During the set-up phase of an international study of genetic influences on outcomes from sepsis, we aimed to characterise potential differences in ethics approval processes and outcomes in participating European countries. Between 2005 and 2007 of the FP6-funded international Genetics Of Sepsis and Septic Shock project, we asked national coordinators to complete a structured survey of research ethic committee approval structures and processes in their countries, and linked these data to outcomes. Survey findings were reconfirmed or modified in (...) 2017. Eighteen countries participated in the study, recruiting 2257 patients from 160 ICUs. National practices differed widely in terms of composition of RECs, procedures and duration of the ethics approval process. Eight countries used a single centralised process for approval, seven required approval by an ethics committee in each participating hospital, and three required both. Outcomes of the application process differed widely between countries because of differences in national legislation, and differed within countries because of interpretation of the ethics of conducting research in patients lacking capacity. The RECs in four countries had no lay representation. The median time from submission to final decision was 1.5 months; in nine approval was received within 1 month; six took over 6 months, and in one 24 months; had all countries been able to match the most efficient approvals processes, an additional 74 months of country or institution-level recruitment would have been available. In three countries, rejection of the application by some local RECs resulted in loss of centres; and one country rejected the application outright. The potential benefits of the single application portal offered by the European Clinical Trials Regulation will not be realised without harmonisation of research ethics committee practices as well as national legislation. (shrink)

The activation of leukocytes by bacterial cell wall lipopolysaccharide (LPS) contributes to the pathogenesis of septic shock. It is well established that, in the presence of plasma LPS‐binding protein (LBP), LPS binds with high affinity to CD14. The binding of LPS to CD14 has been associated with the activation of cells, although available evidence indicates that CD14 itself does not transduce intracellular signalling. The physiological function of this interaction is to promote host defense mechanisms of cells to combat (...) the infection and clear LPS from the circulation. At higher concentrations of LPS, however, the activation of cells can take place in the absence of LBP and CD14, presumably through a distinct low‐affinity signalling LPS receptor. On the evidence published by us and others, we propose that in neutrophils, and possibly other leukocytes, L‐selectin can act as a low‐affinity LPS receptor. (shrink)

More than 15 million people have been affected by coronavirus disease 2019 (COVID‐19) and it has caused 640 016 deaths as of July 26, 2020. Currently, no effective treatment option is available for COVID‐19 patients. Though many drugs have been proposed, none of them has shown particular efficacy in clinical trials. In this article, the relationship between the Adrenergic system and the renin‐angiotensin‐aldosterone system (RAAS) is focused in COVID‐19 and a vicious circle consisting of the Adrenergic system‐RAAS‐Angiotensin converting enzyme 2 (...) (ACE2)‐severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) (which is referred to as the “ARAS loop”) is proposed. Hyperactivation of the ARAS loop may be the underlying pathophysiological mechanism in COVID‐19, and beta‐adrenergic blockers are proposed as a potential treatment option. Beta‐adrenergic blockers may decrease the SARS‐CoV‐2 cellular entry by decreasing ACE2 receptors expression and cluster of differentiation 147 (CD147) in various cells in the body. Beta‐adrenergic blockers may decrease the morbidity and mortality in COVID‐19 patients by preventing or reducing acute respiratory distress syndrome (ARDS) and other complications. Retrospective and prospective clinical trials should be conducted to check the validity of the hypothesis. Also see the video abstract here https://youtu.be/uLoy7do5ROo. (shrink)

One of the immediate eukaryotic cellular responses to DNA breakage is the covalent post‐translational modification of nuclear proteins with poly(ADP‐ribose) from NAD+ as precursor, mostly catalysed by poly(ADP‐ribose) polymerase‐1 (PARP‐1). Recently several other polypeptides have been shown to catalyse poly(ADP‐ribose) formation. Poly(ADP‐ribosyl)ation is involved in a variety of physiological and pathophysiological phenomena. Physiological functions include its participation in DNA‐base excision repair, DNA‐damage signalling, regulation of genomic stability, and regulation of transcription and proteasomal function, supporting the previously observed correlation of cellular (...) poly(ADP‐ribosyl)ation capacity with mammalian life. The pathophysiology effects are mediated through PARP‐1 overactivity, which can cause cell suicide by NAD+ depletion. It is apparent that the latter effect underlies the pathogenesis of a wide range of disease states including type‐1 diabetes, ischaemic infarcts in various organs, and septic or haemorrhagic shock. Therefore pharmacological modulation of poly(ADP‐ribosyl)ation may prove to be an exciting option for various highly prevalent, disabling and even lethal diseases. BioEssays 23:795–806, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

