ABSTRACTThis paper critically analyses current depictions of prevention and tries to offer a new theoretical reflection on the concept by reconstructing it on the basis of Jeremy Bentham’s writings on indirect legislation. It is my aim not only to explore Bentham’s concept of indirect legislation as an outstanding example of enlightened social/public policy, but also to show to what extent his thoughts might be a fruitful contribution to a necessary reconceptualization of current conceptions of prevention, which are heavily criticized by (...) many scholars. (shrink)

Na literatura recente sobre os desafios gerados pelas novas tecnologias, certos autores defendem o Princípio da Precaução como um princípio de racionalidade central em deliberações sobre práticas associadas àquelas tecnologias. Há dois sentidos possíveis para ‘precaução’: um formal, outro substantivo. Tais autores parecem interpretar o PP no último sentido, a fim de eliminar absolutamente os riscos possíveis das novas tecnologias à humanidade. Contra esta interpretação, argumentaremos que precaução não é o tipo de consideração que figure adequadamente em uma teoria da (...) deliberação para ações humanas e sugeriremos que o PP parece, na verdade, para tais autores, envolver um compromisso moral. Mas, neste caso, ele não é menos controverso do que outros princípios morais. (shrink)

Introduction The bioethics literature reflects significant interest in and concern with the use of genetic and genomic information in various settings. Because psychiatric treatment and research raises unique ethical, legal, and social issues, we conducted a scoping review of the biomedical, bioethics, and psychology literature regarding the application of genetic and genomic tools to psychiatric disorders (as listed in the DSM-5) and two associated behaviors or symptoms to provide a more detailed overview of the state of the field. Objectives The (...) primary objective was to examine the available bioethics, biomedical, and psychology literature on applying genetic and genomic tools to psychiatric disorders (other than neurodevelopmental disorders) and two behaviors or symptoms sometimes associated with them (aggression or violence and suicidality) to identify the disorders to which these tools have been applied, the contexts in or purposes for which they have been applied, the ethical, legal, or social concerns associated with those uses, and proposed recommendations for mitigating those concerns. Methods We used Arksey and O’Malley’s scoping review framework: (1) identify the research question; (2) identify relevant studies; (3) select studies; (4) chart the data; and (5) collate, summarize, and report results (2005). We relied on Levac et al. to inform our application of the framework (2010). The PRISMA extension for scoping reviews checklist informed our reporting (2018). We searched three electronic databases MEDLINE (PubMed), Embase, and PsycInfo (EbscoHost) for peer-reviewed journal articles in English to identify relevant literature. One author screened the initial results and additional screening was done in consultation with other authors. A data extraction form using DSM-5 diagnostic categories (excluding neurodevelopmental disorders) was developed and two authors independently each reviewed approximately half of the articles. Inter-rater reliability was ensured by double-coding approximately 10% of the papers. An additional author independently coded 10% of the articles to audit the data. Results In 365 coded publications, we identified 15 DSM-5 diagnostic categories in addition to the two pre-selected behaviors or symptoms (aggression or violence and suicidality) to which genetic or genomic tools have been applied. We identified 11 settings in or purposes for which these tools were applied. Twenty-two types of ethical, legal, or social concerns associated with the application of genetic or genomic tools to these disorders or behaviors/symptoms were identified along with 13 practices or policies that could mitigate these concerns. Conclusion Genetic and genomic tools have been applied to a wide range of psychiatric disorders. These raise a range of ethical, legal, and social concerns. Additional research is warranted to better understand the concerns and effective ways to address them. Advancing the literature to identify relevant ethical, legal, or social concerns and solutions to those problems likely requires greater attention to specific applications of genetic or genomic tools to particular psychiatric disorders and associated behaviors/symptoms as well as broad stakeholder engagement. (shrink)

This essay examines the relationship between the precautionary principle and uncertainty factors used by toxicologists to estimate acceptable exposure levels for toxic chemicals from animal experiments. It shows that the adoption of uncertainty factors in the United States in the 1950s can be understood by reference to the precautionary principle, but not by cost-benefit analysis because of a lack of relevant quantitative data at that time. In addition, it argues that uncertainty factors continue to be relevant to efforts to implement (...) the precautionary principle and that the precautionary principle should not be restricted to cases involving unquantifiable hazards. (shrink)