The enormous destructive power of present stocks of nuclear weapons poses the greatest threat to public health in human history. Technical changes in weapons design are leading to an increased emphasis on the ability to fight a nuclear war, eroding the concept of deterrence based on mutually assured destruction and increasing the risk of nuclear war. Medical planning and civil defence preparations for nuclear war have recently been increased in several countries although there is little evidence (...) that they will be of significant value in the aftermath of a nuclear conflict. These developments have raised new ethical dilemmas for those in health professions. If there is any risk of use of weapons of mass destruction, then support for deterrence with these weapons as a policy for national or global security appears to be incompatible with basic principles of medical ethics and international law. The primary medical responsibility under such circumstances is to participate in attempts to prevent nuclear war. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Direct Nuclear Reprogramming: Response to Condic, Lee, and GeorgeGerard Magill, Ph.D. and William B. NeavesWe read with great interest the response of Maureen Condic, Patrick Lee, and Robert George (2009) to our essay, “Ontological and Ethical Implications of Direct Nuclear Reprogramming” in the March 2009 issue of the Kennedy Institute of Ethics Journal (Magill and Neaves 2009). Much of their response addressed issues that are not in (...) dispute: somatic cells are not zygotes, neurons and hepatocytes are different, growth-factor signals from the trophoblast influence development of the inner cell mass, membranes derived from the trophectoderm are critically required for embryonic survival, and stem cells cannot produce a fetus “on their own.”The crucial point of disagreement deals with the fact that iPS cells are not totipotent but zygotes are. Zygotes can generate their own placental structures while iPS cells must be given them through tetraploid complementation. Condic, Lee, and George consider totipotency to be crucial to natural potentiality. We present an alternative view in our essay (Magill and Neaves 2009, pp. 28–29). Placental structures make no lasting contribution to the postnatal organism, and the equivalency of iPS cells with the inner cell mass of the blastocyst is apparent from tetraploid complementation experiments.The respondents acknowledge the following:... somatic cells can be “converted” into zygotes by the process of somatic cell nuclear transfer (SCNT) or direct reprogramming in combination with tetraploid complementation—just as sperm and egg cells can be “converted” into a zygote by the process of natural fertilization—....(Condic, Lee, and George 2009, p. 35)As the respondents recognize, different ways of manipulating cells can lead to embryogenesis: sperm and egg cells in the process of natural fertilization, the enucleated egg and an ordinary body cell in the process of somatic cell nuclear transfer, and reprogrammed skin cells and a tetraploid blastocyst in the case of induced pluripotent stem (iPS) cells. In each case, different cells are manipulated—or “converted” in the respondents’ terminology—in a process that alters their biological fate within a supportive environment facilitating embryogenesis.The developmental potential that resides in the human genome does not unfold in isolation, not even in a zygote. In all cases, whether involving a zygote or an iPS cell, interaction with a supportive environment is required to express the developmental program residing in the genome. [End Page 201]This biological reality supports what we have described as “early cellular development along the continuum of natural potentiality that can result in the formation of a fetus” (Magill and Neaves 2009, p. 30), and it presents a significant challenge to the natural potentiality argument.Gerard MagillVernon F. Gallagher Chair for the Integration of Science, Theology, Philosophy, and Law, and Professor, Center for Healthcare Ethics Duquesne University Pittsburgh, PA.William B. NeavesPresident and CEO Stowers Institute for Medical Research and Professor of Basic Medical Science University of Missouri at Kansas City School of Medicine Kansas City, MOReferencesCondic, Maureen L.; Lee, Patrick; and George, Robert P. 2008. Ontological and Ethical Implications of Direct Nuclear Reprogramming: Response to Magill and Neaves. Kennedy Institute of Ethics Journal 19: 33–40. Google ScholarMagill, Gerard, and Neaves William B. 2009. Ontological and Ethical Implications of Direct Nuclear Reprogramming. Kennedy Institute of Ethics Journal 19: 23–32. Google ScholarCopyright © 2009 The Johns Hopkins University Press... (shrink)

The widespread adoption of radioisotopes as tools in biomedical research and therapy became one of the major consequences of the "physicists' war" for postwar life science. Scientists in the Manhattan Project, as part of their efforts to advocate for civilian uses of atomic energy after the war, proposed using infrastructure from the wartime bomb project to develop a government-run radioisotope distribution program. After the Atomic Energy Bill was passed and before the Atomic Energy Commission was formally established, the Manhattan Project (...) began shipping isotopes from Oak Ridge. Scientists and physicians put these reactor-produced isotopes to many of the same uses that had been pioneered with cyclotron-generated radioisotopes in the 1930s and early 1940s. The majority of early AEC shipments were radioiodine and radiophosphorus, employed to evaluate thyroid function, diagnose medical disorders, and irradiate tumors. Both researchers and politicians lauded radioisotopes publicly for their potential in curing diseases, particularly cancer. However, isotopes proved less successful than anticipated in treating cancer and more successful in medical diagnostics. On the research side, reactor-generated radioisotopes equipped biologists with new tools to trace molecular transformations from metabolic pathways to ecosystems. The U.S. government's production and promotion of isotopes stimulated their consumption by scientists and physicians, such that in the postwar period isotopes became routine elements of laboratory and clinical use. In the early postwar years, radioisotopes signified the government's commitment to harness the atom for peace, particularly through contributions to biology, medicine, and agriculture. (shrink)

We raise a problem of applicability of RCTs to validate nuclear diagnostic imaging tests. In spite of the wide application of PET and other similar techniques that use radiopharmaceuticals for diagnostic purposes, RCT-based evidence on their validity is sparse. We claim that this is due to a general conceptual problem that we call Prevalence of Treatment, which arises in connection with designing RCTs for testing any diagnostic procedure in the present context of medical research, and is particularly apparent in (...) this case. We also identify three practical reasons why RCTs do not qualify as the best option for PET validation, which have to do with specific characteristics of nuclear diagnostic imaging, and of radiopharmaceuticals. The paper is meant to contribute both to the philosophical discussion on the EBM hierarchy of evidence, and on the specific debate on radiopharmaceuticals in nuclear medicine. (shrink)

Novel therapies resulting from regenerative medicine and tissue engineering technology may offer new hope for patients with injuries, end-stage organ failure, degenerative disorders and many other clinical issues. Currently, patients suffering from diseased and injured organs are treated with transplanted organs. However, there is a shortage of donor organs that is worsening yearly as the population ages and new cases of organ failure increase. Scientists in the field of regenerative medicine and tissue engineering are now applying the principles (...) of cell transplantation, material science, and bioengineering to construct biological substitutes that can restore and maintain normal function in diseased and injured tissues. In addition, the stem cell field is a rapidly advancing part of regenerative medicine, and new discoveries in this field create new options for this type of therapy. For example, new types of stem cells, such as amniotic fluid and placental stem cells, that can circumvent the ethical issues associated with embryonic stem cells have been discovered. The process of somatic cell nuclear transfer and the creation of induced pluripotent cells provide still other potential sources of stem cells for cell-based tissue engineering applications. While stem cells are still in the research phase, some therapies arising from tissue engineering endeavors that make use of autologous, adult cells have already entered the clinical setting, indicating that regenerative medicine holds much promise for the future. (shrink)

We examine whether the current regulatory regime instituted in South Korea and the United States would have prevented Hwang’s potential transgressions in oocyte procurement for somatic cell nuclear transfer, we compare the general aspects and oversight framework of the Bioethics and Biosafety Act in South Korea and the US National Academies’ Guidelines for Human Embryonic Stem Cell Research, and apply the relevant provisions and recommendations to each transgression. We conclude that the Act would institute centralized oversight under governmental auspices (...) while the Guidelines recommend politically-independent, decentralized oversight bodies including a special review body for human embryonic stem cell research at an institutional level and that the Guidelines would have provided more vigorous protection for the women who had undergone oocyte procurement for Hwang’s research than the Act. We also suggest additional regulations to protect those who provide oocytes for research in South Korea. (shrink)

I argue that contraception is morally wrong but that periodic abstinence (or natural family planning) is not. Further, I argue that altered nuclear transfer—a proposed technique for creating human stem cells without destroying human embryos—is morally wrong for the same reason that contraception is. Contrary to what readers might expect, my argument assumes nothing about the morality of cloning or abortion and requires no premises about God or natural teleology. Instead, I argue that contraception and altered nuclear transfer (...) are morally wrong because they fail to treat humanity as an inviolable end. (shrink)

Reprogramming of somatic cells to a pluripotent state holds huge potentials for regenerative medicine. However, a debate over which method is better, somatic cell nuclear transfer (SCNT) or induced pluripotent stem (iPS) cells, still persists. Both approaches have the potential to generate patient‐specific pluripotent stem cells for replacement therapy. Yet, although SCNT has been successfully applied in various vertebrates, no human pluripotent stem cells have been generated by SCNT due to technical, legal and ethical difficulties. On the other (...) hand, human iPS cell lines have been reported from both healthy and diseased individuals. A recent study reported the generation of triploid human pluripotent stem cells by transferring somatic nuclei into oocytes, a variant form of SCNT. In this essay, we discuss this progress and the potentials of these two reprogramming approaches for regenerative medicine. (shrink)

First responders to chemical, biological, radiological, or nuclear (CBRN) events face decisions having significant human consequences. Some operational decisions are supported by standard operating procedures, yet these may not suffice for ethical decisions. Responders will be forced to weigh their options, factoring-in contextual peculiarities; they will require guidance on how they can approach novel (indeed unique) ethical problems: they need strategies for “on the spot” ethical decision making. The primary aim of this paper is to examine how first responders (...) should approach on the spot ethical decision-making amid the stress and uncertainty of a CBRN event. Drawing on the long-term professional CBRN experience of one of the authors, this paper sets out a series of practical ethical dilemmas potentially arising in the context of a large-scale chemical incident. We propose a broadly consequentialist approach to on the spot ethical decision-making, but one which incorporates ethical values and rights as “side-constraints”. (shrink)

The prelims comprise: Nuclear Transfer at Present Potential Applications Implications of the Present Inadequacies General Conclusions.

