaled,serializedprocessstructurewithinthepsychologicalmoment.Ourdatasuggeststhatnot alleventsareprocessedasco-temporalwithinthepsychologicalmomentandinstead,someareprocessedsuccessivel y.Thisevidencequestionstheanalogrelationshipbetweensynchronizedprocessandsimultaneousexperienceandop ensdebateontheontologyandfunctionof“moments”inpsychologicalexperience.

Abstract:Moral imagination is a reasoning process thought to counter the organizational factors that corrupt ethical judgment. We describe the psychology of moral imagination as composed of the four decision processes identified by Rest (1986), i.e., moral sensitivity, moral judgment, moral intention, and moral behavior. We examine each process in depth, distilling extant psychological research and indicating organizational implications. The conclusion offers suggestions for future research.The majority of men are subjective toward themselves and objective toward all others—terribly objective sometimes—but the real (...) task is in fact to be objective toward one’s self and subjective toward all others. (shrink)

Books Reviewed in this Article: Transforming Bible Study. By Walter Wink. Pp.175, London, SCM Press, 1981, £3.50. Isaiah 1–39. By R.E. Clements. Pp.xvi. 301, London, Marshall, Morgan and Scott, 1980, £3.95. Isaiah 40–66. By R.N. Whybray. Pp.301, London, Marshall, Morgan and Scott, 1975, Reprinted 1981, £3.95. Die Gestalt Jesu in den synoptischen Evangelien. By Heinrich Kahlefeld. Pp.264, Frankfurt, Verlag Josef Knecht, 1981, no price given. Following Jesus: Discipleship in the Gospel of Mark. By Ernest Best. Pp.283, Sheffield, JSOT Press, (...) 1981, £15.00, £5.95. The Origin of Paul's Gospel. By Seyoon Kim. Pp.xii, 391, Tübingen, J.C.B. Mohr, 1981, 78 DM. An die Römer. By Ernst Käsemann. Pp.xvi, 411, Tübingen, J.C.B. Mohr, 1980, 48 DM. Les Récits de Resurrection des Morts dans le Nouveau Testament. By Gerard Rochais. Pp.xv, 252, Cambridge, Cambridge University Press, 1981, £15.00. Prêtres Anciens, Prétre Nouveau selon le Nouveau Testament. By Albert Vanhoye. Pp.366, Paris Editions du Seuil, 1980, no price given. Woman in the World of Jesus. By Evelyn and Frank Stagg. Pp.292, Edinburgh, The St Andrew Press, 1981, no price given. Jesus, Man and the Church. By Karl Rahner. Pp.260, London, Darton Longman & Todd, 1981, £14.50. Jesus Lord and Savior: A Theopathic Christology and Soteriology. By William M. Thompson. Pp.ix, 287, Leominster, Fowler Wright, 1981, £7.45. God and World in Schleiermacher's ‘Dialektik’ and ‘Glaubenslehre’. Criticism and the Methodology of Dogmatics. By John E. Thiel. Pp.xiv, 239, Bern, Frankfurt and Las Vegas, Peter Lang, 1981, SF 49.50. Ministry: A Case for Change. By Edward Schillebeeckx. Pp.ix, 165, London, SCM Press, 1981, £4.95. The Sacraments: Readings in Contemporary Sacramental Theology. Edited by Michael J. Taylor. Pp.274, New York, Alba House, 1981, $7.95. Believing in the Church: The Corporate Nature of Faith. A Report by the Doctrine Commission of the Church of England. Pp.ix, 310, London, SPCK, 1981, £8.50. Confessing the Faith in the Church of England Today. By R.T. Beckwith. Pp.36, Oxford, La timer House, 1981, £1.00. A Kind of Noah's Ark? The Anglican Commitment to Comprehensiveness. By J.I. Packer. Pp.39, Oxford, Latimer House, 1981, £1.00. Reasonable Belief: A Survey of the Christian Faith. By Anthony Hanson and Richard Hanson. Pp.xii, 283, Oxford University Press, 1981, £8.50. Doctrine in the Church of England. The 1938 Report with a new introduction by G.W.H. Lampe. Pp.lx, 242, London, SPCK, 1982, £8.50. The Divine