Pediatric psychopharmacology is a relatively new science. Although the use of psychotropic medications in children has risen in the past decade, there are few standard treatments for serious psychiatric or developmental disorders of childhood. The relative absence of standard treatments is further complicated by the fact that many of the agents used in pediatric psychopharmacology have been adapted from other fields. Therefore, investigators have a responsibility to make incremental progress from concept through pilot studies and large-scale, multisite efficacy and safety (...) trials. Thus, although there is a pressing need to conduct medication trials that can guide clinical practice, there are scientific and ethical considerations to bear in mind when designing clinical trials in pediatric psychopharmacology. This article reviews essential ethical and scientific issues that are relevant to designing clinical trials in children with psychiatric and developmental disorders. Using examples from recently published literature, the article describes the challenges and pitfalls of various clinical trial study designs. The application of sound ethical and scientific principles is necessary to ensure that clinical trials are properly conducted and to guard against ambiguous results that can not guide practice. (shrink)

Understanding the clinical significance of variants associated with hereditary cancer risk requires access to a pooled data resource or network of resources—a “cancer gene variant commons”—incorporating representative, well-characterized genetic data, metadata, and, for some purposes, pathways to case-level data. Several initiatives have invested significant resources into collecting and sharing cancer gene variant data, but further progress hinges on identifying and addressing unresolved policy issues. This commentary provides insights from a modified policy Delphi process involving experts from a range of stakeholder (...) groups involved in the data-sharing ecosystem. In particular, we describe policy issues and options generated by Delphi participants in five domains critical to the development of an effective cancer gene variant commons: incentives, financial sustainability, privacy and security, equity, and data quality. Our intention is to stimulate wider discussion and lay a foundation for further work evaluating policy options more in-depth and mapping them to those who have the power to bring about change. Addressing issues in these five domains will contribute to a cancer gene variant commons that supports better care for at-risk and affected patients, empowers patient communities, and advances research on hereditary cancers. (shrink)

As citizen science expands, questions arise regarding the applicability of norms and policies created in the context of conventional science. This article focuses on data sharing in the conduct of health-related citizen science, asking whether citizen scientists have obligations to share data and publish findings on par with the obligations of professional scientists. We conclude that there are good reasons for supporting citizen scientists in sharing data and publishing findings, and we applaud recent efforts to facilitate data sharing. At the (...) same time, we believe it is problematic to treat data sharing and publication as ethical requirements for citizen scientists, especially where there is the potential for burden and harm without compensating benefit. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

Making data broadly accessible is essential to creating a medical information commons. Transparency about data-sharing practices can cultivate trust among prospective and existing MIC participants. We present an analysis of 34 initiatives sharing DNA-derived data based on public information. We describe data-sharing practices captured, including practices related to consent, privacy and security, data access, oversight, and participant engagement. Our results reveal that data-sharing initiatives have some distance to go in achieving transparency.

There are questions about how ethics is best taught to undergraduate business students. There has been a proliferation in the number of stand-alone ethics courses for undergraduate students but research on the effectiveness of integrated versus stand-alone mode of delivery is inconclusive. Christensen et al. :347–368, 2007), in a comprehensive review of ethics, corporate social responsibility and sustainability education, investigated how ethics education has changed over the last 20 years, including the issue of integration of these topics into the core (...) course offerings. We use Brenner and Molander’s :57–71, 1977) situational ethics survey instrument to examine the effect of the mode of delivery of business ethics education on undergraduate student responses. We found a significant difference on mode of delivery. Studies have also found interesting results in respect of the effect of cultural differences and gender on the effectiveness of business ethics instruction. While not the primary focus of this study, we also looked at the influence of gender and culture on students’ responses. Our results indicate significant differences in respect of mode of delivery and culture. In contrast to other studies, we found that gender was not significant. We did test for any interactive effects of gender, culture and mode of delivery. However, no significant differences were found. (shrink)