The combination of genuine ethical concerns and fear of learning to use germ-line therapy for human disease must now be confronted. Until now, no established techniques were available to perform this treatment on a human. Through an integration of several fields of science and medicine, we have developed a nine step protocol at the germ-line level for the curative treatment of a genetic disease. Our purpose in this paper is to provide the first method to apply germ-line therapy to (...) treat those not yet born, who are destined to have a life threatening, or a severely debilitating genetic disease. We hope this proposal will initiate the process of a thorough analysis from both the scientific and ethical communities. As such, this proposal can be useful for official groups studying the advantages and disadvantages of germ-line therapy. (shrink)

Discussion of the worldwide corporate development of biotechnologies is sometimes diverted through the introduction of images of heroic medical intervention, exemplified by the statement, I would do anything to save my daughter. Such heroic images seem to justify virtually any deployment of resources and nearly any health or environmental risk. But it is instructive for future public discussions to examine the use of such images, and to note that those advocating a prominent role for biotechnologies in an expanding global economy (...) welcome such diversionary patterns. Our responsibility to do our own thinking is beset by conditions that may lead us astray. In a time burdened by profound worry—crushing inequalities among the world's peoples, an ecological crisis, and threat of nuclear war—it is tempting to avert our eyes when we are faced with grave new dangers. Moreover, in our increasingly visual culture, images have come to function as a facsimile of and substitute for real thinking. If we are to have significant discussions about the potential of biotechnology, we must not only be wary of promises of economic growth but must also be mindful of sources of diversion and the appeals of image-thinking. We should strive to become more critical of our own ways of thinking, thus opening the discussion to a fuller consideration of what needs to be saved. (shrink)

This is the first book to explore the epistemology and ethics of advanced imaging tests, in order to improve the critical understanding of the nature of knowledge they provide and the practical consequences of their utilization in healthcare. Advanced medical imaging tests, such as PET and MRI, have gained center stage in medical research and in patients’ care. They also increasingly raise questions that pertain to philosophy: What is required to be an expert in reading images? How are standards for (...) interpretation to be fixed? Is there a problem of overutilization of such tests? How should uncertainty be communicated to patients? How to cope with incidental findings? This book is of interest and importance to scholars of philosophy of medicine at all levels, from undergraduates to researchers, to medical researchers and practitioners (radiologists and nuclear physicians) interested in a critical appraisal of the methodology of their discipline and in the ethical principles and consequences of their work. -/- . (shrink)

War and Nature is an important, cogent, and timely book about the double‐edged nature of technology. Edmund Russell, through meticulous research, establishes a key nexus between the increased use of chemicals in war and peace during several key decades of the twentieth century and the generalized backlash against technology and its unintended consequences that occurred beginning in the mid‐1960s. He clearly places pesticides, rodenticides, herbicides, and chemical warfare agents alongside atomic energy, electronics, massive water harnessing and diversion projects, and other (...) prime examples of America's romance with progress. Thus, he joins his work with a significant body of research examining the United States's headlong plunge to embrace technology, along with sometimes belated efforts to grapple with its effects.The idea of progress has always been a distinctive factor in American identity. However, the fascination with progress was perhaps never so intense, so unreserved, and so naive as in the fifty years from 1914 to the early 1960s. During these years, as Russell points out, the pace of change was accelerated by two world wars that spawned the growth of powerful government agencies as well as commercial companies whose new products benefited richly from government‐funded research. Wartime imperatives hastened development of “miracle chemicals” that preserved the health of American soldiers, as when DDT was widely employed in the Pacific theater of war to kill malaria‐bearing mosquitoes. The result was what President Dwight D. Eisenhower, as he left office, termed the “military‐industrial complex.”Russell uses well‐chosen examples from the archives of chemical manufacturers to illustrate how defense contractors supplying electronics, atomic expertise, and other forms of technological expertise useful in warfare softened their public images by touting beneficent peacetime applications of their products. “Better Living Through Chemistry” along with “Progress Is Our Most Important Product” and other slogans familiar to citizens of the 1950s appealed not just to America's love of convenience and gadgetry. They also appealed to a fundamental U.S. belief that “modern science” would solve age‐old problems, erase perennial blights, and free people to live on a higher plane than any previously experienced by humankind.However, because defoliants, flame‐throwers, poison gases, and other chemical weapons that aided the war effort almost always conjured up negative images in the public mind, manufacturers used analogies of “victory” in war to victory over man's environment to retain a reputable and lucrative place in peacetime society.Perhaps most striking are the parallels between chemicals and atomic energy during the 1940s, 1950s, and early 1960s in the United States. Both chemicals and atomic energy proved their awesome power in hastening victory in World War II, and both needed softer images after the war ended. The promises of disease‐free fields and enormously increased crop yields appealed to the American public, just as did the hope of electricity “too cheap to meter” and nuclear medicine that might cure cancers.When chemicals began to poison birds, fish, and other species recognized as valuable and desirable to man, when fields lost their productivity, and when illnesses arose in certain occupations that could be linked to chemical exposure, the downsides of progress became evident. America recoiled and reevaluated. Russell weaves congressional testimony together with advertisements, popular cartoons, and other ephemera to bring to life this uniquely American story. He compels the reader to ask striking questions about a nation maturing and itself asking complex questions about one of its most cherished ideals.The final irony of Russell's book may lie in the fact that it was written before the World Trade Center attack on 11 September 2001 but published just afterward, in the midst of America's anthrax episodes in the fall of the same year. The world focus on chemical and biological warfare should now provide a whole set of additional readers for this valuable book. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Chair’s Perspective on the Work of the Advisory Committee on Human Radiation ExperimentsRuth Faden (bio)On January 15, 1994, President Clinton created the Advisory Committee on Human Radiation Experiments in response to his concern about the increasing number of reports describing alleged unethical conduct of the U.S. Government, and institutions funded by the government, in the use of, or exposure to, ionizing radiation in human beings at the height of (...) the Cold War. He directed the Committee: (1) to uncover the history of human radiation experiments and intentional environmental releases of radiation; (2) to identify the ethical and scientific standards for evaluating these events; and (3) to make recommendations to ensure that whatever wrongdoing may have occurred in the past will not be repeated.The Committee was composed of 14 members: a citizen representative and 13 experts in bioethics, radiation oncology and biology, epidemiology and statistics, public health, history of science and medicine, nuclear medicine, and law. We reported to a cabinet-level group (the Human Radiation Interagency Working Group) convened by the president, which includes the secretaries of defense, energy, health and human services, and veterans affairs; the attorney general; the administrator of the National Aeronautics and Space Administration; the director of the Central Intelligence Agency; and the director of the Office of Management and Budget.On April 21, 1994, at the end of the first day of our first meeting, President Clinton invited us to the White House to personally communicate his commitment to the process we were about to undertake. He urged us to be fair, thorough, and unafraid to shine the light of truth on this hidden and poorly understood aspect of our nation’s past. Our most important task, he said, was to tell the full story to the American public. [End Page 215] At the same time, we were to examine the present, to determine how the conduct of human research today compares with that of the past, and to assess whether, in light of this inquiry, changes need to be made in the policies of the federal government. Eighteen months later, the Committee’s attempt to tell the story of the past and to report on our inquiry into the present was delivered to the president in a 900-page Final Report (ACHRE 1995) and several supplemental volumes.The Committee’s charge was enormous. We were asked to conduct a massive investigation into events that occurred as much as 50 years ago and that involved the highest reaches of the defense establishment and the medical community. This investigation necessitated an examination of the conduct and policies of six federal agencies and countless agents in the private sector, as well as the location and interpretation of hundreds of thousands of documents, many of which were buried in obscure locations or were still classified.In addition, the Committee was instructed to establish standards for judging, in moral terms, the events that it uncovered. This charge necessitated the confrontation of contentious debates in moral thought and theory about history, relativism, and the significance of context in moral judgment. But our purpose was not to engage in these debates in the abstract. Although the Committee was not expressly charged with considering issues relating to remedies, including financial compensation, we felt obliged to address the type of remedies that we believed the government, as an ethical matter, should provide to subjects of experiments where the circumstances warranted such a response. Thus our deliberations about relativism and moral judgment were tied to concrete recommendations for public policy and were conducted in a public context that included participants from numerous adversarial legal proceedings.In tandem with our reconstruction of the past, we undertook three projects to examine the current state of human radiation experiments. First, we studied how each federal agency that currently conducts or funds research involving human subjects regulates and oversees its research activity. Second, from among the very large number of federally-supported research projects involving human subjects, we randomly selected 125 projects for closer scrutiny. We reviewed all available relevant documentation for each project in order to assess how well it appeared to protect the rights and interests of the participating subjects. Third... (shrink)

