Non-invasive prenatal testing is at the forefront of prenatal screening. Current uses for NIPT include fetal sex determination and screening for chromosomal disorders such as trisomy 21. However, NIPT may be expanded to many different future applications. There are a potential host of ethical concerns around the expanding use of NIPT, as examined by the recent Nuffield Council report on the topic. It is important to examine what NIPT might be used for before these possibilities become consumer reality. There is (...) limited research exploring views of women on possible future uses of NIPT, particularly those of women who have undergone NIPT. In this study, we examined the views of women who undertook NIPT previously on the acceptability of and interest levels in using NIPT for a number of current and possible future applications. These included several medical conditions encompassing psychiatric, neurodevelopmental and adult-onset conditions as well as non-medical traits such as intelligence. One thousand women were invited to participate and 235 eligible surveys were received. Women generally reported an interest in using NIPT for medical conditions that severely impacted quality of life and with an onset earlier in life and stressed the importance of the accuracy of the test. Concerns were raised about the use of NIPT for non-medical traits. Respondents indicated that termination of pregnancy was not their only reason for testing, particularly in the case of sex. These results can further inform the ethical debate around the increasing integration of NIPT into healthcare systems. (shrink)

What is the nature of the fundamental relation we have to ourselves that makes each of us a self? To answer this question, Charles Larmore develops a systematic theory of the self, challenging the widespread view that the self’s defining relation to itself is to have an immediate knowledge of its own thoughts. On the contrary, Larmore maintains, our essential relation to ourselves is practical, as is clear when we consider the nature of belief and desire. For to believe or (...) desire something consists in committing ourselves to thinking and acting in accord with the presumed truth of our belief or the presumed value of what we desire. Larmore develops this conception with frequent reference to such classic authors as Montaigne, Stendhal, and Proust and by comparing it to other views of the self in contemporary philosophy. He also discusses the important ethical consequences of his theory of the self, arguing that it allows us to better grasp what it means to be ourselves and why self-understanding often involves self-creation. Winner of the Académie Française’s Grand Prix de Philosophie, _The Practices of the Self_ is that rare kind of lucid yet rigorous work that transcends disciplinary boundaries. (shrink)

This paper discusses the character of medical ethics and suggests that there are significant gaps that warrant greater attention. It describes ways in which the content and form of medical ethics may exclude or marginalise perspectives and contributions, thereby reducing its influence and its potential impact on, and value to, patients, students, carers and society. To consider what it is ‘to do good medical ethics’ suggests an active approach that seeks out, and learns from, contributions beyond the traditional boundaries of (...) scholarship. (shrink)

Trust is frequently discussed with reference to the professional–patient relationship. However, trust is less explored in relation to the ways in which understanding of, and responses to, questions of ethics are discussed by both the “public” and “experts.” Public engagement activity in healthcare ethics may invoke “trust” in analysing a moral question or problem but less frequently conceives of trust as integral to “public engagement” itself. This paper explores the relationship between trust and the ways in which questions of healthcare (...) ethics are identified and negotiated by both “experts” and the public. Drawing on two examples from the author’s “public engagement” work—a radio programme for the British Broadcasting Corporation and work with a playwright and theatre—the paper interrogates the ways in which “public engagement” is often characterized. The author argues that the common approach to public engagement in questions of ethics is unhelpfully constrained by a systemic disposition which continues to privilege the professional or expert voice at the expense of meaningful exchange and dialogue. By creating space for novel interactions between the “expert” and the “public,” authentic engagement is achieved that enables not only the participants to flourish but also contributes to trust itself. (shrink)

Modern bioethics, which is based on Western moral philosophy and Western biomedical perspectives, has evolved within a complex, highly individualistic culture that draws a sharp distinction between church and state and tolerates a multitude of values. This discipline defines its principles in secular and objective terms that often are bewildering to people of non-Western origin. Despite much discourse, principlism remains the fundamental framework of bioethics. Principlism is held in such high regard that many bioethicists equate autonomy with personhood, as if (...) autonomy exists independently of specific beliefs and commitments.In addition, we continue to minimize the substantial differences in the way people of different cultures perceive, experience, and explain illness, although our views of the potential cultural limitations of Western medicine have grown and expanded in recent years. At the heart of it we continue to be tied to a biomedical focus that largely neglects the context of the situation. (shrink)