Right of the Papacy in Recent Ecumenical Theology. By J. Michael Miller. Pp.xvi, 322, Rome, Università Gregoriana Editrice, 1980, 18,000 Lire. Der heilige Geist in der Theologie von Heribert Mühlen: Versucheiner Darstellung und Würdigung. By John B. Banawiratma. Pp.ix, 310, Frankfurt and Bern: Peter D. Lang, 1981, SFr. 60.00. Standing Before God: Studies on Prayer in Scriptures and Tradition with Essays in Honor of John M. Oesterreicher. Edited by Asher Frinkel and Lawrence Frizzell. Pp.410, New York, Ktav Publishing House, 1981, $29.50. Judaism and Healing. By J. David Bleich. Pp.xiii, 199, New York, Ktav, 1981, $15.00. The Diversity of Moral Thinking. By Neil Cooper. Pp.x, 303, Oxford, Clarendon Press: Oxford University Press, 1981, £15.00. L'Homme: Sujet ou Objet? By Jacques Croteau. Pp.260, Montreal, Bellarmin: Tournai, Desclée et Cie, 1981, $15.00. The Texture of Knowledge: An Essay on Religion and Science. By James W. Jones. Pp.97, Washington, University Press of America, 1981, no price given. Cosmos and Creator. By Stanley L. Jaki. Pp.xii, 168, Edinburgh, Scottish Academic Press, 1980, £6.75. Dante, Philomythes and Philosopher: Man in the Cosmos. By Patrick Boyde. Pp.vii, 408, Cambridge, Cambridge University Press, 1981, £30.00. Dissidence et Philosophie au Mayen Âge. By E.L. Fortin. Pp.201, Montreal, Bellarmin, 1981, $12.00. The Philosophy of John Norris of Bemerton. By Richard Acworth. Pp.x, 388, Hildesheim, Georg Olms, 1979, 74 DM. Philosophy and Ideology in Hume's Political Thought. By David Miller. Pp.xii, 218, Oxford, Clarendon Press, 1981, £15.00. Hegelianism. By John Edward Toews. Pp.x, 450, Cambridge, Cambridge University Press, 1980, £25.00. One Hundred Years of Thomism. Edited by V.B. Brezik. Pp.210, Houston, Centre for Thomistic Studies, 1981, no price given. Gramsci's Political Thought: Hegemony, Consciousness and the Revolutionary Process. By J.V. Femia. Pp.xiii, 303, Oxford, Clarendon Press, 1981, £17.50. Greek and Roman Slavery. By Thomas Wiedemann. Pp.xvi, 284, London, Croom Helm, 1981, £10.95, £5.95. Prophecy and Millenarianism. Essays in Honour of Marjorie Reeves. Edited by Ann Williams. Pp.x, 355, London, Longman, 1980, £25.00. Of Prelates and Princes: A Study of the Economic and Social Position of the Tudor Episcopate. By Felicity Heal. Pp.xv, 353, Cambridge, Cambridge University Press, 1980, £17.50. Radical Religious Movements in Early Modern Europe. By Michael Mullett. Pp.xxiv, 193, London, George Allen & Unwin, 1980, £10.50. The Jesuits. By J.C.H. Aveling. Pp.390, London, Blond and Briggs, 1981, £16.95. The Beginnings of Ideology. By Donald R. Kelley. Pp.xv, 351, Cambridge, Cambridge University Press, 1981, £24.00. Utopia and the Ideal Society: A Study of English Utopian Writing 1516–1700. By J.C. Davis. Pp.x, 427, Cambridge, Cambridge University Press, 1981, £25.00. Eastern Politics of the Vatican 1917–1979. By Hansjakob Stehle. Pp.466, Athens, Ohio University Press, 1981, £16.20, £8.10. Structuralism or Criticism? By Geoffrey Strickland. Pp.viii, 209, Cambridge, Cambridge University Press, 1981, £17.50. The Call of God: The Theme of Vocation in the Poetry of Donne and Herbert. By Robert B. Shaw. Pp.xiii, 123, Cambridge, Mass., Cowley Publications, 1981, $5.00. John and Charles Wesley: Selected Prayers, Hymns, Journal Notes, Sermons, Letters and Treatises. Edited by Frank Whaling. Pp.xx, 412, London, SPCK, 1981, £8.95. The Trickster in West Africa: A Study of Mythic Irony and Sacred Delight. By Robert D. Pelton. Pp.312, Berkeley, University of California Press, 1980, £15.00. (shrink)