We have only a limited understanding of how the brain enables thought and behavior and how it becomes dysfunctional in neuropsychiatric disorders. Research in cognitive psychology, psychiatry, neurology, neurosurgery and nuclear medicine has been critical to our current understanding of the brain. Continued research is necessary to gain more knowledge of the etiology and pathophysiology of brain disorders and develop therapies to safely and effectively control and possibly prevent them. Yet mapping the brain through neuroimaging and intervening in (...) the brain with psychotropic drugs, growth factors or implantable neuromodulating devices entail certain risks for research subjects participating in clinical trials. These risks need to be weighed against the potential benefit of knowledge gained from the outcomes of these trials to millions of people suffering from psychiatric and neurological diseases. The risks in neuroscience research are greater than in any other area of medicine and biotechnology because the brain is the source of the mind and the psychological properties that define persons. Can patients with neuropsychiatric disorders give informed consent to participate in neuroscience research? If they cannot consent, then can others give proxy consent on their behalf? What are the obligations of investigators recruiting and monitoring research subjects? In discussing the ethical issues in this research, this chapter focuses on neuroimaging to assess patients with severe brain injuries, neuromodulating techniques such as deep brain stimulation in neurology and psychiatry and brain-computer interfaces to bypass brain and spinal cord injury in restoring movement and communication. (shrink)

Recently, there has been increasing interest in methodological aspects of advanced imaging, including the role of guidelines, recommendations, and experts’ consensus, the practice of self-referral, and the risk of diagnostic procedure overuse. In a recent Delphi study of the European Association for Nuclear Medicine (EANM), panelists were asked to give their opinion on 47 scientific questions about imaging in prostate cancer. Nine additional questions exploring the experts’ attitudes and opinions relating to the procedure of consensus building itself were (...) also included. The purpose was to provide insights into the mechanism of recommendation choice and consensus building as seen from the experts’ point of view. Results: Regarding the factors likely to influence the willingness to refer a patient for imaging, the most voted were incorporation into guidelines and data from scientific literature, while personal experience and personal relationship were chosen by a small minority. Regarding the recommendations more relevant to prescribe an imaging procedure, it resulted the incorporation into guidelines promoted by scientific societies (59% of votes); these guidelines also resulted the more trusted. With respect to patients’ preferences considered when prescribing an imaging procedure, the most voted was accuracy, resulted more important than easy access and time to access to the procedure. The majority of the experts expressed the opinion that there is a scarce use of imaging procedures in prostate cancer. With respect to the most relevant factor to build consensus, it resulted the transparency of the process (52% of votes), followed by multidisciplinarity of contributors. The main obstacle to incorporation of modern imaging procedures into guidelines resulted the lack of primary literature on clinical impact. Conclusions: Firstly, the panelists portray themselves as having Evidence-Based Medicine oriented and scientifically inclined attitudes and preferences. Secondly, guidelines and recommendations from scientific societies, especially clinical ones, are positively taken into account as factors influencing decisions, but panelists tend to consider their own appraisal of the scientific literature as more relevant. Thirdly, in respect of overuse, panelists do not think that advanced diagnostic procedures are overutilized in the specific case of Prostate Cancer, but rather they are underutilized. (shrink)

After WWII, global concerns about the uses of nuclear energy and radiation sources in agriculture, medicine, and industry brought about calls for radiation protection. At the beginning of the 1960s radiation protection involved the identification and measurement of all sources of radiation to which a population was exposed, and the evaluation and assessment of populations in terms of the biological hazard their exposure posed. Mexico was not an exception to this international trend. This paper goes back to the (...) origins of the first studies on the effects of radiation and on radioprotective compounds in the Genetics and Radiobiology Program of the National Commission of Nuclear Energy founded in 1960, at a time when the effects of radiation on living beings and radiation protection demanded the attention of highly localized groups of scientists and the creation of international as well as national institutions, and its connection to dosimetry and radiation protection until the 1990s. This historical reconstruction examines the circulation of knowledge, scientists, and their material and cognitive resources, to show that radiobiology, with dosimetry and radiation protection as cases in point, not only were carried out with high international standards in parallel with international agencies, but also reflected local material needs, including the standardization of new experimental techniques. (shrink)

While bioethicist Arthur Caplan claims that “The Nazi analogy is equivalent to dropping a nuclear bomb in ethical battles about science and medicine”, we claim that such total exclusion of this analogy is equally problematic. Our analysis builds on Roberto Esposito’s conceptualization of immunitas and communitas as key elements of biopolitics. Within public health theories and practices there is an inherent tension between exclusion (immunitas) and inclusion (communitas) forces. Taking the immunitas logic to the extreme, as National Socialist (...) medicine did in the name of securing the German race, is a constant danger that needs to be taken seriously into consideration when discussing public health policies. The tension between the silencing of the Holocaust in bioethical debates on one side, and the persistent use of National Socialist medicine metaphors, on the other hand, is the focus of this paper. By delving into the meanings and the implications of this two‐edged discourse, we argue that comparing post‐war bioethics with pre‐war medical practices from a biopolitical perspective has the potential to depict a more nuanced account of continuities and discontinuities in bioethics. (shrink)

During its career in North American social sciences and anthropology since the late 1960s the concept of ‘biomedicine’ acquired a large variety of meanings, sometimes even contradictory ones. Originating in research on biological and medical phenomena in technical areas like nuclear weapons, space flight, informatics or engineering, the term ‘biomedical’ entered politics and the social sciences, especially medical anthropology. Here it could mean medical research methods derived from biology as opposed to behavioural research or social sciences in general, the (...) complex of Western health care in non-Western countries and the reductionism and alleged Cartesian dualism of its approach - the opposite of traditional, religious, holistic and psychic views and treatment of illness. Oscillating between the levels of anthropological research or analysis and of practical health care delivery, intra- and cross-cultural perspectives and affirmative and critical attitudes the term has to be carefully considered in any reading of past and recent literature. The rather late German reception included replacing the term Schulmedizin born of older controversies on naturopathy, as well as naming the more somatic part of illness and medicine—as opposed to psychic or social aspects—and serving as the criticised object of many feminist and post-colonial studies on health. (shrink)

What is the true significance of biological kinship? During the last decades, it seemed to be uncontroversial that abandoned and even adopted people feel the negative impact of biological parents’ absence throughout life in several ways (Miller et al. 2000; Keyes, Margaret A., Anu Sharma, Irene J Elkins, and William G. Iacono, Matt McGue. 2008. The Mental Health of US Adolescents Adopted in Infancy. Archive Pediatric Adolescense Medicine 162(5): 419–425.). However, in the case of people conceived via “third-party reproduction”, (...) especially in sperm donation, the disruption of the kinship network derived from natural bonds tends to be presented as something irrelevant. This article disputes that assumption, explores its relationship with a deconstructivist vision that presents kinship as a purely social construct and defends the personal and existential value of a person’s biological bonds with her parents. While analysing the anthropological shift inherent to the way some political discourses present the nuclear family and heterologous biotechnology, it proposes renewed philosophical attention on the significance of filiation and human affinity. This article argues for the density of genealogical ties and defends that the consecration of an individual “right to a child”, namely (but not exclusively) through the normalised access to sperm banks, is incompatible with the rights of the child, since it deprives people from knowing not only who but also how is their father. (shrink)

Many Christian scholars, if not all of them, consider Genesis to be foundational texts of the Bible and the spring for all the other doctrines of the Scripture. Therefore, I'm considering the attempt to search and find arguments for cell therapy ethical issues in the fundamental text of Genesis as a challenging and educative task. Moreover, this could be the first step in analyzing the relationships between Christian religions and bioethics, in terms of finding reasonable decisions for ethical challenges, raised (...) by the current biomedical research. As for many other dilemmas of humanity, we have to recall the text of Genesis for analyzing the goodness or evilness of our actions in translational medicine, even though that is not the only way to get a reasonable ethical decision. My contribution is an essay that is trying to correlate the Genesis lessons with the needed arguments in deciding what could be good and what could be evil in the stem cell research, according to the religious convictions. The biggest challenges of biomedical research for Christian religions were due to the human cloning issue, made possible by the somatic cell nuclear transfer, but those challenges update the older debates on birth control pill, technologically assisted reproduction, or gene therapy. Issues related to in vitro fertilization, gene enhancement and gene therapy, human cell cloning, embryonic stem cell using, and chimera cell obtaining for research are being considered and related to the putative arguments extracted from the book of Genesis, describing the origins. As a matter of fact, I may conclude that the single way to reach a reasonable ethical decision in our society is to intersect ethics, science and theology and to engage large debates involving scientists, theologians, civil society representatives, ethicists (experts in applied ethics) and moral philosophers, having the two latest professionals as referees. (shrink)