Background Non-invasive prenatal testing (NIPT), which can screen for aneuploidies such as trisomy 21, is being implemented in several public healthcare systems across Europe. Comprehensive communication and information have been highlighted in the literature as important elements in supporting women’s reproductive decision-making and addressing relevant ethical concerns such as routinisation. Countries such as England and France are adopting broadly similar implementation models, offering NIPT for pregnancies with high aneuploidy probability. However, we do not have a deeper understanding of how professionals’ (...) counselling values and practices may differ between these contexts. Methods In this paper, we explore how professionals in England and France support patient decision-making in the provision of NIPT and critically compare professional practices and values. We draw on data from semi-structured interviews with healthcare professionals. Results Both English and French professionals emphasised values relating to patient choice and consent. However, understandings and application of these values into the practice of NIPT provision differed. English interviewees placed a stronger emphasis on interpreting and describing the process of counselling patients and clinical care through a “principle” lens. Their focus was on non-directiveness, standardisation, and the healthcare professional as “decision-facilitator” for patients. French interviewees described their approach through a “procedural” lens. Their focus was on formal consent, information, and the healthcare professional as “information-giver”. Both English and French professionals indicated that insufficient resources were a key barrier in effectively translating their values into practice. Conclusion Our findings illustrate that supporting patient choice in the provision of NIPT may be held as an important value in common on a surface level, but can be understood and translated into practice in different ways. Our findings can guide further research and beneficially inform practice and policy around NIPT provision. (shrink)

This article introduces and develops the concept of trade narrative to understand how business sectors defend against public disapproval and the threat of increased regulation or removed subsidy. Trade narrative works by accumulating lists of benefits and occluding costs, and is created by consultants for economic interests organized via trade associations. This represents an under-analysed ‘policy-based evidence machine’, the aim of which is to format the discourses of the media and political classes about the contribution of the sector in ways (...) that frame political choice about what is thinkable and doable. In doing so it supports elite power by providing a relay for intra-elite communication. Using illustrations from privatized railways, banking and pharmaceuticals in the UK and US, the argument explores how the causal arrow runs in the opposite direction from that supposed in most discussion of discourse-economy relations in the field of cultural economy. (shrink)

Having been invited to a conference with the title of “The Pedagogics of Unlearning,” the first challenge I faced was to work out how to make sense of and respond to the rhetorical contortions of this title itself.1 Why this phrasing? What conceptualization did it imply? What could the conference organizers possibly have been thinking in coming up with such a phrase and setting it up as the very organizing “idea” of the conference, as the rhetorico-conceptual challenge for speakers to (...) tackle? “The Pedagogics of Unlearning” is definitely an unusual and awkward phrase, for what may quite possibly be an unusual, awkward, or even impossible formulation. To make sense of it I had to translate it, expand it... (shrink)

As courts become increasingly technologically sophisticated, it can be expected that the use of the latest visualisation techniques will also increase to make the most of this technology. In particular, the use of computer-generated animations can be expected to become more dominant. There is, however, very little research into the effects of animated evidence on jurors and other members of the judicial process. This paper investigates whether there is a difference in the quality and robustness of memories formed by either (...) hearing an oral testimony or seeing an animated version of it. Also, the paper investigates whether different opinions and attitudes are produced when testimony is presented as an animation as opposed to being verbally presented. Preliminary results reported here indicate that there is indeed a difference in attitude (and therefore potential bias) when animations are used instead of verbal testimony, but that this difference is only apparent in the long term (four weeks or more after the presentation of the animated evidence). The results point to the need for improved knowledge structures for mapping verbal testimony into animations, where issues of implicit knowledge and potential bias are explicitly referenced in the knowledge structure. The paper argues that, until and unless such issues are addressed, it is not safe to use animations in court except to present purely factual information. (shrink)