Hospital administrators may lack familiarity with what clinical ethicists do (and do not do), and many clinical ethicists report receiving inadequate financial support for their clinical ethics consultation services (CECSs). Ethics consultation is distinct in that it is not reimbursable by third parties, and its financial benefit to the hospital may not be quantifiable. These peculiarities make it difficult for clinical ethicists to resort to tried-and-true outcome-centered evaluative strategies, like cost reduction or shortened length of stay for patients, to show (...) a “need” for ethics consultation. Likewise, it can be difficult for clinical ethicists to “speak the same language” as healthcare administrators and managers, which, in turn, means that CECSs run the risk of being unable to demonstrate value to those who pay for the service. The purpose of this descriptive article is to provide practical guidance to clinical ethicists and program directors on how to cultivate administrative support for a CECS. Specifically, we discuss two elements that clinical ethics leaders must critically appraise and successfully argue to meet the expectations of administrators— the value of a CECS and its fit in clinical workflow. (shrink)

Advances in technologies and biomedical informatics have expanded capacity to generate and share biomedical data. With a lens on genomic data, we present a typology characterizing the data-sharing landscape in biomedical research to advance understanding of the key stakeholders and existing data-sharing practices. The typology highlights the diversity of data-sharing efforts and facilitators and reveals how novel data-sharing efforts are challenging existing norms regarding the role of individuals whom the data describe.

A medical information commons is a networked data environment utilized for research and clinical applications. At three deliberations across the U.S., we engaged 75 adults in two-day facilitated discussions on the ethical and social issues inherent to sharing data with an MIC. Deliberants made recommendations regarding opt-in consent, transparent data policies, public representation on MIC governing boards, and strict data security and privacy protection. Community engagement is critical to earning the public's trust.

A 2011 National Academies of Sciences report called for an “Information Commons” and a “Knowledge Network” to revolutionize biomedical research and clinical care. We interviewed 41 expert stakeholders to examine governance, access, data collection, and privacy in the context of a medical information commons. Stakeholders' attitudes about MICs align with the NAS vision of an Information Commons; however, differences of opinion regarding clinical use and access warrant further research to explore policy and technological solutions.

There is a national movement supporting the retention and use of bio-specimens from deceased individuals for the purpose of genetic testing. This manuscript discusses the significance of postmortem genetic testing in the context of death determination by medical examiners. We highlight distinctive concerns that are raised in the areas of consent, confidentiality, and return of results when genetic testing is performed as part of a public molecular autopsy. We believe our manuscript will contribute to the development of a robust ethical (...) and legal framework for genetic testing in this context. (shrink)

Background Citizen science is increasingly prevalent in the biomedical sciences, including the field of human genomics. Genomic citizen science initiatives present new opportunities to engage individuals in scientific discovery, but they also are provoking new questions regarding who owns the outputs of the research, including intangible ideas and discoveries and tangible writings, tools, technologies, and products. The legal and ethical claims of participants to research outputs become stronger—and also more likely to conflict with those of institution-based researchers and other stakeholders—as (...) participants become more involved, quantitatively and qualitatively, in the research process. It is not yet known, however, how genomic citizen science initiatives are managing the interests of their participants in accessing and controlling research outputs in practice. To help fill this gap, we conducted an in-depth review of relevant policies and practices of U.S.-based genomic citizen science initiatives. Methods We queried the peer-reviewed literature and grey literature to identify 22 genomic citizen science initiatives that satisfied six inclusion criteria. A data collection form was used to capture initiative features, policies, and practices relevant to participants’ access to and control over research outputs. Results This analysis revealed that the genomic citizen science landscape is diverse and includes many initiatives that do not have institutional affiliations. Two trends that are in apparent tension were identified: commercialization and operationalization of a philosophy of openness. While most initiatives supported participants’ access to research outputs, including datasets and published findings, none supported participants’ control over results via intellectual property, licensing, or commercialization rights. However, several initiatives disclaimed their own rights to profit from outputs. Conclusions There are opportunities for citizen science initiatives to incorporate more features that support participants’ access to and control over research outputs, consistent with their specific objectives, operations, and technical capabilities. (shrink)