Since the advent of the natural sciences, natural scientists have spread the idea that the pursuit of truth about the facts of the world is the main drive of scientific research. The aim, they say, is to acquire knowledge and to provide explanations and predictions of phenomena and events. Surprisingly, even in our contemporary world in which scientific research is strongly involved in seeking solutions to practical problems pertaining to the pursuit of food, water, energy, health, labor, peace, war, (...) class='Hi'>nuclear weapons, money, and the like, the pursuit-of-truth postulate nevertheless enjoys vigorous advocacy, especially in philosophy. In this chapter, the role that truth actually plays in medicine will be examined. Our discussion of this issue divides into the following four sections: 24.1 Truth in Medical Sciences; 24.2 Truth in Clinical Practice; 24.3 Misdiagnoses; 24.4 Truth Made in Medicine. In summary, it is shown that medical knowledge does not contain much truth because it mainly consists of hypotheses, theories, and deontic rules. The truth values of the former are unknown, while theories and deontic rules do not assume truth values. Likewise, in clinical practice true diagnoses and prognoses are not always attainable because (i) medical knowledge is inevitably vague, uncertain, and unreliable and is therefore scarcely truth-conducive; (ii) this also applies to most parts of patient data; (iii) physicians are not trained in viable and efficient methodology of clinical reasoning; and (iv) neither clinical decision support systems nor the automation of clinical decision-making will be able to compensate for the first two shortcomings. So, misdiagnoses will remain inevitable forever, although their frequency may be reduced by improving the techniques of clinical judgment. Since medical theories are artifactual structures and medical languages are artifactual systems, the truth of diagnoses and prognoses, and of any other judgment based thereon is made in medicine. (shrink)

Early practitioners of the social studies of science turned their attention away from questions of institutionalisation, which had tended to emphasize macrolevel explanations, and attended instead to microstudies of laboratory practice. The author is interested in re-investigating certain aspects of institution formation, notably the formation of scientific, medical, and engineering disciplines. He emphasises the manner in which science as cultural practice is imbricated with other forms of social, political, and even aesthetic practices. The author considers the following topics: the organic (...) physics of 1847; the innovative research program of Carl Ludwig as a model for institutionalising science-based medicine, optics, painting, and ideology in Germany, 1845-95; the Haber-Bosch synthesis of ammonia; and the introduction of nuclear magnetic resonance instrumentation into the practice of organic chemistry. (shrink)

Although many scientists view cloning as a useful procedure for scientific research into early embryo development—one that cannot currently be used to produce multiple copies of humans—the popular literature has led some individuals to view it as sinister. To address the concerns of the public, various conceptions of cloning are distinguished and their basis in fact analyzed. The possible uses, benefits, and detriments of both embryo splitting and nuclear transplantation are explained. Once the nature and purposes of cloning are (...) understood, and the distinctive ethical dilemmas created by embryo splitting and nuclear transplantation are sorted out, these procedures should be clinically implemented to assist in vitro fertilization treatment for those who are infertile and to further other therapeutic and investigational efforts in medicine. (shrink)

This doctoral dissertation deals with the psychotherapeutic factor that permeates the whole Epicurean philosophical program. It is the aim of this study to research and to rehabilitate its healing function. Since the Garden’s philosophy is a very systematic one, the question about the natural reality, φύσις, had to be addressed firstly. Anti-nihilism, materialism, eternal atoms, infinite void, perpetual movement, clinamen and the plurality worlds are key notions of the axiomatic and scientific Epicurus’ physics. Once we had gained clarity about those (...) core concepts, the central role of human beings in the system was to be discussed. As natural, yet exceptional, atomic compounds, men and women do have flesh and soul and are, therefore, completely mortal. Nevertheless, they possess numerous qualities, originating in their ψυχή, which render them unique : freedom, rationality and even a material community with the gods. According to Epicurus, there is a fourth element constituting the souls of both people and deities, so that a physical continuity and material formation are preserved through the entire nature. Gods are studied from a naturalistic physiologic perspective and at the very same time they act exemplary and, freed from any providential, governing tasks, they provide a regula uitae in order to achieve a pleasant, authentic happiness. In fact, this research tries to demonstrate that complete curation is not to be linked to an eternal extra-corporeal soul, but arises from the removal of pain and fear, aponia and ataraxia. These two are the paramount pleasures, far distant from a gross hedonism. Ethics are, then, presented as a soothing practice, having a nuclear medical purpose. Taking this into account, it was necessary to explore the historical connections between philosophy and rational Hellenic medicine before Epicurus. After that, multiple therapeutic forms conceived or applied by the Samian philosopher were analyzed. The λόγος proved to be the unifying element among them and involved not only human reason but also analogy. Epicurus’ diagnose is very sad: we are in pain. To reverse that, he presented exercises such as meditation, confession, self-examination, laugh therapy, emotional intelligence, intrusive thoughts control, companionship, solidarity and friendship. There are still two additional therapies completing the above mentioned: an Epicurean thanatology, because we miss the point when considering (im)mortality and forget about sensation as the ground of any life; and an ars desidrandi, because we should accept only natural and necessary desires, instead of chasing whimsy dreams with vain hopes. All this will help us regain our primal bodily and mental health and happiness, our essential, frugal and glad wellbeing. By means of prudence and reflection, governing our body and cultivating our mind we will liberate ourselves and taste a durable, profound, stable joy, comparable to that of the gods. (shrink)

This book deals with the psychotherapeutic factor that permeates the whole Epicurean philosophical program. It is the aim of this study to research and to rehabilitate its healing function. Since the Garden’s philosophy is a very systematic one, the question about the natural reality, φύσις, had to be addressed firstly. Anti-nihilism, materialism, eternal atoms, infinite void, perpetual movement, clinamen and the plurality worlds are key notions of the axiomatic and scientific Epicurus’ physics. Once we had gained clarity about those core (...) concepts, the central role of human beings in the system was to be discussed. As natural, yet exceptional, atomic compounds, men and women do have flesh and soul and are, therefore, completely mortal. Nevertheless, they possess numerous qualities, originating in their ψυχή, which render them unique: freedom, rationality and even a material community with the gods. According to Epicurus, there is a fourth element constituting the souls of both people and deities, so that a physical continuity and material formation are preserved through the entire nature. -/- Gods are studied from a naturalistic physiologic perspective and at the very same time they act exemplary and, freed from any providential, governing tasks, they provide a regula uitae in order to achieve a pleasant, authentic happiness. In fact, this research tries to demonstrate that complete curation is not to be linked to an eternal extra-corporeal soul, but arises from the removal of pain and fear, aponia and ataraxia. These two are the paramount pleasures, far distant from a gross hedonism. Ethics are, then, presented as a soothing practice, having a nuclear medical purpose. Taking this into account, it was necessary to explore the historical connections between philosophy and rational Hellenic medicine before Epicurus. After that, multiple therapeutic forms conceived or applied by the Samian philosopher were analyzed. The λόγος proved to be the unifying element among them and involved not only human reason but also analogy. Epicurus’ diagnose is very sad: we are in pain. To reverse that, he presented exercises such as meditation, confession, self-examination, laugh therapy, emotional intelligence, intrusive thoughts control, companionship, solidarity and friendship. There are still two additional therapies completing the above mentioned: an Epicurean thanatology, because we miss the point when considering (im)mortality and forget about sensation as the ground of any life; and an ars desidrandi, because we should accept only natural and necessary desires, instead of chasing whimsy dreams with vain hopes. All this will help us regain our primal bodily and mental health and happiness, our essential, frugal and glad wellbeing. (shrink)