Centralized, democratic rules are often asserted as a superior basis for rationing than individualized physician discretion. This article counters this prevailing wisdom by exploring the deficiencies of rule-based rationing. Rules are too imprecise to accurately reflect all the nuances of physical and mental impairment and the complexity of medical science, particularly considering the widely varying personal values that different patients attach to medical risk and benefit. Rule-based rationing also suffers from the biasing effects of interest group pressure on political processes (...) and the tendency to absolve physicians from any moral responsibility for the rationing decisions they implement. Internalizing cost constraints is a more socially and professionally acceptable means of rationing and, in any event, it is inevitable since even a preponderance of rule-based rationing will leave considerable areas of discretion for physician judgment in the implementation and interpretation of the rules. As a consequence, despite the flaws of bedside rationing, it is foolhardy to dispense with it entirely in favor of an exclusively rule-based system. Keywords: Bedside rationing, cost-constraints, rule-based rationing CiteULike Connotea Del.icio.us What's this? (shrink)

Mobile devices with health apps, direct-to-consumer genetic testing, crowd-sourced information, and other data sources have enabled research by new classes of researchers. Independent researchers, citizen scientists, patient-directed researchers, self-experimenters, and others are not covered by federal research regulations because they are not recipients of federal financial assistance or conducting research in anticipation of a submission to the FDA for approval of a new drug or medical device. This article addresses the difficult policy challenge of promoting the welfare and interests of (...) research participants, as well as the public, in the absence of regulatory requirements and without discouraging independent, innovative scientific inquiry. The article recommends a series of measures, including education, consultation, transparency, self-governance, and regulation to strike the appropriate balance. (shrink)

Beginning in the 20th century, scientific research came to be dominated by a growing class of credentialed, professional scientists who overwhelmingly displaced the learned amateurs of an earlier time. By the end of the century, however, the exclusive realm of professional scientists conducting research was joined, to a degree, by “citizen scientists.” The term originally encompassed non-professionals assisting professional scientists by contributing observations and measurements to ongoing research enterprises. These collaborations were especially common in the environmental sciences, where citizen scientists (...) participated in counting wildlife and measuring environmental conditions. Later, patient groups began to play a more active role in supporting clinical trials and collecting health records from affected individuals. (shrink)

Researchers increasingly rely on large data sets of health information, often linked with biological specimens. In recent years, the argument has been made that obtaining informed consent for conducting records-based research is unduly burdensome and results in ?consent bias.? As a type of selection bias, consent bias is said to exist when the group giving researchers access to their data differs from the group denying access. Therefore, to promote socially beneficial research, it is argued that consent should be unnecessary. After (...) analyzing the biostatistics evidence and bioethics arguments, the article concludes that (1) claims about the amount of consent bias are overstated; (2) commonly used statistical methods usually can account for consent bias; and (3) any residual effects of consent bias are below an acceptable level of imprecision and constitute a reasonable social cost for conducting ethically responsible research. (shrink)

