Background Scientific and technological advancements in mapping and understanding the interrelated pathways through which biological and environmental exposures affect disease development create new possibilities for detecting disease risk factors. Early detection of such risk factors may help prevent disease onset or moderate the disease course, thereby decreasing associated disease burden, morbidity, and mortality. However, the ethical implications of screening for disease risk factors are unclear and the current literature provides a fragmented and case-by-case picture. Methods To identify key ethical considerations (...) arising from the early detection of disease risk factors, we performed a systematic scoping review. The Scopus, Embase, and Philosopher’s Index databases were searched for peer-reviewed, academic records, which were included if they were written in English or Dutch and concerned the ethics of (1) early detection of (2) disease risk factors for (3) disease caused by environmental factors or gene-environment interactions. All records were reviewed independently by at least two researchers. Results After screening 2034 titles and abstracts, and 112 full papers, 55 articles were included in the thematic synthesis of the results. We identified eight common ethical themes: (1) Reliability and uncertainty in early detection, (2) autonomy, (3) privacy, (4) beneficence and non-maleficence, (5) downstream burdens on others, (6) responsibility, (7) justice, and (8) medicalization and conceptual disruption. We identified several gaps in the literature, including a relative scarcity of research on ethical considerations associated with environmental preventive health interventions, a dearth of practical suggestions on how to address expressed concerns about overestimating health capacities, and a lack of insights into preventing undue attribution of health responsibility to individuals. Conclusions The ethical concerns arising with the early detection of risk factors are often interrelated and complex. Comprehensive ethical analyses are needed that are better embedded in normative frameworks and also assess and weigh the expected benefits of early risk factor detection. Such research is necessary for developing and implementing responsible and fair preventive health policies. (shrink)

After describing the disorder of psychopathy, I examine the theories and the evidence concerning the psychopaths’ deficient moral capacities. I first examine whether or not psychopaths can pass tests of moral knowledge. Most of the evidence suggests that they can. If there is a lack of moral understanding, then it has to be due to an incapacity that affects not their declarative knowledge of moral norms, but their deeper understanding of them. I then examine two suggestions: it is their deficient (...) practical reason or their stunted emotions that are at fault. The evidence supports both explanations. I conclude with an overview of the debate concerning whether they are morally or legally responsible for their actions. (shrink)

Innovations in science and technology are often the source of public concern, but few have generated debates as intense and at the same time with such a popular fascination as those surrounding genetic technologies. Unequal access to preimplantation diagnosis could give some individuals the opportunity to select children with more advantageous predispositions.

The moral enhancement of humans by biological or genetic means has recently been urged as a response to the pressing concerns facing human civilization. In this paper, I argue that proponents of biological moral enhancement have misrepresented the facts of human moral psychology. As a result, the likely effectiveness of traditional methods of moral enhancement has been underestimated, relative to biological or genetic means. I review arguments in favor of biological moral enhancement and argue that the complexity of moral psychology (...) raises serious problems for such interventions. I offer a programmatic sketch of the ways in which our improved understanding of moral psychology can help facilitate more traditional methods of moral enhancement. I conclude that the best response to the dangers faced by human civilization is the continued use of traditional methods of moral enhancement and the use of our improved understanding of moral psychology to further refine and develop these methods. (shrink)

Innovations in science and technology are often the source of public concern, but few have generated debates as intense and at the same time with such a popular fascination as those surrounding genetic technologies. Unequal access to preimplantation diagnosis could give some individuals the opportunity to select children with more advantageous predispositions.

Many cases of gene‐environment interaction, or , are misconstrued as evincing a genetic predisposition. I diagnose this misconstrual and then introduce a new concept— interactive predisposition —to correct for the mistake. I conclude by examining how recent debates over screening for individual predispositions are related to older debates about group differences between populations , drawing on the lessons of the latter to inform the former. †To contact the author, please write to: Department of Philosophy, University of Utah, Salt Lake City, (...) UT 84112; e‐mail: [email protected]. (shrink)