This article argues that, of the leading Continental feminist theorists who have expressed an interest in women's mysticism, most have inadvertently or otherwise taken up the theoretical model of William James, the early-twentieth-century scholar of religion. In particular, Simone de Beauvoir and Luce Irigaray have accepted the view that mysticism operates on an epistemological plane divorced from the categories of rationality and intelligibility. Both thinkers hold that the mystic is typically hysterical, although Irigaray takes a more positive view of the (...) hysteric as a subject position from which the feminine voice is first heard. Through a brief examination of the mystical and political careers of Hildegard of Bingen, we conclude that the theoretical perspective of Julia Kristeva provides a more useful theoretical perspective from which to analyse women's mystical texts. (shrink)

In referendum elections, voters are often required to register simultaneous votes on multiple proposals. The separability problem occurs when a voter’s preferred outcome on one proposal depends on the outcomes of other proposals. This type of interdependence can lead to unsatisfactory or even paradoxical election outcomes, such as a winning outcome that is the last choice of every voter. Here we propose an iterative voting scheme that allows voters to revise their voting strategies based on the outcomes of previous iterations. (...) Using a robust computer simulation, we investigate the potential of this approach to solve the separability problem. (shrink)

The philosophy of Spinoza can hardly be said to have been in the fore-front of recent developments in the philosophy of mind. Notwithstanding, Stuart Hampshire has put himself on record as saying “that in the philosophy of mind he [Spinoza] is nearer to the truth at certain points than any other philosopher ever has been.” The purpose of this paper is to get even nearer the truth with Spinoza’s leading. The idea of the body is, however, a confused idea; so (...) confused, in fact, that Spinoza was never able to form an adequate idea of the idea. I wish to argue that Spinoza has even worse reasons than Descartes for taking the idea of the body to be the idea of something that “actually exists.” Lacking any appeal to the divine veracity, Spinoza’s contention that the body does exist constitutes a standing petitio for the whole of the philosophy of mind. (shrink)

The question whether, in the interim, the "socialist morality" allows adequate restraint on revolutionary action, cannot fairly be answered in abstraction from history, in this case our epoch. We submit that the group of projects called corporate "globalization" - imposing free trade, privatization, and dominance of transnational corporations - shapes that epoch. These projects are associated with polarization of wealth, deepening poverty, and an alarming new global U.S. military domination. Using 9/11 as pretext for a "war on terror," this domination (...) backs corporate globalization. If Nazi occupation of France and French occupation of Algeria made Sartre and Beauvoir assign moral primacy to overcoming oppressive systems, then U.S. global occupation should occasion rebirth of that commitment. Parallels among the three occupations are striking. France's turning of colonial and metropolitan working classes against each other is echoed by globalization's pitting of (e.g.) Chinese against Mexican workers in a race to lower wages to get investment. Seducing first-world workers with racial superiority and cheap imports from near-slavery producers once again conceals their thralldom to their own bosses. Nazi and French use of overwhelming force and even torture are re-cycled by the U.S. and its agents, again to hide the vulnerability of their small forces amidst their enemies. (shrink)

This Article argues that U.S. law should give protection to relationships between cohabitants and their partners’ children when necessary to avoid the economic and emotional trauma that may be caused by separation of the child from a member of his or her household if the cohabitation ends. After examining the social science literature about the welfare of both stepchildren and children of cohabitants and the inadequate legal treatment of custody, visitation, and child support issues under current law, the author recommends (...) that cohabiting stepparents be given standing to seek custody if they have acted as de facto parents, with a presumption in favor of custody by the stepparent when the cohabitant who is the child’s biological parent has died and the possibility of joint custody in other cases; be awarded visitation if both the ex-cohabitant and child desire it; and be obligated to pay child support for the child if the cohabitation dissolves after a period of two years or more. (shrink)