On September 27, 2016 people across the world looked down at their buzzing phones to see the AP Alert: “Baby born with DNA from 3 people, first from new technique.” It was an announcement met with confusion by many, but one that polarized the scientific community almost instantly. Some celebrated the birth as an advancement that could help women with a family history of mitochondrial diseases prevent the transmission of the disease to future generations; others held it unethical, citing medical (...) tourism and consequences for the future of the therapy. The child in question was actually born a few months earlier on April 6, 2016, but the research was published a few months later in the October edition of Fertility and Sterility. The mother carries DNA that could have given the baby Leigh Syndrome, a severe neurological disorder characterized by psychomotor regression that typically results in death between ages two and three.[1] Also known as subacute necrotizing encephalomyelopathy, Leigh Syndrome is caused by genetic mutations in mitochondrial DNA, which causes defective oxidative phosphorylation. Because people with this condition cannot re-form ATP, “demyleniation, gliosis, necrosis, spongiosis, or capillary proliferation”[2] can occur, thereby producing bilateral lesions across the central nervous system. The 36-year-old mother previously had four miscarriages and successfully birthed two children, both of whom survived less than six years due to the syndrome. For religious reasons, the mother opted for Spindle Nuclear Transfer instead of Pronuclear Transfer,[3] which many religious organizations oppose because it entails the destruction of fertilized eggs.[4] In Pronuclear Transfer, both the parent and donor egg are fertilized. The parent’s nuclear material is then removed from the egg containing mutated mitochondria and inserted into the fertilized donor egg—from which the original nuclear material has been removed and destroyed. Spindle Nuclear Transfer, on the other hand, removes the mother’s nuclear material from the egg with unhealthy mitochondria, then implants it into a donor’s egg. The newly created egg is then fertilized with the father’s sperm. This Spindle Nuclear Transfer was performed in Mexico by a team of doctors led by Dr. John Zhang, the founder of the New Hope Fertility Center in New York City. In their report, the doctors outline that five oocytes were successfully reconstituted, four of which developed into blastocysts. Only one was euploid: containing 46 XY chromosomes. Researchers then biopsied that blastocyst and found that the transmission rate of maternal mtDNA was, “5.10 ± 1.11% and the heteroplasmy level for 8993T>G was 5.73%.”[5] This indicates that at the blastocyst stage, around five percent of the mitochondria are from the original maternal egg with the mutation for Leigh Syndrome. After birth, they biopsied different tissues and found that they had an average of less than 1.60 ± 0.92% of transmitted mtDNA from the original maternal egg. The baby is reportedly doing well and the team of doctors concluded that “[h]uman oocytes reconstituted by SNT are capable of producing a healthy live birth. SNT may provide a novel treatment option in minimizing pathogenic mtDNA transmission from mothers to their babies."[6] Even when considered theoretically, Spindle Nuclear Transfer is controversial. Many doctors believe that the risks at this stage of research are too great. Dr. Trevor Stammers, a bioethicist at St. Mary’s University in London, points out: “We do not yet have a clear picture of the interaction between nuclear DNA and mitochondria.”[7] Others hold that faulty mitochondrial DNA can still be transferred during the procedure. Still more argue this technology could create problems because of germline modification.[8] Dr. Paul Knoepfler, a cell biologist at the UC Davis School of Medicine, explains: “Since this is uncharted territory and the children born from this technology would have heritable genetic changes, there are also significant unknown risks to future generations.”[9] However, proponents counter these arguments. They say the benefits outweigh the risks, as “mitochondrial replacement techniques [like Spindle Nuclear Transfer] would eliminate maternal transmission of mitochondrial disease… allowing a woman with a family history of mitochondrial diseases to ensure her children would not be affected.”[10] Additionally, experts say that no symptoms will occur if less than 20% of the transferred mitochondrial DNA is faulty.[11] And while opponents see potential germline modification as a problem, advocates answer that this could stop a family history of mitochondrial disease, which they deem a more serious concern. In this case specifically, however, there are more issues at hand. While the team of doctors did eliminate the possibility of germline modification by selecting a male embryo, there are other ethical concerns. Some argue that this case could be described as “medical tourism.” While New Hope Medical Clinic does maintain a branch in Mexico, Dr. Zhang stated that Mexico has “no rules.”[12] It is a country with underdeveloped regulations, making it difficult to confirm that doctors adhere to widely-held medical and ethical standards. Furthermore, while it is highly unlikely that the child will develop Leigh’s Syndrome, Dr. Dietrich Egli of the New York Stem Cell Foundation says the 5% mitochondrial transfer rate indicates that the technique “was not carried out well.”[13] He points to studies of embryos where the rate of mtDNA transfer was almost ten times lower. Spindle Nuclear Transfer is currently legal in the UK,[14] and many are hoping to see it legalized in the US, although Congress currently prohibits the FDA from considering applications that would entail trials in people.[15] While Dr. Zhang’s work is arguably revolutionary, many wonder if the manner in which this study was performed—in Mexico and with a high mitochondrial transfer rate—will impact the technology’s future in the US. Last week, Dr. Zhang presented the report to scientists gathered in Salt Lake City, saying that while science isn’t a race, it is “in a sense, a race for the family to find a cure, to find hope.”[16] Only time will tell if this study set back other families racing and hoping for a cure. References 1. "Leigh Syndrome." Genetics Home Reference, US National Library of Medicine, 25 Oct. 2016. Accessed 26 Oct. 2016. 2. McKusick, Victor A., and Ada Hamosh. "LEIGH SYNDROME; LS." Online Mendelian Inheritance in Man, Johns Hopkins University, 20 Jan. 2016. Accessed 30 Oct. 2016. 3. Zhang, J, H Liu, S Luo, A Chavez-Badiola, and Z Liu. "First live birth using human oocytes reconstituted by spindle nuclear transfer for mitochondrial DNA mutation causing Leigh syndrome." Fertility and Sterility, vol. 106, no. 3, 2016, pp. e375-76. Accessed 30 Oct. 2016. 4. Sample, Ian. "‘Three-parent’ babies explained: what are the concerns and are they justified?" The Guardian, 2 Feb. 2015. Accessed 30 Oct. 2016. 5. Zhang, et al. 6. Ibid. 7. Knapton, Sarah. "Three-parent babies: the arguments for and against." The Telegraph, 3 Feb. 2015. 8. Ibid. 9. Ibid. 10. "Mitochondrial Replacement Therapy FAQs." New York Stem Cell Foundation Research Institute, New York Stem Cell Foundation. Accessed 30 Oct. 2016. 11. Reardon, Sara. "‘Three-parent baby’ claim raises hopes — and ethical concerns." Nature, 28 Sept. 2016. Accessed 30 Oct. 2016. 12. Hamzelou, Jessica. "Exclusive: World’s first baby born with new “3 parent” technique." New Scientist, 27 Sept. 2016. Accessed 30 Oct. 2016. 13. Reardon, Sara. "‘Three-parent baby’ claim raises hopes — and ethical concerns." Nature, 28 Sept. 2016. Accessed 30 Oct. 2016. 14. "3-Person IVF: A Resource Page." Center for Genetics and Society, 24 Oct. 2016. Accessed 30 Oct. 2016. 15. Ritter, Malcolm. "Baby born with DNA from 3 people, first from new technique." Associated Press, 27 Sept. 2016. Accessed 30 Oct. 2016. 16. Chen, Daphne. "Controversy swirls around first three-parent baby." Deseret News, 19 Oct. 2016. Accessed 30 Oct. 2016. Works consulted Swetlitz, Ike. "FDA urged to approve ‘three-parent embryos,’ a new frontier in reproduction." STAT, 3 Feb. 2016. Accessed 30 Oct. 2016. (shrink)

This volume brings together research in the GeoHumanities from various intellectual perspectives to illustrate the benefits of humanities-inspired approaches in understanding and confronting historically entrenched and recently emergent health-related challenges. In three main sections, this volume seeks to foreground the richness of work entangling medicine and health with the concerns of geography and of the Humanities. This volume will be of interest to academics and researchers in the Geographies of health and medicine, social sciences in GeoHumanities, and health (...) humanities, and students in programs focusing on the humanities and health. In the book's first section, Bodies, the authors explore the material, sensory and more than physical capacities of bodies in accounting for experiences of death, air raids, immigration, dance therapy, asthma and blindness. Section two, Voice, addresses the nature of evidence, HIV/AIDS policy, patient voices in animal research, homelessness, and constructions of truth. The final section, Practice, focuses on creative writing, as well as the pedagogic tools of teaching with the asylum, the creative practice of nuclear emergency planning zones, arts-based care for the elderly, and cartographic practices within health research. (shrink)

While chemists today work in a variety of professional domains—ranging from medicine and pharmaceutical companies to nuclear technology, biotechnology, and nanotechnology—students are taught chemistry as if it were a unified discipline with a specific territory and a common language shared by all chemists. The chemists’ imaginary is shaped around the image of a diaspora: a scattered population of former inhabitants of a homeland immersed in foreign countries and yet retaining their cultural identity. This essay suggests an alternative perspective (...) on the basis of four different case studies of engagement of chemists beyond the traditional turf of chemistry: nuclear technology, materials science and engineering, synthetic biology, and nanotechnology. Instead of assuming that there is a predetermined territory of chemistry, it argues that the epistemic profile of chemistry is shaped by the various “terrains” (or fields) where chemists are working. The image of a family tree deeply rooted in soil should be replaced by that of a large and loose rhizome network. (shrink)

