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

The shapes of neurons and glial cells dictate many important aspects of their functions. In olfactory systems, certain architectural features are characteristics of these two cell types across a wide variety of species. The accumulated evidence suggests that these common features may play fundamental roles in olfactoryinformation processing. For instance, the primary olfactory neuropil in most vertebrate and invertebrate olfactory systems is organized into discrete modules called glomeruli. Inside each glomerulus, sensory axons and CNS neurons branch and synapse in patterns (...) that are repeated across species. In many species, moreover, the glomeruli are enveloped by a thin and ordered layer of glial processes. Theglomerular arrangement reflects the processing of odor information in modules that encode the discrete molecular attributes of odorant stimuli being processed. Recent studies of the mechanisms that guide the development of olfactory neurons and glial cells have revealed complex reciprocal interactions between these two cell types, which may be necessary for the establishment of modular compartments. Collectively, the findings reviewed here suggest that specialized cellular architecture plays key functional roles in the detection, analysis, and discrimination of odors at early steps in olfactory processing. (shrink)

Sensation of Movement explores the role of sensation in motor control, bodily self-recognition and sense of agency. The sensation of movement is dependent on a range of information received by the brain, from signalling in the peripheral sensory organs to the establishment of higher order goals. Through the integration of neuroscientific knowledge with psychological and philosophical perspectives, this book questions whether one type of information is more relevant for the ability to sense and control movement. Addressing conscious sensations of movement, (...) experimental designs and measures, and the possible functions of proprioceptive and kinaesthetic information in motor control and bodily cognition, the book advocates the integration of neuroscientific knowledge and philosophical perspectives. With an awareness of the diverse ideas and theories from these distinct fields, the book brings together leading researchers to bridge these divides and lay the groundwork for future research. -/- Contributors: Thor Grünbaum and Mark Schram Christensen Andreas Kalckert Myrto Mylopoulos Mads Jensen, Mia Dong, Mikkel C. Vinding, and Morten Overgaard Anne Kavounoudias Matthew R. Longo Hong Yu Wong. (shrink)

The argument of the Transcendental Deduction of the Categories in the Critique of Pure Reason is the deepest and most far-reaching in philosophy. In his new book, Robert Howell interprets main themes of the Deduction using ideas from contemporary philosophy and intensional logic, thereby providing a keener grasp of Kant's many subtleties than has hitherto been available. No other work pursues Kant's argument through every twist and turn with the careful, logically detailed attention maintained here. Surprising new accounts of apperception, (...) the concept of an object, the logical functions of thought, the role of the Metaphysical Deduction, and Kant's relations to his Aristotelian-Cartesian background are developed. Howell makes a precise contribution to the discussion of most of the disputed issues in the history of Deduction interpretation. Controversial in its conclusions, this book demands the attention of all who take seriously the task of understanding Kant's work and evaluating it dispassionately. (shrink)

Ancillary care is care that research participants need that is not essential to make the research safe or scientifically valid and is not needed to remedy injuries that eventuate as a result of the research project itself. Ancillary care duties have recently been defended on the grounds of beneficence, entrustment, utility and consent. Justice has also been mentioned as a possible basis of ancillary care duties, but little attention has been paid to this approach. In this paper, the author seeks (...) to rectify this omission by arguing that ancillary care duties can be based on a principle of justice as rectification. (shrink)

We present a comprehensive study of the axiom schemas IΣ - n , BΣ - n (induction and collection schemas for parameter free Σ n formulas) and some closely related schemas.

Objective—To report the ethical development of medical students across four years of education at one medical school.Design and setting—A questionnaire was distributed to all four classes at the Wake Forest University School of Medicine during the Spring of 1996. Participants—Three hundred and three students provided demographic information as well as information concerning their ethical development both as current medical students and future interns. Main measurements—Results were analyzed using cross-tabulations, correlations, and analysis of variance.Results—Results suggested that the observation of and participation (...) in unethical conduct1 may have disparaging effects on medical students' codes of ethics with 35% of the total sample (24% of first years rising to 55% of fourth years) stating that derogatory comments made by residents/attendings, either in the patient's presence or absence, were “sometimes” or “often” appropriate. However, approximately 70% of the sample contended that their personal code of ethics had not changed since beginning medical school and would not change as a resident. Conclusions—Results may represent an internal struggle that detracts from the medical school experience, both as a person and as a doctor. Our goal as educators is to alter the educational environment so that acceptance of such behaviour is not considered part of becoming a physician. (shrink)

Govind Chandra Pande, b. 1923, Indian philosopher and historian; contributed articles.