This article is an extended commentary inspired by Alan Drengson's paper “Shifting Paradigms: From Technocrat to Planetary Person” (Drengson 2011). In this article Susan Greenwood and I echo Drengson's criticism that Euro-American science is incomplete, having committed what Thomas Roberts calls “The Singlestate Fallacy: the erroneous assumption that all worthwhile abilities reside in our normal, awake mindbody state” (Roberts 2006:105). This singlestate fallacy is vividly portrayed in Mary Shelley's novel Frankenstein, whose critique of Euro-American science is revisited in this article. (...) Alternatively, Greenwood and I suggest that what is needed is a multimodel framework “that allows for in-depth analysis of the different modes of consciousness.” Roberts refers to this alternative attitude toward science as the Multistate Paradigm. An awareness of the transformational character of shamanism is also explored in this article as a means to overcome the oppositions between the technocratic and person planetary perspective, and their related gender associations. (shrink)

National decline is typically blamed on special interests from the demand side of politics corrupting a country's institutions. The usual demand-side suspects include crony capitalists, consumer activists, economic elites, and labor unions. Less attention is given to government insiders on the supply side of politics - rulers, elected officials, bureaucrats, and public employees. In autocracies and democracies, government insiders have the motive, means, and opportunity to co-opt political power for their benefit and at the expense of national well-being. Many storied (...) empires have succumbed to such inside jobs. Today, they imperil countries as different as China and the United States. Democracy - government by the people - does not ensure government for the people. Understanding how government insiders use their power to subvert the public interest - and how these negative consequences can be mitigated - is the topic of this book by Mark A. Zupan. (shrink)

The author reviews the arguments made by Mark Hanson, James Keenan, S.J., and Joel Shuman in this issue. In the first section, she argues that they offer a significant contribution toward an understanding of the inner logic of a new trend in contemporary medicine, genetic engineering. However, she criticizes the authors for relying excessively on procedural guidelines and for failing to bring the practical realities of medicine and technology to bear on theory. She argues that more concrete guidelines, (...) which are ultimately grounded in a Christian conception of the person and on the commandment to love, are necessary. Writing from the Roman Catholic perspective, the author argues that the distinction between genetic enhancement and gene therapy is essential, despite the criticisms which have been offered of this distinction. Understanding this distinction will be critical for identifying as licit only those forms of genetic manipulation which respect the dignity of the human person. (shrink)

If there is to be a natural theory of consciousness that would satisfy both philosophers and scientists, it must be based on naturalistic data and minimal clutter accumulated from semantic arguments. Carruthers offers a 'natural' theory of consciousness that is rather myopic. To explore the evolutionary basis of consciousness, a natural theory should include comparative psychological and neurological data that encompass nonlinguistic measures. Such an approach could provide a clearer picture of the adaptive function, mechanisms, and origins of consciousness.

Since the fourth century, B.C.E., the Oath of Hippocrates has been the starting point in analyzing the obligations of physicians to protect the privacy and confidentiality interests of their patients. The pertinent provision of the Oath reads as follows: “What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account must be spread abroad, I will keep to myself, holding such things shameful (...) to be spoken about.”This part of the Oath is subject to more than one interpretation, but its commonly accepted meaning provides the ethical foundation for the physician’s duty of confidentiality. The Oath expressly declares that a physician’s obligation of confidentiality applies beyond matters of medical care. At a time when there were no hospitals or physician offices, patients received medical care in their homes or in public places. Physicians treating patients in their homes could be expected to see and hear a wide range of activities that might be considered embarrassing, immoral, or even illegal. (shrink)

Opponents of the Affordable Care Act have attempted to topple it in court by challenging the legality of two of its three legs. Three years ago, in NFIB v. Sibelius, Chief Justice Roberts narrowly upheld the constitutionality of the individual mandate, in a 5-to-4 decision that characterized the mandate as an optional tax rather than as a regulatory command. This year, on June 25, the health policy community exhaled a giant sigh of relief when the Supreme Court upheld the subsidy (...) leg of the ACA structure. In King v. Burwell, Justice Roberts again wrote the majority opinion, ruling as a matter of statutory interpretation that subsidies for insurance premiums are available not just through state-based exchanges but also through the federal exchange. (shrink)