This paper traces the diverse contexts of radiation protection from liberation in post-1945 South Korea to its professionalization by the early 1970s, using the emerging field of health physics as the focus. The Korean nuclear center, AERI, started two affiliates, RRIA and RRIM in the early 1960s. In particular, RRIM emphasized the use of radiation within cancer research, especially the use of cobalt in treating patients. In this context, health physics initially took the form of “radiation medicine.”With the (...) two institutes returning to AERI’s fold in 1973, health physics took another turn: the second major subfield, following “radiation medicine,” invoked a broader conception of “radiation protection,” which now referred to a cluster of related interests, including the environment and the effects of industrialization.Rather than a simple transfer of American and international models after 1953, Korean health physics reflects its origins in a post-colonial research setting, one more diverse than its “official” institutional context at AERI. (shrink)

Stem cell research has important implications for medicine. The source of stem cells influences their therapeutic potential, with stem cells derived from early-stage embryos remaining the most versatile. Somatic cell nuclear transfer (SCNT), a source of embryonic stem cells, allows for understandings about disease development and, more importantly, the ability to yield embryonic stem cell lines that are genetically matched to the somatic cell donor. However, SCNT requires women to donate eggs, which involves injection of ovulation-inducing hormones and (...) egg retrieval through laparoscopy or transvaginal needle aspiration. Risks from this procedure are fiercely debated, most notably risk of ovarian hyperstimulation syndrome (OHSS). This review examines risk of OHSS resulting from oocyte donation. We conclude that risk posed by OHSS in egg donation is not significant enough to warrant undue concern, and much of this can be eliminated when proper precautions are taken. This bears relevance to the future of stem cell research policymaking. (shrink)

Law can greatly facilitate responses to public health emergencies, including naturally-occurring infectious disease outbreaks and intentional or accidental exposures to chemical, biological, radiological, or nuclear agents. At the federal level, the Secretary of the Department of Health and Human Services, as the lead for federal public health and medical responses to public health emergencies and incidents, has a range of authorities to support federal, state, tribal, local, and territorial responses. For example, under the Public Health Service Act, the Secretary (...) may provide temporary assistance to States to meet health emergency needs or deploy medicine and supplies from the Strategic National Stockpile. The Secretary also may determine that a disease or disorder presents a public health emergency, which may be the first step in triggering other critical legal authorities for response.Since the 2001 anthrax attacks, one focus of public health preparedness has been on developing, distributing, and rapidly dispensing medical countermeasures for CBRN emergencies and pandemics. (shrink)

This paper discusses two proposals to the US President’s Council on Bioethics that try to overcome the issue of killing embryos in embryonic stem cell research and argues that neither of them can hold good as a compromise solution. The author argues that the groups of people for which the compromises are intended neither need nor want the two compromises, the US government and other governments of countries with restrictive regulation on ES cell research have not provided a clear and (...) sound justification to take into account minority views on the protection of human life to such a considerable extent as to constrain the freedom of research in the area of stem cell research, and the best way to deal with these issues is to accept that many people and most governments adopt a gradualist and variable viewpoint on the human embryo which implies that embryos can be sacrificed for good reasons and to try to find other, less constraining, ways to take into account minority views on the embryo. Finally, another more efficient and time and money sparing compromise will be proposed for those who accept IVF, a majority in most societies.STEM CELL RESEARCHStem cells are widely believed to represent one of the greatest promises for medicine and biomedical research in the coming century with hopes raised for treatments for common diseases and conditions, including neurological disease or injury, diabetes, and myocardial infarct. At present there are three main lines of stem cell research, namely on stem cells originating from early in vitro embryos, left over from infertility treatment, or especially created for research through in vitro fertilisation or cell nuclear transfer cells), on cord blood derived stem cells, and on stem cells from more developed tissues or organs from foetuses …. (shrink)

Fifteen to twenty years ago one might have been forgiven for thinking that both the philosophy and history of science constituted specialized academic backwaters, far removed from debates in the forefront of either philosophic or public attention. But times have changed; science and technology have in many ways and in many guises become central foci of public debate, whether through concern over nuclear safety, the massive price to be paid for continued research in areas such as high energy physics, (...) the cost of high technology medicine, the spectre of genetic engineering, or the wonders of information processing and the computer revolution. At the same time that there is public questioning of the authority of expert scientific pronouncements and debate about the wisdom of courses of action proposed in the name of technology and progress, there is political pressure to direct eduction in an increasingly scientific and technological direction. But even so, in this country, the history and philosophy of science remain peripheral disciplines, not only in relation to the total academic scene but even in relation to philosophy, which is itself being academically marginalized. (shrink)

Table of Contents I. WHO ARE THE SCIENTISTS? Historically. Women in the Origins of Modern Science, Londa Schiebinger. Women of Third World Descent in the Sciences, Sandra Harding. Recently. Women in Science: Half In Half Out, Vivian Gornick.”How Can a Little Girl Like You Teach a Great Big Class of Men?’ the Chairman Said, and Other Adventures of a Woman in Science, Naomi Weisstein. The Anomaly of a Woman in Physics, Evelyn Fox Keller. Currently. Women Join the Ranks of Science (...) but Remain Invisible at the Top, Natalie Angier. Creeping Toward Inclusivity in Science, Phyllis Goldberg. II. WHAT KIND OF ENTERPRISE IS SCIENCE? Science’s Aims, Methods, and Norms of Behavior. Patriarchy, Scientists, and Nuclear Warriors, Brian Easlea. Culturally Inclusive Chemistry, Catherine Hurt Middlecamp. A World of Difference, Evelyn Fox Keller. Interviewing Women: A Contradiction in Terms, Ann Oakley. Science’s Subject Matter. Have Only Men Evolved?, Ruth Hubbard. Empathy, Polyandry, and the Myth of the Coy Female, Sarah Blaffer Hrdy. The Importance of Feminist Critique for Contemporary Cell Biology, The Biology and Gender Study Group. The Engendering of Archaeology: Refiguring Feminist Science Studies, Alison Wylie. Still Seeking Transformation: Feminist Challenges to Psychology, Sue Wilkinson. Science’s Social Effects. Androcentric Bias in Clinical Research, Sue Rosser. Man-Made Medicine and Women’s Health, Nancy Krieger and Elizabeth Fee. The New Procreative Technologies, Ruth Hubbard. A Question of Genius: Are Men Really Smarter Than Women?, Anne Fausto-Sterling. III. WHAT KIND OF ENTERPRISE OUGHT SCIENCE TO BE? Feminist Empiricism. Subjects, Power, and Knowledge: Description and Prescription in Feminist Philosophies of Science, Helen Longino. Epistemological Communities, Lynn Hankinson Nelson. Feminist Standpoint Theory. ”Strong Objectivity’: A Response to the New Objectivity Question, Sandra Harding. Introduction to Tomorrow’s Tomorrow: The Black Woman, Joyce Ladner. Feminist Postmodernism. Situated Knowledges: The Science Question in Feminism and the Privilege of Partial Perspective, Donna Haraway. Though This Be Method, Yet There Is Madness in It: Paranoia and Liberal Epistemology, Naomi Scheman. (shrink)

Despite a long tradition of research in applied genetics, particularly in agricultural research, in Italy the transition to the new knowledges and techniques of molecular biology was long and difficult. Political and financial constraints made academic institutions very slow to grasp the importance of molecular approaches to biology and medicine. In fact, the main studies concerning problems of molecular biology took place inside non-academic institutions. We reconstruct the complex paths leading to the birth of the International Laboratory of Genetics (...) and Biophysics (LIGB) in Naples, and describe its work and activities in the period in which it was directed by its creator, Adriano Buzzati-Traverso, between 1962 and 1969. The origins of the LIGB are inextricably bound to the growth of biophysical research at the University of Pavia and at the Higher Health Institute in Rome. For a short period, with the aid provided by Italian and European physicists to biological research on the effects of nuclear radiation, LIGB became a focal point in European molecular biology. In 1968 the scientific and educational activities of the LIGB dramatically fell victim to the contradictions of the Italian academic and scientific system, and to the political climate which emerged in Italy at the time. (shrink)

‘The living will envy the dead’: Medical responsibility in the face of a nuclear apocalypse, 1960-1989 During the 1980s, the heightening of tensions between nato and the Eastern Bloc motivated thousands of physicians to voice concerns about the medical consequences of a nuclear war. It seemed certain that such a conflict, extending to the major civilian centers and industrial areas of the protagonists, would see millions of casualties engulfing the health care systems. These gloomy predictions were coupled with (...) the prevalent idea that nuclear war is immoral and physicians have a special responsibility to prevent it. Although contested by a majority of physicians, the medical movement against nuclear weapons found more support than ever before. In the Netherlands this is explained by (1) the intensity of the public debate, (2) the medicalization of the subject and (3) the compulsory registration of all physicians for Civil Defense plans. These factors motivated one third of all Dutch physicians to openly refuse cooperation with Civil Defense authorities. The article concludes that fear of an uncontrollable disaster put an emphasis on the ethics of consequentialism. This encouraged physicians to take political action and stress the importance of social responsibility in medicine. (shrink)