The problem that confronts us when we try to compare the structure of discourse and explanation in different domains of knowledge is that no one is an insider in more than one field, and insider information is essential. An observer who is not immersed in the practice of a particular scholarship and who wants to understand it is at the mercy of the practitioners. Yet those practitioners are themselves mystified by a largely unexamined communal myth of how scholarship is carried (...) on. R. G. Collingwood, although primarily a philosopher, was immersed in the community of historians and understood how history is done, so that he has had an immense influence on our ideas about historiography. Every historian knows The Idea of History.1 He was also a metaphysician, yet his influence on scientists’ understanding of nature, and of science, has been nil, and it is a rare scientist indeed who has ever heard of Collingwood or read The Idea of Nature.2 Collingwood’s views of the structure of science had to be constructed in large part from the elaborate fictions created by scientists and by an earlier generation of philosophers and historians of science who participated in the Baconian myth of the hypothetical-deductive scheme. 1. See R. G. Collingwood, The Idea of History .2. See Collingwood, The Idea of Nature . R. C. Lewontin is Alexander Agassiz Professor at Harvard University. He is an experimental and theoretical evolutionary geneticist who has also worked extensively on epistemological issues in biology. He is the author of The Genetic Basis of Evolutionary Change and, with Richard Levins, of The Dialectical Biologist . His current research concerns the nature of genetic variation among individuals within species. (shrink)

At the library of the Ecole Normale Supérieure in Paris, the dissertations in the Humanities are arranged in chronological order. A single glance suffices to tell us that this classification by years coincides almost exactly with a classification by bulk. As we pass along through time, year by year, the volumes grow thicker; pamphlets merge imperceptibly into modest books, these into larger books, these in turn into weighty tomes; until finally we come across works embracing several volumes, each volume imposing (...) in its own right. The explanation is simple: every author is normally led to consider the opinions of his predecessors in the same field or in neighbouring fields; these opinions he discusses, contests, approves, or amends; and finally this leads to the growth in bulk, gradual but unlimited, so evident on the shelves at the library. (shrink)

1. HUME’S ARGUMENT, FLEW CORRECTLY EXPLAINS, IS NOT THAT MIRACLES CANNOT HAPPEN, BUT THAT THERE MUST BE A CONFLICT IN THE EVIDENCE TO SHOW THAT THEY DO. 2. (I) FLEW FURTHER APPEALS TO THE INHERENT WEAKNESS OF HISTORICAL AS OPPOSED TO SCIENTIFIC EVIDENCE. BUT ONE’S ASSESSMENT OF THE EVIDENCE MUST DEPEND ON WHETHER THE CONCEPT IS POSSIBLE. (II) FLEW CLAIMS THAT HUME CAN BE TAKEN TO MEAN THAT WHAT IS ALLOWED TO BE A LOGICAL POSSIBILITY SHOULD YET BE DISMISSED AS (...) IMPOSSIBLE IN FACT. BUT THIS DISTINCTION CANNOT BE APPLIED IN ADVANCE OF AN OCCURRENCE, WITHOUT BEGGING THE QUESTION AS TO WHETHER IT IS INDEED POSSIBLE OR NOT. 3. PACE HUME AND FLEW, ENTERTAINING THE CONCEPT IS NOT INCOHERENT. FOR (I) THE RELEVANT "LAW OF NATURE" CAN BE THOUGHT OF AS POTENTIALLY APPLICABLE, THOUGH NOT IN FACT SO; (II) ONE MAY CONCEIVE OF AN "UNCAUSED" EVENT, ONCE ONE SUPPOSES THAT IN MOST OTHER CASES THE UNIVERSE IS UNIFORM. THUS IT COULD BE RATIONAL TO JUDGE THAT A MIRACLE HAD OCCURRED, SINCE THIS WOULD NOT CAL. (shrink)

Book reviewed in this article: Not In Our Genes: Biology, Ideology, and Human Nature. By R. C. Lewontin, Steven Rose, and Leon J. Kamin.