© 2015, Springer-Verlag Berlin Heidelberg.Genetic studies have identified single nucleotide polymorphisms associated with the risk of prostate cancer. It remains unclear whether such genetic variants are associated with disease aggressiveness. The NCI-SPORE Genetics Working Group retrospectively collected clinicopathologic information and genotype data for 36 SNPs which at the time had been validated to be associated with PC risk from 25,674 cases with PC. Cases were grouped according to race, Gleason score and aggressiveness. Statistical analyses were used to compare the frequency (...) of the SNPs between different disease cohorts. After adjusting for multiple testing, only PC-risk SNP rs2735839 was significantly and inversely associated with aggressive and high-grade disease in European men. Similar associations with aggressive and high-grade disease were documented in African-American subjects. The G allele of rs2735839 was associated with disease aggressiveness even at low PSA levels in both European and African-American men. Our results provide further support that a PC-risk SNP rs2735839 near the KLK3 gene on chromosome 19q13 may be associated with aggressive and high-grade PC. Future prospectively designed, case-case GWAS are needed to identify additional SNPs associated with PC aggressiveness. (shrink)

The concept of self-motion is not only fundamental in Aristotle's argument for the Prime Mover and in ancient and medieval theories of nature, but it is also central to many theories of human agency and moral responsibility. In this collection of mostly new essays, scholars of classical, Hellenistic, medieval, and early modern philosophy and science explore the question of whether or not there are such things as self-movers, and if so, what their self-motion consists in. They trace the development of (...) the concept of self-motion from its formulation in Aristotle's metaphysics, cosmology, and philosophy of nature through two millennia of philosophical, religious, and scientific thought. This volume contains "Self-Movers" (David Furley), "Aristotle on Self-Motion" (Mary Louise Gill), "Aristotle on Perception, Appetition, and Self-Motion" (Cynthia Freeland), "Self-Movement and External Causation" (Susan Sauvé Meyer), "Aristotle on the Mind's Self-Motion" (Michael Wedin), "Mind and Motion in Aristotle" (Christopher Shields), "Aristotle's Prime Mover" (Aryeh Kosman), "The Transcendence of the Prime Mover" (Lindsay Judson), "Self-Motion in Stoic Philosophy" (David Hahm), "Duns Scotus on the Reality of Self-Change" (Peter King), "Ockham, Self-Motion, and the Will" (Calvin Normore), and "Natural Motion and Its Causes: Newton on the 'Vis Insita' of Bodies" (J. E. McGuire). Originally published in 1994. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

This is the first book to explore the cognitive science of effortless attention and action. Attention and action are generally understood to require effort, and the expectation is that under normal circumstances effort increases to meet rising demand. Sometimes, however, attention and action seem to flow effortlessly despite high demand. Effortless attention and action have been documented across a range of normal activities--from rock climbing to chess playing--and yet fundamental questions about the cognitive science of effortlessness have gone largely unasked. (...) -/- This book draws from the disciplines of cognitive psychology, neurophysiology, behavioral psychology, genetics, philosophy, and cross-cultural studies. Starting from the premise that the phenomena of effortless attention and action provide an opportunity to test current models of attention and action, leading researchers from around the world examine topics including effort as a cognitive resource, the role of effort in decision making, the neurophysiology of effortless attention and action, the role of automaticity in effortless action, expert performance in effortless action, and the neurophysiology and benefits of attentional training. -/- Contributors: Joshua M. Ackerman, James H. Austin, John A. Bargh, Roy F. Baumeister, Sian L. Beilock, Chris Blais, Matthew M. Botvinick, Brian Bruya, Mihaly Csikszentmihalyi, Marci S. DeCaro, Arne Dietrich, Yuri Dormashev, László Harmat, Bernhard Hommel, Rebecca Lewthwaite, Örjan de Manzano, Joseph T. McGuire, Brian P. Meier, Arlen C. Moller, Jeanne Nakamura, Evgeny N. Osin, Michael I. Posner, Mary K. Rothbart, M. R. Rueda, Brandon J. Schmeichel, Edward Slingerland, Oliver Stoll, Yiyuan Tang, Töres Theorell, Fredrik Ullén, Robert D. Wall, Gabriele Wulf. (shrink)

