Correct interpretation of the data from integral laboratory tests, including Thrombin Generation Test, requires biochemistry-based mathematical models of blood coagulation. The purpose of this study is to describe the experimental TGT data from healthy donors and hemophilia A and B patients. We derive a simplified ODE model and apply it to analyze the TGT data from healthy donors and HA/HB patients with in vitro added tissue factor pathway inhibitor antibody. This model allows the characterization of hemophilia patients in the (...) space of three most important model parameters. The proposed approach may provide a new quantitative tool for the analysis of experimental TGT. Also, it gives a reduced model of coagulation verified against clinical data to be used in future theoretical large-scale modeling of thrombosis in flow. (shrink)

Approaches to the analysis of theory choice in science studies often focus either on objective criteria or subjective values for evaluating theories or on critical experiments for testing theories. In the present article a historical case study in the biomedical sciences is reconstructed, in which experimentation was performed to choose between two competing theories of blood coagulation. Analysis of this case study reveals that experimentation exhibits a particular structure, composed of design, execution, and results, and specific characteristics, consisting (...) of controllability, reproducibility, plasticity, and fecundity. Although this structure and these characteristics are not used to replace objective criteria or subjective values of theory evaluation or to define critical experiments, they are instrumental for analyzing and understanding theory choice. (shrink)

As the health care system transitions to a precision medicine approach that tailors clinical care to the genetic profile of the individual patient, there is a potential tension between the clinical uptake of new technologies by providers and the legal system's expectation of the standard of care in applying such technologies. We examine this tension by comparing the type of evidence that physicians and courts are likely to rely on in determining a duty to recommend pharmacogenetic testing of patients (...) prescribed the oral anti-coagulant drug warfarin. There is a large body of inconsistent evidence and factors for and against such testing, but physicians and courts are likely to weigh this evidence differently. The potential implications for medical malpractice risk are evaluated and discussed. (shrink)

We address the ethics of scenarios in which one party entraps, intentionally tempts or intentionally tests the virtue of another. We classify, in a new manner, three distinct types of acts that are of concern, namely acts of entrapment, of intentional temptation and of virtue testing. Our classification is, for each kind of scenario, of itself neutral concerning the question whether the agent acts permissibly. We explain why acts of entrapment are more ethically objectionable than like acts of intentional (...) temptation and why these, in turn, are more ethically objectionable than like acts of virtue testing. Along the way, we scrutinize, and eventually reject, the view that acts of entrapment are ethically unacceptable because intentional temptation is involved in entrapment. (shrink)

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)

Purpose This systematic review aims to identify factors that influence parents’ decisions regarding pediatric diagnostic and predictive genetic testing (DT/PT). Factors are integrated into a conceptual model of decision-making. Implications for genetic counseling, research, and ethics are derived. Methods PubMed, PsychInfo, WebofScience and references of related reviews were searched for original publications between 2000 and 2023. Extracted factors were categorized into an existing model. Results Of 5843 publications, 56 met inclusion criteria. The included studies differentiate between DT, traditional, and (...) expanded PT and describe factors impacting parental decisions on both to have the child genetically tested and to be informed about additional findings. Factors included: 1. benefits/hopes, 2. worries/concerns, 3. values and beliefs, 4. individual circumstances, and 5. emotional states. Conclusion Our work extends an existing empirical decision model of family decisions about genome sequencing to genetic testing in pediatrics in general, adding the categories “individual circumstances” and “emotional states”. The factors can be further integrated into the Health Belief Model; the importance of emotional states is reflected in dual-process theories, such as Fuzzy Trace Theory. Research is required on emotional states, differences between DT and PT, parents’ decisions about result disclosure, and dyadic variables as decision-making predictors. (shrink)