The term Monte Carlo method indicates any computer-aided procedure for numerical estimation that combines mathematical calculations with randomly generated numerical input values. Today it is an important tool in high energy physics while physicists and philosophers also often consider it a sort of virtual experiment. The Monte Carlo method was developed in the 1940s, in the context of U.S. American nuclear weapons research, an event often regarded as the origin of both computer simulation and “artificial reality” (Galison 1997). The (...) present paper interrogates this strong claim by focusing on the emergence of Monte Carlo event generators in particle physics in the early 1960s. This historical case study shows how, as Monte Carlo computation became part of the toolbox of particle physicists around 1960, it was neither usually referred to as a “computer simulation” nor was it regarded as a surrogate for experimentation. In revising the history of this method, this paper asks, in what context did particle physicists of the 1960s decide to create FAKE, the first high-energy-physics Monte Carlo event simulator? What was their goal? And what epistemic role did FAKE play? In answering these questions, it is argued that Monte Carlo computations were not introduced into particle physics to simulate experiments, but rather they played the role of theoretical tools. The Monte Carlo method was able to do this thanks to its random component, a property which provided a means of modeling a specific phenomenon, so-called “(particle) resonances”. Indeed, in doing so, event generators even came to mutually assimilate and reshape the notions of particle and resonance, taking up an epistemic function which had previously been confined to physical-mathematical formulae: that of a medium which could express aspects of particle theory. (shrink)

The world is in a state of crisis. Global problems that threaten our future include: the climate crisis; the destruction of natural habitats, catastrophic loss of wild life, and mass extinction of species; lethal modern war; the spread of modern armaments; the menace of nuclear weapons; pollution of earth, sea and air; rapid rise in the human population; increasing antibiotic resistance; the degradation of democratic politics, brought about in part by the internet. It is not just that universities around (...) the world have failed to help humanity solve these global problems; even worse, they have made the genesis of these problems possible. Modern science and technology, developed in universities, have made possible modern industry and agriculture, modern hygiene and medicine, modern power production and travel, modern armaments, which in turn make possible much that is good, all the great benefits of the modern world, but also all the global crises that now threaten our future. What has gone wrong? The fault lies with the whole conception of inquiry built into universities around the world. The basic idea is to help promote human welfare by, in the first instance, acquiring scientific knowledge and technological know-how. First, knowledge is to be acquired; once acquired, it can be applied to help solve social problems, and promote human welfare. But this basic idea is an intellectual disaster. Judged from the standpoint of promoting human welfare, it is profoundly and damagingly irrational, in a structural way. As a result of being restricted to the tasks of acquiring and applying knowledge, universities are prevented from doing what they most need to do to help humanity solve global problems, namely, engage actively with the public to promote action designed to solve global problems. We need urgently to bring about a revolution in universities around the world, wherever possible, so that their central task becomes to help humanity learn how to solve the climate crisis and other problems of living, local and global, so that we may make progress towards a good, civilized world. Almost every branch and aspect of the university needs to change. (shrink)

“Iatrophilosophy” is defined as the translational discipline between medicine and philosophy that has a double objective, theoretical and practical. It is presented a model of practical iatrophilosophy applied to chronic pain associated with depression and stress—depresalgia—, that expands Phenomenologic, Hermeneutic, Dynamic Psychotherapy (PHD) to the general medical field. It starts from the general model of the medical triad - disease, illness, and sickness- and, in the horizon of Ortega's anthropology, five nuclear metaphors are proposed: greed of the body, (...) anguish of circumstance, personal tear, personal knots, and personal expropriation. These are related to the neurobiological mechanisms of central sensitization, allostasis, and alteration of the hypothalamic-pituitary-adrenal axis. A personal recovery process based on therapeutic concord is proposed. The analysis of chronic pain and other complex health problems can benefit from philosophical methodologies such as clinical hermeneutics. (shrink)

The US FDA currently encourages the addition of vitamin D to milk and cereals, with the aim of reducing rickets in children and osteoporosis in adults. However, vitamin D not only regulates the expression of genes associated with calcium homeostasis, but also genes associated with cancers, autoimmune disease, and infection. It does this by controlling the activation of the vitamin D receptor (VDR), a type 1 nuclear receptor and DNA transcription factor. Molecular biology is rapidly coming to an understanding (...) of the multiplicity of roles played by the VDR, but clinical medicine is having difficulty keeping up with the pace of change. For example, the FDA recently proposed a rule change that will encourage high levels of vitamin D to be added to even more foods, so that the manufacturers can claim those foods “reduce the risk of osteoporosis”. The FDA docket does not review one single paper detailing the transcriptional activity of vitamin D, even though, on average, one new paper a day is being published on that topic. Nor do they review whether widespread supplementation with vitamin D, an immunomodulatory secosteroid, might predispose the population to immune dysfunction. This BioEssay explores how lifelong supplementation of the food chain with vitamin D might well be contributing to the current epidemics of obesity and chronic disease. BioEssays 30:173–182, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