The fungal cell wall is a dynamic structure that protects the cell from changes in osmotic pressure and other environmental stresses, while allowing the fungal cell to interact with its environment. The structure and biosynthesis of a fungal cell wall is unique to the fungi, and is therefore an excellent target for the development of anti‐fungal drugs. The structure of the fungal cell wall and the drugs that target its biosynthesis are reviewed. Based on studies in a number of fungi, (...) the cell wall has been shown to be primarily composed of chitin, glucans, mannans and glycoproteins. The biosynthesis of the various components of the fungal cell wall and the importance of the components in the formation of a functional cell wall, as revealed through mutational analyses, are discussed. There is strong evidence that the chitin, glucans and glycoproteins are covalently cross‐linked together and that the cross‐linking is a dynamic process that occurs extracellularly. BioEssays 28: 799–808, 2006. © 2006 Wiley Periodicals, Inc. (shrink)

A Professor of Medical Ethics and a theatre director, also mother and daughter, talk about health, illness, suffering, performance and practice. Using the lenses of ethical and performance theory, they explore what it means to be a patient, a spectator and a practitioner and cover many plays, texts and productions: Samuel Beckett’s Not I and All That Fall, Sarah Kane’s Crave, Tim Crouch’s An Oak Tree, Enda Walsh’s Ballyturk, Annie Ryan’s adaptation of Eimear McBride’s novel A Girl Is a Half-Formed (...) Thing, Duncan MacMillan’s People, Place and Things and Henrik Ibsen’s Hedda Gabler. These were selected because first we have seen, studied or worked with each and they have continued to inspire us. Second, they offer rich and revealing insights into the ways in which meaning is/are both negotiated and contested in relation to health and illness. It is the iterative negotiation of meaning that, it is argued, is the essence of narrative practice, be it in medicine or in the theatre. The difference and divergence of perception, response and interpretation to dramatic performance can test relationships, be they professional, creative or familial. Yet, the capacity to understand, and embrace, disagreement and uncertainty is vital; fundamental to a flourishing life. For it is by recognising our part in creating narratives, broken and otherwise, that we can begin to recognise the necessary interactionism and humanity of both medicine and theatre. (shrink)

Unlike most texts in critical thinking, _Reason in the Balance_ focuses broadly on the practice of critical inquiry, the process of carefully examining an issue in order to come to a reasoned judgment. Although analysis and critique of individual arguments have an important role to play, this text goes beyond that dimension to emphasize the various aspects that go into the practice of inquiry, including identifying issues and relevant contexts, understanding competing cases, and making a comparative judgment._ Distinctive Features of (...) the Text:_ Emphasis on applying critical thinking to complex issues with competing arguments Inclusion of chapters on inquiry in specific contexts Attention to the dialogical aspects of inquiry, including sample dialogues Emphasis on the spirit of inquiry _The Second Edition Features:_ Updated examples and items of current interest New dialogues on vaccination, prostitution, and climate change New material on biases in reasoning, including emotional, psychological, social, and cognitive _The _Reason in the Balance_ Website includes:_ An Appendix on Logic Exercises Quizzes. (shrink)

World Athletics have introduced regulations preventing female athletes with certain differences in sex development from competing in the female category. We argue these regulations are not justified and should be removed. Firstly, we examine the reasoning and evidence underlying the position that these athletes have a substantial mean difference in performance from other female athletes such that it constitutes an advantage, and argue it is not sufficient. Secondly, if an advantage does exist, it needs to be demonstrated it is unfair. (...) We argue the advantage would not be unfair because to say otherwise relies on a presupposition about whether these athletes are female, which involves contradictory and inconsistent definitions of sex. Thirdly, we contend that even if it is established that there is an advantage and it is unfair, the response of requiring athletes to take testosterone-suppressing medication is not appropriate and is unfair. (shrink)

This book disrupts disciplinary boundaries to make a case for the future direction and growth of martial arts studies as a unique field.

The scope of noninvasive prenatal testing (NIPT) could expand in the future to include detailed analysis of the fetal genome. This will allow for the testing for virtually any trait with a genetic contribution, including “non-medical” traits. Here we discuss the potential use of NIPT for these traits. We outline a scenario which highlights possible inconsistencies with ethical decision-making. We then discuss the case against permitting these uses. The objections include practical problems; increasing inequities; increasing the burden of choice; negative (...) impacts on the child, family, and society; and issues with implementation. We then outline the case for permitting the use of NIPT for these traits. These include arguments for reproductive liberty and autonomy; questioning the labeling of traits as “non-medical”; and the principle of procreative beneficence. This summary of the case for and against can serve as a basis for the development of a consistent and coherent ethical framework. (shrink)

Engaging images accompany information about animal control officers. The combination of high-interest subject matter and light text is intended for students in grades 3 through 7.