Within legal scholarship and practice, among the most pervasive tasks is the interpretation of texts. And within legal interpretation, perhaps the most pervasive inquiry is the search for “ordinary meaning.” Jurists often treat ordinary meaning analysis as an empirical inquiry, aiming to discover a fact about how people understand language. When evaluating ordinary meaning, interpreters rely on dictionary definitions or patterns of common usage, increasingly via “legal corpus linguistics” approaches. However, the most central question about these popular methods remains open: (...) Do they reliably reflect ordinary meaning? This Article presents a series of experiments that assess whether (a) dictionary definitions and (b) common usage data reflect (c) how people actually understand language today. -/- The Article elaborates the implications of two main experimental results. First, neither the dictionary nor legal corpus linguistics methods reliably track ordinary people’s judgments about meaning. This shifts the argumentative burden to jurists who rely on these tools to identify “ordinary meaning” or “original public meaning”: these views must articulate and demonstrate a reliable method of analysis. Moreover, this divergence illuminates several interpretive fallacies. For example, advocates of legal corpus linguistics often contend that the nonappearance of a specific use in a corpus indicates that the use is not part of the relevant term’s ordinary meaning. The experiments reveal this claim to be a “Nonappearance Fallacy.” Ordinary meaning exceeds datasets of common usage — even very large ones. -/- Second, dictionary and legal corpus linguistics verdicts diverge dramatically from each other. Part of that divergence is explained by the finding that broad dictionary definitions tend to direct interpreters to extensive interpretations, while data of common usage tends to point interpreters to more prototypical cases. This suggests two different criteria that are often relevant in interpretation: a more extensive criterion and a more narrow, prototypical criterion. Although dictionaries and corpus linguistics might, in some cases, help us identify these criteria, a hard legal-philosophical question remains: Which of these two criteria should guide the interpretation of terms and phrases in legal texts? Insofar as there is no compelling case to prefer one, the results suggest that dictionary definitions, legal corpus linguistics, or even other more scientific measures of meaning may not be equipped in principle to deliver simple and unequivocal answers to inquiries about the so-called “ordinary meaning” of legal texts. (shrink)

Prenatal genetic testing is becoming available for an increasingly broad set of diseases, and it is only a matter of time before parents can choose to test for hundreds, if not thousands, of genetic conditions in their fetuses. Should access to certain kinds of fetal genetic information be limited, and if so, on what basis? We evaluate a range of considerations including reproductive autonomy, parental rights, disability rights, and the rights and interests of the fetus as a potential future (...) child. We conclude that parents should be able to access information that could be useful during pregnancy, but that testing for non-medical information should be limited. Next, we argue that the government lacks a compelling state interest in regulating prenatal genetic testing and propose that regulation should occur through medical professional organizations. Finally, we present a framework for determining what testing physicians should recommend, offer neutrally, or not offer at all. (shrink)

Because physical theories typically predict numerical values, an improvement in experimental precision reduces the tolerance range and hence increases corroborability. In most psychological research, improved power of a statistical design leads to a prior probability approaching 1/2 of finding a significant difference in the theoretically predicted direction. Hence the corroboration yielded by "success" is very weak, and becomes weaker with increased precision. "Statistical significance" plays a logical role in psychology precisely the reverse of its role in physics. This problem is (...) worsened by certain unhealthy tendencies prevalent among psychologists, such as a premium placed on experimental "cuteness" and a free reliance upon ad hoc explanations to avoid refutation. (shrink)

Empowerment, an already central concept in public health, has gained additional relevance through the expansion of mobile health (mHealth). Especially direct-to-consumer self-testing app companies mobilise the term to advertise their products, which allow users to self-test for various medical conditions independent of healthcare professionals. This article first demonstrates the absence of empowerment conceptualisations in the context of self-testing apps by engaging with empowerment literature. It then contrasts the service these apps provide with two widely cited empowerment definitions by (...) the WHO, which describe the term as a process that, broadly, leads to knowledge and control of health decisions. We conclude that self-testing apps can only partly empower their users, as they, we argue, do not provide the type of knowledge and control the WHO definitions describe. More importantly, we observe that this shortcoming stems from the fact that in the literature on mHealth and in self-testing marketing, empowerment is understood as a goal rather than a process. This characterises a shift in the meaning of empowerment in the context of self-testing and mHealth, one that reveals a lack of awareness for relational and contextual factors that contribute to empowerment. We argue that returning to a process-understanding of empowerment helps to identify these apps’ deficits, and we conclude the article by briefly suggesting several strategies to increase self-testing apps’ empowerment function. (shrink)

The development of new methods in the field of prenatal testing leads to an expansion of information that needs to be provided to expectant mothers. The aim of this research is to explore opinions and attitudes of gynecologists in Germany, Poland and Russia towards access to prenatal testing and diagnostics in these countries. Semi-structured interviews were conducted with n = 18 gynecologists in Germany, Poland and Russia. The interviews were analyzed using the methods of content analysis and thematic (...) analysis. Visible in all three countries is a connection of prenatal medicine with the politically and socially contentious issue of pregnancy termination. Respondents in Poland and Russia concentrated on the topic of inadequate resources. Quality of information for expectant mothers is an important point in all three countries. Only in Germany was the issue of language barriers in communication raised. With regard to non-invasive prenatal testing (NIPT) respondents in Germany focused on the ethical issues of routinization of testing; in Poland and Russia they concentrated on fair access to NIPT. Challenges in all three countries arise from structural factors such as imprecise and prohibitive regulations, lack of resources or organization of healthcare services. These should be addressed on a political and medico-ethical level. (shrink)