If Kant's account of rights had continued the "early modern Natural Law tradition", basing rights on some notion of human flourishing, there would be no difficulty about including socio-economic rights for the needy in his theory. However, his division of moral philosophy into Rechtslehre and Tugendlehre limits Rechtspflichten to duties that a moral agent can be coerced to fulfill. If a state is to give the needy statutory rights, the justification for using coercion on its citizens cannot be that they (...) have a duty of virtue to assist the needy. In order to determine whether such a justification can be found, the one innate socio-economic right Kant admits, a child's right to be cared for and educated, is examined and found to be a right against its parents, not against the state. Kant does, however, hold that a state should establish institutions to provide for abandoned children and for the poor in general. His justification for a state's use of coercion with regard to such statutory rights is considered and a criterion is suggested for the possible consent of its non-virtuous citizens to proposed measures for assistance to the needy. It is suggested that if advocates of aid to the needy cannot justify their proposals by such a criterion they will have to provide a very different account of rights than Kant gives in his Rechtslehre , which is concerned with the moral permissibility of using coercion. Wenn Kants Lehre von den subjektiven Rechten nichts anderes wäre als eine Fortsetzung der "ihr vorangehenden modernen Naturrechtstradition" und die subjektiven Rechte infolgedessen auf das eine oder andere Konzept von menschlichem Wohlergehen gestützt hätte, dann wäre es nicht sonderlich schwierig, sozio-ökonomische Rechte für die Bedürftigen in diese Lehre einzubauen. Nun schränkt Kants Einteilung der Moralphilosophie in Rechtslehre und Tugendlehre den Begriff der Rechtspflicht allerdings auf diejenigen Pflichten ein, zu deren Erfüllung ein Mensch gezwungen werden kann. Deshalb kann, wenn ein Staat den Bedürftigen durch ein positives Gesetz irgendwelche Rechte auf Hilfe gewährt, die Rechtfertigung der Anwendung von staatlichem Zwang nicht darin gesucht werden, daß die dadurch in Anspruch genommenen Personen die Tugendpflicht haben, die Bedürftigen zu unterstützen. Um festzustellen, ob sich staatlicher Zwang in bezug auf solche Hilfspflichten überhaupt rechtfertigen läßt, erörtert der Beitrag das Recht des Kindes auf Fürsorge und Ausbildung als das eine und einzige angeborene sozio-ökonomische Recht, das Kant akzeptiert. Freilich ist das Recht des Kindes ein Recht gegen seine Eltern und nicht gegen den Staat. Gleichwohl nimmt Kant an, daß der Staat Einrichtungen schaffen sollte, die für verlassene Kinder und für die Armen im allgemeinen zu sorgen haben. Der Beitrag untersucht die Rechtfertigung, die Kant für die Anwendung von staatlichem Zwang zur Durchsetzung solcher positiv-gesetzlicher Rechte gibt, und arbeitet die Gründe dafür heraus, warum der nicht tugendhafte Staatsbürger in die vorgesehenen Hilfsmaßnahmen für die Bedürftigen einwilligen könnte. Wenn sich die Verfechter von Hilfsmaßnahmen für die Bedürftigen außerstande sehen, ihre Vorschläge auf Gründe dieser Art zu stützen, dann werden sie mit einem Konzept von subjektivem Recht aufwarten müssen, das sich von dem Konzept Kants von Recht und Rechtslehre , bei dem es allein um die moralische Erlaubtheit von Zwangsmaßnahmen geht, ganz erheblich unterscheidet. (shrink)

Here is Lukcs among his friends, lovers, and peers in those important years before 1918, when he converted to Communism and Marxism at the age of thirty-nine.