This study examines an important aspect of energy history and policy: the intertwinement of energy technologies with ideals. Ideals play an important role in energy visions and innovation pathways. Aspirations to realize technical, social, and political ideals indicate a long-term commitment in the design of energy systems, distinguishable from commitment to other abstract goals, such as values. This study offers an analytical scheme that could help to conceptualize these differences and their impact on energy policy. In the proposed model, two (...) spheres of interaction are highlighted: a material sphere in which values and technologies co-evolve, and an imaginary sphere in which ideals interact with idealized technologies. Furthermore, the relation between these two spheres can be understood in different ways. This study examines three cases that are illustrative of the different roles of ideals in the development of energy technologies and visions: (1) the evolution of safety in nuclear reactor design; (2) visions of atomic power in France; (3) the political idealization of a tidal power scheme in the Severn Estuary. Finally, the developed model implies more general insights for the development of sociotechnical systems. Amongst others, it shows why certain projects and technologies remain a political, but not a techno–economic option. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Future Directions for Human Cloning by Embryo Splitting:After the HullabalooCynthia B. Cohen (bio)In October 1993, a paper entitled, "Experimental Cloning of Human Polyploid Embryos Using an Artificial Zona Pellucida," was presented at a joint meeting of the American Fertility Society and the Canadian Fertility and Andrology Society. Although it was awarded a prize, its authors, who are affiliated with George Washington University, decided against calling a press conference to (...) announce their findings. Word of their experiment soon leaked out, however, and the New York Times blazoned on its front page that human embryo cloning had been achieved. The story was accompanied by a diagram of cloning by nuclear transplantation.Newspapers and television networks around the world picked up the story and embellished it. The idea of unlimited, xeroxed copies of human beings gripped the public imagination. Wild scenarios of hundreds of Hitlers plotting to take over the world and of clones giving birth to their own twins enlivened media reports. Only gradually did it become clear that the term "polyploid" in the title of the paper referred to abnormal embryos that could never develop into living human beings and that "cloning" referred to embryo splitting or twinning, not to nuclear transplantation or the transfer of a donor nucleus into an enucleated egg. Once this sank into public consciousness, the "hullabaloo," as Dr. Howard W Jones, Jr., called it, died down.It left in its wake unanswered questions about the ethics of splitting embryos. During the height of the publicity given to the George Washington experiment, newspaper and TV stories had not delved in any depth into the ethical issues it raised. Ethicists, given limited time to discuss the ethical questions at stake, had been quoted in quick, simplistic responses. Some had offered little analysis of the rights and wrongs of embryo splitting, but, revealing tremendous creative talent, had spun out [End Page 187] imaginary and frightening applications of the procedure. This was a story essentially about ethics in which ethics was never really discussed.The National Advisory Board on Ethics in Reproduction* (NABER), an independent, multidisciplinary group that addresses ethical issues in modern reproductive science, technology, and care, became concerned about the sparsity of reflective ethical debate about embryo splitting. NABER's chair, Albert Jonsen, observed that "reporters phoning ethicists for comment and ethicists appearing on talk shows do not a debate make. Debate requires face to face (or at least essay to essay) argument among persons sharing the same information. This has yet to take place." Consequently, NABER decided to convene a workshop on human cloning by embryo splitting at the National Academy of Sciences in February 1994. The board invited participants who would provide a broad range of opinion about the ethical and public policy issues entailed by human embryo splitting. Embryologists, ethicists, reproductive biologists, public policy experts, staff from the National Institutes of Health (NIH), legal scholars, journalists, and infertility specialists were among those who participated. The feature articles in this issue of the Kennedy Institute of Ethics Journal derive from that workshop. Their authors were given free rein to take whatever stance they deemed ethically supportable.The first article is designed to provide some understanding of the science of human cloning as a basis for exploring the ethical issues raised by this set of techniques. Jacques Cohen, a leading reproductive embryologist, and Giles Tomkin, a science writer, both of Cornell University Medical School, explain, in a way that is clear to laypersons and biologists alike, the meaning, nature, and function of cloning. They discuss recent: advances in this area and offer an assessment of feasible uses of human cloning procedures, hoping to dispel what they view as mistaken fears about its future applications. Dr. Howard W Jones, Jr., a pioneer infertility specialist, briefly comments on Cohen and Tomkin's paper, pointing out that embryo splitting may not improve pregnancy results if genetic heterogeneity is required for successful embryo transfer and implantation.In the next article, three major ethical arguments against human cloning by embryo splitting are analyzed and rejected by Ruth Macklin, an expert in reproductive ethics from Albert Einstein College of Medicine. She finds the first argument, that the worth of individuals... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 12.1 (2002) 95-102 [Access article in PDF] Bioethics Inside the Beltway Some Initial Reflections on NBAC Eric M. Meslin and Harold T. Shapiro On 3 October 2001, Executive Order 12975 expired, and with it so too did the National Bioethics Advisory Commission (NBAC). Established by President Bill Clinton in 1995, NBAC was the fifth national committee since 1974 created to advise the U.S. government (...) on bioethics policy. In the long political tradition in this country that national bioethics policy advice should use temporary rather than permanent bodies, NBAC followed in the footsteps of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (1974-78); the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (1980-83); the Ethics Advisory Board (1978-80); and the Biomedical Ethics Advisory Committee (1988-89). Arguably, other distinguished panels could lay claim to recognition as a "national bioethics committee" including the Advisory Committee on Human Radiation Experiments (ACHRE) (1994-95); the Fetal Tissue Transplantation Research Panel (1988); the Human Embryo Research Panel (1994); and the National Institutes of Health (NIH) Recombinant DNA Advisory Committee (RAC), which continues to function.These committees and commissions form a kind of a continuum, albeit occasionally interrupted by periods during which no such bodies existed. Each arose from a particular confluence of events and circumstances. NBAC was no different; its history can be traced both to a series of discussions within the White House Office of Science and Technology Policy beginning in 1993 (NBAC 1998a, p. 3), and to a specific recommendation from ACHRE that called for a national committee to address ethical issues in human subjects research (ACHRE 1995, p. 817). Nbac's Impact In his useful comparison of the accomplishments of the National Commission and the President's Commission, Brad Gray concluded that seven lessons were learned, the sixth of which was that "nothing substitutes for having a perceptible impact on either policy or practice" (Gray 1995, p. 304). Assessing NBAC's [End Page 95] impact on "policy or practice" is difficult, particularly given the fact that it so recently completed its work. More time may be needed before a full assessment can be undertaken of the impact of its six reports (and their total of 120 recommendations). Instead, in this essay we offer some reflections on NBAC's initial impact, using some specific examples of how bioethics gets done Inside the Beltway. Eliciting Reaction If immediate reaction by the White House is any measure of impact, then Cloning Human Beings (NBAC 1997) had a significant one. The day after he received this report in a Rose Garden ceremony, President Clinton submitted a bill to Congress that would have extended the moratorium on federal funding to create a child using somatic cell nuclear transfer. This bill never passed, nor has any other bill emerged that has enjoyed the support of the House and the Senate. Five states have enacted legislation to date, but these vary in their permissibility from bans on all forms of cloning to bans similar to the one proposed by NBAC, which recommended a time-limited prohibition only on somatic cell transfer to create a child (reproductive cloning).If the Cloning report elicited speedy action from the White House, this paled in comparison to the reaction that led to and, in turn, was created by Ethical Issues in Human Stem Cell Research (NBAC 1999a). Those who believe that government moves slowly need only be reminded of the events of 8-14 November 1998 (and, as we shall mention below, the further events of 14 July 1999). Some will recall that early in the second week of November 1998, James Thomson and his colleagues published in Nature and John Gearhart and his colleagues published in the Proceedings of the National Academy of Sciences that they had isolated and cultured human primordial stem cells and germ cells respectively. Within days of these remarkable reports, Advanced Cell Technology (ACT) announced via an article written by Nicholas Wade in the... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 12.3 (2002) 305-323 [Access article in PDF] Scope Note 41 Bioethics and Cloning, Part I Susan Cartier Poland and Laura Jane Bishop This is Part One of a two part Scope Note on Bioethics and Cloning. Part Two will be published in the December 2002 issue of the Kennedy Institute of Ethics Journal and as a separate reprint. Contents For Parts 1 And 2 (...) Part 1Part 2I.History of the ScienceI.Ethical PerspectivesII.Historical CommentaryII.Religious PerspectivesIII.Animal WelfareIII.Fiction and FilmIV.Laws and Legal Literature"Clone" is a collective noun (I, Stewart 1997, p. 771). A collective noun names a group and is composed of individual members, such as "herd" or "flock." Derived from the Greek kl¯on for twig or slip, "clone" was first used in biology to describe the aggregate of asexually produced progeny of an individual, either naturally occurring or man-made; the definition later expanded to mean a group of genetically identical members who originate from a single ancestor. Thus, a clone is a group that results from the process of asexual reproduction.In nature, cloning occurs either by parthenogenesis (reproduction without fertilization) or by fission (embryo splitting). In a pioneering experiment in 1952, Robert Briggs and Thomas J. King (I, 1952), cancer researchers at the Institute for Cancer Research (today part of the Fox Chase Cancer Center) in Philadelphia, demonstrated on frogs another method of cloning by transplanting nuclei into enucleated cells, a technique called "nuclear transplantation," which John B. Gurdon and colleagues (I, 1958, 1975) used to create clones of frogs.Then, in the late 1970s and early 1980s, two back-to-back frauds in cloning occurred. First, the cloning of a human described by American science journalist David Rorvik in the 1978 book In His Image was called a hoax by a court in [End Page 305] 1982. Second, the cloning of three mice, announced by German wunderkind Karl Illmensee to scientific circles in 1979 (and to the public in 1981), could not be proven to be true, according to convincing evidence by McGrath and Solter (I) published in 1984.With their pronouncement that mammalian cloning was impossible, McGrath and Solter essentially stopped cloning research and funding for such biological research. So by the mid-1980s, instead of further investigating cloning, developmental biologists studied embryology related to in vitro fertilization, while molecular biologists studied recombinant DNA under the newly relaxed NIH guidelines. These two strands of scientific investigation came together in the work of Ian Wilmut, who created in vitro embryos using nuclear transplantation to reproduce genetically engineered cattle. Wilmut was seeking a way to increase the successful birth rate when, in the 1990s, he produced identical twin sheep, Megan and Morag, cloned from an embryonic cell, followed by another sheep, Dolly, cloned from an adult cell. The birth of a mammal from an embryo whose genetic material came from an adult cell firmly re-established the possibility of cloning from adults. Prior to Dolly's birth, scientists believed that adult cells lost the ability to dedifferentiate—i.e., to become unspecialized—and so could not direct the development of an embryo through to birth.The 1997 announcement of Dolly's birth initiated the present widespread discussion of cloning. Because of its potentially vast applications across human health, medicine, agriculture, and business/economics, cloning raises a host of issues including those concerning: genetics and genetic engineering, patenting, animal rights and/or animal welfare (especially for transgenic, research, or cloned animals), organ transplantation, reproduction, eugenics, pharmacology (drug production using transgenic animals), research practices, informed consent, stem cell research, women's rights, children's rights, parental rights and responsibilities, and theology and philosophy. It fosters questions about the meaning and purpose of life, the limits of human powers to intervene in research and therapy, and what it means to be human or animal. In addition, environmentalists and organic farmers raise concerns about the effect of novel animals and plants on the environment, while nutritionists and the lay public wonder... (shrink)

Two groups of scientists have just announced what is being described as a leap forward in human stem cell research.1–3 Both have found ways of producing what are being called “induced pluripotent cells” , stem cells that they hope will demonstrate the same key properties of regeneration and unrestricted differentiation that human embryonic stem cells possess, but which are derived from skin cells not from embryos. In simple terms, these scientists have succeeded in reprogramming skin cells to behave like hESCs.Stem (...) cell research has been hailed as one of the most important and exciting areas of science, because it is believed that these types of cells will not only play an important part in regenerative medicine, but also yield valuable scientific information. These latest developments in cell reprogramming represent a milestone for stem cell science. No longer does the paradigm of irreversible cell specialisation hold true; instead, almost any type of cell might have the potential to become any other.The advent of techniques for producing these iPCs has also been hailed as an ethical breakthrough. Up until now, the production of hESCs has required a process which involves the destruction of embryos. Many of these embryos are available as by-products of IVF; but in addition, the process of somatic cell nuclear transfer to produce cloned embryonic stem cells requires a supply of human oocytes, which must currently be harvested from female donors at no insignificant cost. In a nutshell, iPCs seem to enable us to produce “embryo-free” human pluripotent stem cells, and in a “gender-neutral” way—that is, without the need for human oocytes.The response from the scientific community, ethical commentators and the public has, however, reflected an inherent confusion over the ethical significance of this research. The anti-embryo …. (shrink)