In the past, hypothesis testing in medicine has employed the paradigm of the repeatable experiment. In statistical hypothesis testing, an unbiased sample is drawn from a larger source population, and a calculated statistic is compared to a preassigned critical region, on the assumption that the comparison could be repeated an indefinite number of times. However, repeated experiments often cannot be performed on human beings, due to ethical or economic constraints. We describe a new paradigm for hypothesis testing (...) which uses only rearrangements of data present within the observed data set. The token swap test, based on this new paradigm, is applied to three data sets from cardiovascular pathology, and computational experiments suggest that the token swap test satisfies the Neyman Pearson condition. (shrink)

Sripada has recently advanced a new account for asymmetries that have been uncovered in folk judgments of intentionality: the ?Deep Self model,? according to which an action is more likely to be judged as intentional if it matches the agent's central and stable attitudes and values (i.e., the agent's Deep Self). In this paper, we present new experiments that challenge this model in two ways: first, we show that the Deep Self model makes predictions that are falsified, then we present (...) cases that it cannot account for. Finally, we discuss how the Deep Self model could be modified to accommodate these new data. (shrink)

In recent years, the genetic testing and selection of IVF embryos, known as preimplantation genetic testing (PGT), has gained much traction in clinical assisted reproduction for preventing transmission of genetic defects. However, a more recent ethically and morally controversial development in PGT is its possible use in selecting IVF embryos for optimal intelligence quotient (IQ) and other non–disease-related socially desirable traits, such as tallness, fair complexion, athletic ability, and eye and hair colour, based on polygenic risk scores (PRS), (...) in what is referred to as PGT-P. Artificial intelligence (AI) and machine learning–based analysis of big data sets collated from genome sequencing of specific human ethnic populations can be used to estimate an individual embryo’s likelihood of developing such multifactorial traits by analysing the combination of specific genetic variants within its genome. Superficially, this technique appears compliant with Islamic principles and ethics. Because there is no modification of the human genome, there is no tampering with Allah’s creation (taghyīr khalq Allah). Nevertheless, a more critical analysis based on the five maxims of Islamic jurisprudence (qawa'id fiqhiyyah) that are often utilized in discourses on Islamic bioethics, namely qaṣd (intention), yaqın̄ (certainty), ḍarar (injury), ḍarūra (necessity), and `urf (custom), would instead reveal some major ethical and moral flaws of this new medical technology in the selection of non–disease-related socially desirable traits, and its non-compliance with the spirit and essence of Islamic law (shariah). Muslim scholars, jurists, doctors, and biomedical scientists should debate this further and issue a fatwa on this new medical technology platform. (shrink)

Rich with historical and cultural value, these works are published unaltered from the original University of Minnesota Press editions.

Unfounded—conspiracy and health—beliefs about COVID-19 have accompanied the pandemic worldwide. Here, we examined cross-nationally the structure and correlates of these beliefs with an 8-item scale, using a multigroup confirmatory factor analysis. We obtained a two-factor model of unfounded (conspiracy and health) beliefs with good internal structure (average CFI = 0.98, RMSEA = 0.05, SRMR = 0.04), but a high correlation between the two factors (average latent factor correlation = 0.57). This model was replicable across 50 countries (total N = 13,579), (...) as evidenced by metric invariance between countries (CFI = 0.96, RMSEA = 0.06, SRMS = 0.07) as well as scalar invariance across genders (CFI = 0.98, RMSEA = 0.04, SRMS = 0.03) and educational levels (CFI = 0.98, RMSEA = 0.04, SRMS = 0.03). Also, lower levels of education, more fear of COVID-19, and more cynicism were weakly associated with stronger conspiracy and health beliefs. The study contributes to knowledge about the structure of unfounded beliefs, and reveals the potential relevance of affective (i.e., fear of COVID-19) and cognitive (i.e., cynicism) factors along with demographics, in endorsing such beliefs. In summary, we obtained cross-cultural evidence for the distinctiveness of unfounded conspiracy and health beliefs about COVID-19 in terms of their structure and correlates. (shrink)

In many ways, Maddie’s case brings together some of the most challenging features seen in clinical ethics consultation. First, it centers around a heart-wrenching event—the near-drowning of a young...