This paper defends an account of moral shock as an emotional response to intensely bewildering events that are also of moral significance. This theory stands in contrast to the common view that shock is a form of intense surprise. On the standard model of surprise, surprise is an emotional response to events that violated one's expectations. But I show that we can be morally shocked by events that confirm our expectations. What makes an event shocking is not that (...) it violated one's expectations, but that the content of the event is intensely bewildering. What causes moral shock is, I argue, our lack of emotional preparedness for the event. And I show that, despite the relative lack of attention to shock in the philosophical literature, the emotion is significant to moral, social, and political life. (shrink)

The neoliberal-inspired “shock therapy” policies were designed to allow efficiency considerations to shape the new capitalist economies. Most experts theorized that these policies would enable postcommunist countries to close the gap with the West. After more than a decade, this prediction has been falsified. Fieldwork in 25 Russian firms demonstrates that the neoliberal prescription of mass privatization creates shocks that make successful enterprise restructuring almost impossible. Instead, most firms lower their technological level of production and retreat to nonmarket activity (...) to survive. The result is a poorer economy with less growth potential and thus increased divergence with the West. (shrink)

There are two aims of this paper: (1) to explore the affective dimensions of moral shock and how it relates to normative marginalization of those furthest from dominant society, but also, more specifically; (2) to articulate the trans experience of constantly being under moral attack because the dominant “world” normatively defines you out of existence. Toward these ends, I build on Katie Stockdale’s recent work on moral shock, arguing that moral shock needs to be contextualized to “worlds” (...) of sense to understand how marginalized people affectively experience shocking events. My focus is the trans experience of moral shock due to the way trans people are positioned outside of dominant society, creating the conditions to experience cyclical, chronic shock. These affective conditions point to a collective responsibility to ease the affective stress that the most marginalized experience. (shrink)

This paper has two aims: to explore the affective dimensions of moral shock and the way it relates to normative marginalization of those furthest from dominant society and also, more specifically, to articulate the trans experience of constantly being under moral attack because the dominant ‘world’ normatively defines trans individuals out of existence. Toward these ends, I build on Katie Stockdale's recent work on moral shock, arguing that moral shock needs to be contextualized to ‘worlds’ of sense (...) to understand how marginalized people affectively experience shocking events. My focus is the trans experience of moral shock due to the way trans people are positioned outside of dominant society, which creates the conditions to experience cyclical, chronic shock. These affective conditions point to a collective responsibility to ease the affective stress that the most marginalized experience. (shrink)

The mitochondrion is known as the “powerhouse” of eukaryotic cells since it is the main site of adenosine 5′‐triphosphate (ATP) production. Using a temperature‐sensitive fluorescent probe, it has recently been suggested that the stray free energy, not captured into ATP, is potentially sufficient to sustain mitochondrial temperatures higher than the cellular environment, possibly reaching up to 50 °C. By 50 °C, some DNA and mitochondrial proteins may reach their melting temperatures; how then do these biomolecules maintain their structure and function? (...) Further, the production of reactive oxygen species (ROS) accelerates with temperature, implying higher oxidative stresses in the mitochondrion than generally appreciated. Herein, it is proposed that mitochondrial heat shock proteins (particularly Hsp70), in addition to their roles in protein transport and folding, protect mitochondrial proteins and DNA from thermal and ROS damage. Other thermoprotectant mechanisms are also discussed. (shrink)

"Jesus Shock is the second in a series of short works on seminal concerns of the impact that Jesus Christ made in the world. The first work, The Philosophy of Jesus, explored philosophy in light of Jesus, rather than the other way around. The present work investigates the reception Jesus received both in His lifetime and continuously to the present time, not only from His enemies, but from His friends, a reception of shock, astonishment, even disgust." "Jesus-Shock (...) shows the reasons why to this day the name of "Jesus" stirs up controversy, even revulsion, in polite society. In the true spirit of ecumenism, it also points the way toward a true rapprochement among His modern-day disciples."--BOOK JACKET. (shrink)