Introduction -- The problem of Socrates : Kierkegaard and Nietzsche -- Kierkegaard : Socrates vs. the God -- Nietzsche : call for an artistic Socrates -- Plato's Socrates -- Love, generation, and political community (the Symposium) -- The prologue -- Phaedrus' praise of nobility -- Pausanias' praise of law -- Eryximachus' praise of art -- Aristophanic comedy -- Tragic victory -- Socrates' turn -- Socrates' prophetess and the daemonic -- Love as generative -- Alcibiades' dramatic entrance -- Alcibiades' images of (...) socrates -- Alcibiades' praise of Socrates' virtues -- Aftermath -- The incompleteness of the Symposium -- Self-knowledge, love, and rhetoric (Plato's Phaedrus) -- The setting -- Non-lovers (Lysias' speech and Socrates' first speech) -- Souls and their fall -- Lovers and their ascent -- Prayer to love -- Contemporary rhetoric and politics -- A genuine art of rhetoric -- Writing -- Prayer to Pan -- Who is the friend? (the Lysis) -- Joining the group -- Getting acquainted -- Seeking a friend -- Are friends the ones loving, the ones loved, or both? -- Are likes friends? -- Are unlikes friends? -- Are those who are neither good nor bad friends to the good? -- Are the kindred friends? -- Who might friends be? -- Friendly communities -- Socratic philosophizing -- Socrates' youthful search for cause -- Socrates' second sailing and the ideas -- Piety, poetry, and friendship. (shrink)

This book articulates a new approach to medieval aesthetic values, emphasizing the sensory and emotional basis of all medieval arts, their love of play and fine craftsmanship, of puzzles, and of strong contrasts.It offers an understanding of medieval literature and art that is rooted in the perceptions and feelings of ordinary life.

In this book, Mary Townsend proposes that, contrary to the current scholarship on Plato's Republic, Socrates does not in fact set out to prove the weakness of women. Rather, she argues that close attention to the drama of the Republic reveals that Plato dramatizes the reluctance of men to allow women into the public sphere and offers a deeply aporetic vision of women’s nature and political position—a vision full of concern not only for the human community, but for the (...) desires of women themselves. (shrink)

M. M. McCabe presents a selection of her essays which explore the Platonic method of conversation: how it may inform our understanding both of Plato and of his predecessors and successors, and how its centrality accounts for the connections between argument, knowledge, and virtue in the texts McCabe examines.

This paper examines potential ethical and legal issues arising during the research, develop- ment and clinical use of a proposed strategy in personalized medicine (PM): using human induced pluripotent stem cell (iPSC)-derived tissue cultures as predictive models of individ- ual patients to inform treatment decisions. We focus on epilepsy treatment as a likely early application of this strategy, for which early-stage stage research is underway. In relation to the research process, we examine issues associated with biological samples; data; health; vulnerable (...) populations; neural organoids; and what level of accuracy justifies using the iPSC-derived neural tissue system. In relation to clinical use, we examine potential uses in pre-natal screening, and effects on clinical decision-making. Although our focus is providing recommendations for researchers developing work in this area, we identify the novel issue of deciding on an acceptable accuracy level for the system. We also emphasize an issue thus far neglected in the ethics of PM: PM tends to represent treatment decisions as though they should be directed solely by biomedical information, but this in itself could be detri- mental to best personalizing treatment decisions in the clinic. (shrink)

Many philosophers have asserted that evolutionary theory is unfalsifiable. In this paper I refute these assertions by detailing some falsifiable predictions of the theory and the evidence used to test them. I then analyze both these predictions and evidence cited to support assertions of unfalsifiability in order to show both what type of predictions are possible and why it has been so difficult to spot them. The conclusion is that the apparent logical peculiarity of evolutionary theory is not a property (...) of evolutionary theory; it is a property of our human-sized perspective on evolutionary theory. (shrink)