Canada has recently published a new Clinical Practice Guideline on the diagnosis and management of brain death. It states that consent is not necessary to carry out the interventions required to make the diagnosis. A supporting article not only sets out the arguments for this but also contends that ‘UK laws similarly carve out an exception, excusing clinicians from a prima facie duty to get consent’. This is supplemented by the claim that recent court decisions in the UK similarly confirm (...) that consent is not required, referencing two judgements in _Battersbee_. We disagree with the authors’ interpretation of the law on consent in the UK and argue that there is nothing in _Battersbee_ to support the conclusion that consent to testing is not necessary. Where there is a disagreement about testing for brain death in the UK, court authorisation is required. (shrink)

Two first-order logic theories are definitionally equivalent if and only if there is a bijection between their model classes that preserves isomorphisms and ultraproducts (Theorem 2). This is a variant of a prior theorem of van Benthem and Pearce. In Example 2, uncountably many pairs of definitionally inequivalent theories are given such that their model categories are concretely isomorphic via bijections that preserve ultraproducts in the model categories up to isomorphism. Based on these results, we settle several conjectures of Barrett, (...) Glymour and Halvorson. (shrink)

Introduction: Non-invasive prenatal testing (NIPT) allows for genetic testing of a fetus through the analysis of cell-free DNA from the mother’s plasma. NIPT is easy and safe for the fetus, since it only requires a blood draw from the mother and therefore holds no risk of miscarriage. It is considered superior to other prenatal screening tests and can also be performed earlier in the pregnancy. NIPT has the future potential for fetal whole genome sequencing (FWGS) for an expanded (...) range of conditions, such as late onset genetic conditions and carrier status. Objective: To review ethical, legal, social, and policy implications of the potential use of non-invasive prenatal testing for FWGS. Methods: This study is a critical interpretive literature review exploring and reporting ethical, legal, social, and policy implications of potential future implementation of NIPT for FWGS, which will be referred to as non-invasive prenatal whole genome sequencing (NIPW). Database and reference list searching was conducted between 2010 and 2019 for terms related to “non-invasive prenatal testing” AND “fetal whole genome sequencing” and derivatives. Results: Following screening, 32 articles were included. Data were grouped into four thematic categories: 1) ethical implications for the future child concerning autonomy and harms, as well as for prospective parents involving autonomy, informed consent concerns, and harms; 2) legal implications including privacy concerns; 3) social implications including changes in family dynamics, altered societal perceptions and disability concerns, justice and equity in accessing the test, and social pressure to use the test; and 4) policy implications including cost and funding concerns, limiting the scope of testing, as well as counseling, education, and support. Discussion: The discussion of results highlights several ethical, legal, social, and policy implications of NIPT use for FWGS. These findings have implications on NIPT implementation for FWGS including how the autonomy of the future child should be balanced with the autonomy of prospective parents, the scope of conditions that should or should not be tested for – and covered or not covered by the healthcare system – and the regulation of FWGS introduction, among others. Further research needs to be performed to address these concerns and hence guide the discussion about the clinical implementation of FWGS through NIPT. (shrink)

I disagree with several of Chow's traditional descriptions and justifications of null hypothesis testing: (1) accepting the null hypothesis whenever p > .05; (2) random sampling from a population; (3) the frequentist interpretation of probability; (4) having the null hypothesis generate both a probability distribution and a complement of the desired conclusion; (5) assuming that researchers must fix their sample size before performing their study.

The origins of testing scientific models with statistical techniques go back to 18th century mathematics. However, the modern theory of statistical testing was primarily developed through the work of Sir R.A. Fisher, Jerzy Neyman, and Egon Pearson in the inter-war period. Some of Fisher's papers on testing were published in economics journals (Fisher, 1923, 1935) and exerted a notable influence on the discipline. The development of econometrics and the rise of quantitative economic models in the mid-20th century (...) made statistical significance testing a commonplace, albeit controversial tool within economics. -/- In the debate about significance testing, methodological controversies intertwine with epistemological issues and sociological developments. Our aim in this chapter is to expound these connections and to show how the use of, and the debate about, significance testing in economics differs from other social sciences, such as psychology. (shrink)

Starting from the ‘Dewey Lectures’, Rawls presents his conception of justice within a contextualist framework, as an elaboration of the basic ideas embedded in the political culture of liberal-democratic societies. But how are these basic ideas to be justified? In this article, I reconstruct and criticize Rawls’s strategy to answer this question. I explore an alternative strategy, consisting of a genealogical argument of a pragmatic kind – the kind of argument provided by authors like Bernard Williams, Edward Craig and Miranda (...) Fricker. I outline this genealogical argument drawing on Rawls’s reconstruction of the origins of liberalism. Then, I clarify the conditions under which this kind of argument maintains vindicatory power. I claim that the argument satisfies these conditions and that pragmatic genealogy can thus partially vindicate the basic ideas of liberal-democratic societies. (shrink)