Career shocks are the norm, not the exception. Yet, much of research and counseling on career-development holds unrealistic assumptions of a makeable career. Little is understood about the role of shocks on the career path and how the interplay of individual reactions to shocks shapes careers. The purpose of this study is to provide understanding of responses to different attributes of career shocks and career shocks as antecedents to career and job change. A qualitative approach was chosen and data were (...) obtained from 25 semi-structured interviews with a sample of mid-career individuals who had experienced shocks in their work lives. The analysis was 2-fold and aimed at unearthing of individual responses to shocks and the question of the role of shocks on changes in the career path. Firstly, the analysis of career shocks revealed a pattern of distinct agentic responses in relation to shocks of different attributes. Secondly, from the analysis of shock attributes and corresponding responses over time career changer profiles emerged which differ in regard to career change behavior and magnitude of changes in the career. A process model which depicts how post-shock careers are shaped distinctively in relation to different shock attributes and corresponding responses is presented. This study underlines the importance of understanding the unplannable in career development and shows a variety of options for individuals to develop their careers despite shocks. Limitation stems from the investigation of a sample limited to mid-career individuals. The findings provide a new conceptual lens to theorize and conduct research on career shocks and career changes and facilitate the development of coping strategies for career shocks. The originality lies in the investigation of the momentum of career shocks on career paths with detail to different attributes of career shocks and how they impact the career path. (shrink)

Existing debates on business ethics under-represent consumers’ perspectives. In order to progress understanding of ethical judgement in the marketplace, we unpack the interconnections between consumer ethical judgment, consent and context. We address the question of how consumers judge the morality of threat-based experiential marketing communications. Our interpretive qualitative research shows that consumers can feel positively about being shocked, judging threat appeals as more or less ethical by the nature of the negative emotions they experience. We also determine that the intersection (...) between ethical judgement, consent and context lies where consumers’ perceptions of fairness and consequences lend contextualised normative approval to marketing practice. Our research makes three original contributions to existing literature. First, it extends theory in the area of ethical judgement, by highlighting the importance of consent for eliciting positive moral responses. Second, it adds to embryonic research addressing the role of emotions in ethical judgement, by ascertaining that negative emotions can elicit positive consumer ethical judgement. Third, our research contributes an original concept to ethical judgement theorisation, namely consumer-experienced positive shock. We define CEPS as a consensual shock value judged as ethical due to its ephemerality, commercial resonance, brand alignment, target-audience appropriateness and contextual acceptability. We also extrapolate the dimensions of CEPS into an ethical judgement typology, elucidating how consumers judge some threat-based communications as ethical, but not others. Consequently, our work dovetails with wider business ethics debates on ethical judgement, adding value by clarifying the conditions that generate positive consumer ethical judgement. (shrink)

Mathematical Logic had a glorious period in the 1930s, which was briefly rekindled in the 1960s. Any Shock Value, such as it is, has surrounded unprovability from ZFC.

This study investigates the negative reactions of Dutch viewers to the content of television programs. The results show that a vast majority is sometimes irritated by TV programs, that a somewhat smaller majority is sometimes shocked by the programs, and that one fifth of the viewing population consider certain programs to be intolerable. The most frequently mentioned genres are games, shows, and related entertainment programs, while reality TV, news and current affairs, and sex are primarily evaluated as irritating. It appears (...) that violent and frightening material creates by far the largest category of negative responses. Intimidating behavior worries the viewers most, immediately followed by the violation of privacy. This article also discusses the consequences of these results for broadcasting policy in the Netherlands. (shrink)

THE SHOCK of LOVE is a book about spirit. It is a book within a book. The book found within is a manuscript entitled THE SHOCK of LOVE. It is purportedly written by Paolo Cellini, Professor of Romance Languages and a student of the era of the troubadours and courtly love. Based on the idea of a book of the heart, current during that time, it is divided into nine chapters that give allegorical detail of the journey of (...) love, a love that completes the spirit in a person. There the reader follows the courtship, the 'alchemical' marriage, and the dark gestation before emerging transformed and completed. The outer book, the book that encloses the found manuscript, tells the story of Cellini as well as speculating on why it came to be written. (shrink)

The purpose of the study is to reveal the concept of "economic shock", to identify its basic features and to classify shock effects. The article discusses the use of the term "economic shock" in order to improve the tools of economic security. The article analyzes the concept of "shock resistance", details its interpretation in the scientific literature, and considers the differences between shock resistance and "sustainability". The scientific novelty lies in the identification of signs of (...) an economic shock that allow us to separate it from other destructive effects on the economic system. The result of the study was the consideration of enlarged approaches to the classification of economic shocks from the point of view of the nature of their formation, the predicted shock and the unpredictable shock were distinguished. (shrink)

A Shock to Thought brings together essays that explore Deleuze and Guattari's philosophy of expression in a number of contemporary contexts. It will be of interest to all those in philosophy, cultural studies and art theory. The volume also contains an interview with Guattari which clearly restates the 'aesthetic paradigm' that organizes both his and Deleuze's work.