This is the first collection of critical essays on the film work of the philosopher Jacques Rancière. Rancière rose to prominence as a radical egalitarian philosopher, political theorist and historian. Recently he has intervened into the discourses of film theory and film studies, publishing controversial and challenging works on these topics. This book offers an exciting range of responses to and assessments of his contributions to film studies and includes an afterword response to the essays by Rancière himself.

This dissertation serves to expose ideas about poverty by systematically examining its treatment in foundational texts by some of the most significant theorists in Western philosophy. I explore the writings of Plato, Aristotle, John Locke, Adam Smith, Alexis de Tocqueville, G. W. F. Hegel, Karl Marx, John Rawls, and Robert Nozick in historical sequence. These philosophers made significant and provocative contributions toward understanding the problem of poverty. I uncover some major themes in these theorists' work. First, all but one philosopher (...) thinks it disastrous for a society to have large numbers of poor people living in a state. Mass poverty threatens everyone's happiness in the state as well as its political stability. Second, some theorists have oversimplified the problem and possible solutions. These oversimplifications add to the confusion and controversy surrounding the problem of poverty. Third, discussions about government support for the poor dominate much of the writing about poverty. Ought governments give aid to the poor? How can one morally justify taking money from the wealthy to provide aid for the poor? Philosophical and historical explorations of these themes and questions reveal that these same problems have vexed philosophers and politicians from John Locke to contemporary authors like John Rawls. These ideas continue to be relevant today after hundreds and even thousands of years have passed. (shrink)

In many ways set theory lies at the heart of modern mathematics, and it does powerful work both philosophical and mathematical – as a foundation for the subject. However, certain philosophical problems raise serious doubts about our acceptance of the axioms of set theory. In a detailed and original reassessment of these axioms, Sharon Berry uses a potentialist approach to develop a unified determinate conception of set-theoretic truth that vindicates many of our intuitive expectations regarding set theory. Berry further (...) defends her approach against a number of possible objections, and she shows how a notion of logical possibility that is useful in formulating Potentialist set theory connects in important ways with philosophy of language, metametaphysics and philosophy of science. Her book will appeal to readers with interests in the philosophy of set theory, modal logic, and the role of mathematics in the sciences. (shrink)

New biotechnologies have propelled the question of what it means to be human - or posthuman - to the forefront of societal and scientific consideration. This volume provides an accessible, critical overview of the main approaches in the debate on posthumanism, and argues that they do not adequately address the question of what it means to be human in an age of biotechnology. Not because they belong to rival political camps, but because they are grounded in a humanist ontology that (...) presupposes a radical separation between human subjects and technological objects. The volume offers a comprehensive mapping of posthumanist discourse divided into four broad approaches-two humanist-based approaches: dystopic and liberal posthumanism, and two non-humanist approaches: radical and methodological posthumanism. The author compares and contrasts these models via an exploration of key issues, from human enhancement, to eugenics, to new configurations of biopower, questioning what role technology plays in defining the boundaries of the human, the subject and nature for each. Building on the contributions and limitations of radical and methodological posthumanism, the author develops a novel perspective, mediated posthumanism, that brings together insights in the philosophy of technology, the sociology of biomedicine, and Michel Foucault's work on ethical subject constitution. In this framework, technology is neither a neutral tool nor a force that alienates humanity from itself, but something that is always already part of the experience of being human, and subjectivity is viewed as an emergent property that is constantly being shaped and transformed by its engagements with biotechnologies. Mediated posthumanism becomes a tool for identifying novel ethical modes of human experience that are richer and more multifaceted than current posthumanist perspectives allow for. The book will be essential reading for students and scholars working on ethics and technology, philosophy of technology, poststructuralism, technology and the body, and medical ethics. (shrink)