In The Shock of Recognition, Lewis Pyenson uses a method called Historical Complementarity to identify the motif of non-figurative abstraction in modern art and science. He identifies the motif in Picasso's and Einstein's educational environments. He shows how this motif in domestic furnishing and in urban lighting set the stage for Picasso's and Einstein's professional success before 1914. He applies his method to intellectual life in Argentina, using it to address that nation's focus on an inventory of the natural (...) world until the 1940s, its adoption of non-figurative art and nuclear physics in the middle of the twentieth century, and attention to landscape painting and the wonder of nature at the end of the century. (shrink)

Despite their status as high-income food producing nations, children and their caregivers, both in the United States (U.S.) and Australia can experience food insecurity. Nutrition researchers formed a joint U.S.-Australia collaboration to help advance food security for households with young children aged 0–5 years. This study investigated food insecurity from the perspective of caregivers, especially their perceptions of the impact of food insecurity on their own childhood, their current life, and for the children in their care. Semi-structured interviews were conducted (...) from July to September 2020 during the COVID-19 pandemic. Participants were recruited in Omaha, Nebraska, U.S. (_n_ = 19) and Melbourne, Victoria, Australia (_n_ = 22), during periods of stay-at-home public health orders. These two case study sites enabled an exploration of some universal, and some context-specific, social, economic, and health conditions that buffer, or exacerbate, food insecurity for families in these neo-liberal political settings. An inductive thematic analysis was conducted and established six themes:_growing up poor_, _lessons learned_,_ feeding a family amidst a pandemic_,_ caregiver coping strategies_, _food security in the early years_ and _protecting (young) children_. Perspectives on local anti-hunger strategies were organized to outline participant’s preferred solutions. Household food insecurity is conceptualized in public policy in the U.S. and Australia as a short-term crisis for people, justifying austere, time-limited and patchwork solutions. A narrative of caregivers’ lived experience of food insecurity suggests that it is inter-generational, and exacerbated by a food system shock (i.e., COVID-19). These findings from two varying cities and nations offer a different conceptualization of the timespan and nature of the phenomenon of food insecurity, challenging a dominant policy narrative and highlighting the inadequacy of current so-called solutions. (shrink)

Modern empirical macroeconomic models, known as structural autoregressions (SVARs) are dynamic models that typically claim to represent a causal order among contemporaneously valued variables and to merely represent non-structural (reduced-form) co-occurence between lagged variables and contemporaneous variables. The strategy is held to meet the minimal requirements for identifying the residual errors in particular equations in the model with independent, though otherwise not directly observable, exogenous causes (“shocks”) that ultimately account for change in the model. In nonstationary models, such shocks accumulate (...) so that variables have discernible trends. Econometricians have conceived of variables that trend in sympathy with each other (so-called “cointegrated variables”) as sharing one or more of these unobserved trends as a common cause. It is possible for estimates of the values of both the otherwise unobservable individual shocks and the otherwise unobservable common trends to be backed-out of cointegrated systems of equations. The issue addressed in this paper is whether and in what circumstances these values can be regarded as observations of real entities rather than merely artifacts of the representation of variables in the model. The issue is related, on the one hand, to practical methodological problems in the use of SVARs for policy analysis—e.g., does it make sense to estimate of shocks or trends in one model and then use them as measures of variables in a conceptually distinct model? The issue is also related to debates in the philosophical analysis of causation—particularly, whether we are entitled, as assumed by the developers of Bayes-net approaches, to rely on the causal Markov condition (a generalization of Reichenbach’s common-cause condition) or whether cointegration generates a practical example of Nancy Cartwright’s “byproducts” objection to the causal Markov condition. (shrink)

In a similar way to what happens when a wave of electricity impacts the animal body and provokes a convulsive stir of muscles and nerves which can burn and ultimately paralyze the affected surface, some rough emotional experiences may lead us to sudden numbness. Keeping abreast with the most sophisticated phenomenological tools to account for an extremely damaging kind of psychological experience that can ultimately defeat the purpose of a sheer descriptive approach, this chapter does provide a descriptive analysis of (...) the kind of emotional shock that risks threatening the moral integrity of an agent. I shall zoom in my analysis on the typically acknowledged moment when disturbing information from a socially shared context outside ourselves comes suddenly to the fore of our attention, thus disrupting the focus even of the the most trivial perceptive input. I argue that in the longer run the outcome of such an experience may amount to a reconfiguration of the subject’s core values, daily routines and even her life-long expectations and projects. (shrink)

Studies based on the Rankine-Hugoniot relations have classified MHO shock waves as fast, switch-on, intermediate, switch-off, and slow. Any waves found in nature must also: possess steady-state structures and be stable in the presence of small-flow disturbances. In this monograph, Dr. Anderson examines these criteria in relation to plane shocks for which the collision frequency is large compared with cyclotron frequency. It contains a three-dimensional graphic representation of shock end states and presents an exact solution for the (...) class='Hi'>shock adiabatic curve in a convenient form. An MIT Press Research Monograph. (shrink)

This paper takes a recently published text and, in examining it closely, argues that it exemplifies trends within feminist scholarship in law, which might be characterised asestablishing a form of orthodoxy. The paper explores some of the ways in which thiso rthodoxy is constructed and presented, and argues that it is characterised by a commitment both to `grand theory' and Hegelian dialectics. The adoption of this model of work seems to offer a chance to hold together the triangular figure of (...) women/theory/law reform. The paper will argue that, whilst this model is clearly a valid choice, and attractive to feminist scholars in the promise it seems to hold, the model is not to be presumed but rather should be examined and considered in terms of its potential for feminist scholarship. Both within its own terms, and as part of the construction of an orthodoxy, the paper will argue that it is in fact problematic and that feminist scholarship would be better served by seeking an alternative theoretical model. An alternative is suggested, using the work of Deleuze, but it is acknowledged that this will require the acceptance of a very different theoretical configuration from that suggested by the triangular model of women/theory/lawreform. (shrink)

I propose that shock can be morally significant independently of its consequences but only as part of an ongoing commitment to certain norms, in particular norms that constitute recognizing another as a person. When we witness others in agony, or being severely wronged, or when we ourselves severely wrong or mistreat others, our shock can reflect our recognition of them as persons, a recognition constituted by our commitment to certain moral norms. However, if we do not in fact (...) respond to the suffering or wrong in accordance with these norms—if, for example, we do not act to relieve their suffering or to properly address the wrong done, and do not avoid or prevent its recurrence—then our commitment to the relevant norms is undermined. When we consistently violate the norms whose violation initially shocked us, our lingering shock upon repeated violations gradually loses its significance and becomes a mere impulse—a fossil of a past commitment, so to speak—before it disappears completely. The failure to be shocked in such instances marks the failure of our moral commitments, which is the failure to recognize others as persons. (shrink)

Jasper and Poulsen have long argued that moral shocks are critical for recruitment in the nonhuman animal rights movement. Building on this, Decoux argues that the abolitionist faction of the nonhuman animal rights movement fails to recruit members because it does not effectively utilize descriptions of suffering. However, the effectiveness of moral shocks and subsequent emotional reactions has been questioned. This article reviews the literature surrounding the use of moral shocks in social movements. Based on this review, it is suggested (...) that the exploitation of emotional reactions to depictions of suffering can sometimes prove beneficial to recruitment, but successful use is contextually rooted in preexisting frameworks, ideology, and identity. It is concluded that a reliance on images and narratives might be misconstrued in a society dominated by nonhuman animal welfare ideology. (shrink)

The heat shock genes (hsp genes) are a family of truly ubiquitous genes which have been highly conserved throughout evolution. The protein products of these genes, the heat shock proteins (hsps) are thought to play a protective role in cells (although this may not be their only function). The genes and their products have been the subjects of intense research both at the cellular and molecular levels over the past few years. This review deals with the conservation of (...) the heat shock response and with the expression of the hsp genes under different conditions: they are usually activated as a group by different forms of stress, but can be expressed individually or in subsets at different stages during normal development and the expression of one of them is evoked by the products of different transforming genes. Experimental approaches which have provided information or which have led to hypotheses regarding the molecular details of the mechanisms regulating the expression of the genes are discussed. (shrink)

The theme is the encounter. The 17th century Iberian Old World meets the New World and there it finds itself again, its utopias and dystopias, its monsters and its Edenic motifs, its eschatologies and its fates – as if the imagined anticipated the real that the conquerors came across in Portuguese America. Alessandro Zir, a researcher linked to the Federal University of Rio Grande do Sul, uses the approach of styles of thinking – in this expression by Ian Hacking (2002), (...) an author whom Zir chooses as a kind of mentor –, created to better capture the historical course and its changes and as a theoretical strategy that is both relevant to philosophy and the history of science. This strategy is itself an encounter, including the sense of clash, dispute and experience, as predicted by the semantics of the English term “encounter”, contained in the title of the book and very well chosen. In addition to the clashes with the revived monsters on the other side of the Atlantic, the clash soon stands out, aiming to better understand the subject at hand, between this approach to styles of thought and those old (or not so old) mental ways that We collect it from the narratives of travelers, colonizers and missionaries from the 16th century. // O tema é o encontro. O Velho Mundo ibérico seiscentista encontra o Novo Mundo e aí mesmo reencontra a si próprio, suas utopias e distopias, seus monstros e seus motivos edênicos, suas escatologias e seus fados – como se o imaginado adiantasse o real com que os conquistadores vieram a topar na América portuguesa. Alessandro Zir, pesqui- sador ligado à Universidade Federal do Rio Grande do Sul, serve-se da abordagem dos estilos de pensamento (styles of thinking) – nessa expressão de Ian Hacking (2002), autor que Zir elege como espécie de mentor –, criada para melhor captar o curso histórico e suas mudanças e como uma estratégia teórica a um só tempo pertinente à filosofia e à história da ciência. Essa estratégia é ela mesma um encontro, incluindo-se aí o senti- do de embate, disputa e experiência, tal como prevê a semântica do termo inglês “encounter”, constante no título do livro e muito bem escolhido. É que para além dos embates com os monstros revividos no outro lado do Atlântico, logo se destaca o em- bate, visando melhor conhecer o assunto em pauta, entre essa abordagem dos estilos de pensamento e aqueles antigos (ou nem tanto) modos mentais que recolhemos nas nar- rativas de viajantes, colonizadores e missionários do século xvi. (shrink)

We live in a reactionary culture where divisive issues arise, people on either side throw stones, and everyone ends up more entrenched in their opinions than in reaching common ground--or even exhibiting common courtesy! If there ever was a time for Christians to understand and communicate God's truth about controversial and polarizing issues, it is now. Believers must develop convictions based on research, reason, and biblical truth--and be able (and willing) to communicate these convictions with a love and respect that (...) reflects God's own heart. In Culture Shock, bestselling author, pastor, and radio personality Chip Ingram shows readers how they can bring light rather than heat to the most controversial and divisive issues of our day. Covering topics such as right and wrong, sex, homosexuality, abortion, politics, and the environment, Culture Shock is every engaged believer's must-have guidebook to replacing reactionary hate with revolutionary love. (shrink)

In this response article, we challenge a core assumption that lies at the centre of a round table discussion regarding the Pharmacogenetics to Avoid Loss of Hearing trial. The round table regards a genetic test for a variant (mt.1555A>G) that increases the risk of deafness if a carrier is given the antibiotic gentamicin. The idea is that rapid testing can identify neonates at risk, providing an opportunity to prevent giving an antibiotic that might cause deafness. We challenge the assumption that (...) a positive test unequivocally guides antibiotic choice because, aside from the risk of deafness, all antibiotics for neonatal sepsis are equivalent. We argue that this assumption is faulty and has particularly troubling moral consequences. We claim that giving an alternative to gentamicin is potentially providing inferior treatment and thereby may increase the risk of death. Parents and doctors are faced with a terrible choice as a result of positive point-of-care testing (POCT): give gold-standard treatment and risk deafness or give second line care and risk death. While we do not indicate an answer to this choice, what we do argue is that such a deep and difficult choice is one that may make parents wish genetic testing was never undertaken, and therefore, contra some authors in the round table, provides a reason to gain specific consent for POCT. (shrink)