We discuss recent progress in the development of cognitive ontologies and summarize three challenges in the coordinated development and application of these resources. Challenge 1 is to adopt a standardized definition for cognitive processes. We describe three possibilities and recommend one that is consistent with the standard view in cognitive and biomedical sciences. Challenge 2 is harmonization. Gaps and conflicts in representation must be resolved so that these resources can be combined for mark-up and interpretation of multi-modal data. Finally, Challenge (...) 3 is to test the utility of these resources for large-scale annotation of data, search and query, and knowledge discovery and integration. As term definitions are tested and revised, harmonization should enable coordinated updates across ontologies. However, the true test of these definitions will be in their community-wide adoption which will test whether they support valid inferences about psychological and neuroscientific data. (shrink)

New developments in biotechnology radically alter our relationship with our bodies. Body tissues can now be used for commercial purposes, while external objects, such as pacemakers, can become part of the body. Property in the Body: Feminist Perspectives transcends the everyday responses to such developments, suggesting that what we most fear is the feminisation of the body. We fear our bodies are becoming objects of property, turning us into things rather than persons. This book evaluates how well-grounded this fear is, (...) and suggests innovative models of regulating what has been called 'the new Gold Rush' in human tissue. This is an up-to-date and wide-ranging synthesis of market developments in body tissue, bringing together bioethics, feminist theory and lessons from countries that have resisted commercialisation of the body, in a theoretically sophisticated and practically significant approach. (shrink)

Janette Dinishak’s work has helped shed critical light on the scientifically questionable and ethically troubling tendency in psychology and philosophy of mind to theorize autistic people as deficient empathizers. In a recently published reply on the Social Epistemology Review and Reply Collective, Dinishak (2024) brings her important perspective on this topic to bear on our paper “AAC Technology, Autism, and the Empathic Turn” (2022). Dinishak is largely sympathetic to our view while also raising a number of rich and thoughtful philosophical (...) questions. Since each of these questions is capable of jumpstarting a lengthy exchange, we focus our response on those questions that, we hope, are particularly fruitful for advancing further conversation. With this aim in mind, we also engage with some of Dinishak’s own insights from her 2016 chapter “Empathy, Like-mindedness, and Autism.” … [please read below the rest of the article]. (shrink)

Most opponents of somatic cell nuclear transfer and embryonic stem cell technologies base their arguments on the twin assertions that the embryo is either a human being or a potential human being, and that it is wrong to destroy a human being or potential human being in order to produce stem cell lines. Proponents’ justifications of stem cell research are more varied, but not enough to escape the charge of obsession with the status of the embryo. What unites the two (...) warring sides in ‘the stem cell wars’ is that women are equally invisible to both: ‘the lady vanishes.’ Yet the most legitimate property in the body is that which women possess in their reproductive tissue and the products of their reproductive labour. By drawing on the accepted characterisation in the common law of property as a bundle of rights, and on a Hegelian model of contract as mutual recognition, we can lessen the impact of the tendency to regard women and their ova as merely receptacles and women’s reproductive labour as unimportant. (shrink)

The Emotion Ontology is an ontology covering all aspects of emotional and affective mental functioning. It is being developed following the principles of the OBO Foundry and Ontological Realism. This means that in compiling the ontology, we emphasize the importance of the nature of the entities in reality that the ontology is describing. One of the ways in which realism-based ontologies are being successfully used within biomedical science is in the annotation of scientific research results in publicly available databases. Such (...) annotation enables several objectives, including searching, browsing and cross-database data integration. A key benefit conferred by realismbased ontology is that suitably annotated research results are able to be aggregated and compared in a fashion that is based on the underlying reality that the science is studying. This has the potential of increasing the power of statistical analysis and meta-analysis in data-driven science. This aspect has been fruitfully exploited in the investigation of the functions of genes in molecular biology. Cognitive neuroscience uses functional neuroimaging to investigate the brain correlates of areas of mental functioning such as memory, planning and emotion. The use of functional neuroimaging to study affective phenomena such as the emotions is called ‘affective neuroscience’. BrainMap is the largest curated database of coordinates and metadata for studies in cognitive neuroscience, including affective neuroscience (Laird et al., 2005). BrainMap data is already classified and indexed using a terminology for classification, called the ‘Cognitive Paradigm Ontology’ (CogPO), that has been developed to facilitate searching and browsing. However, CogPO has been developed specifically for the BrainMap database, and the data are thus far not annotated to a realism-based ontology which would allow the discovery of interrelationships between research results across different databases on the basis of what the research is about. In this contribution, we describe ongoing work that aims to annotate affective neuroscience data, starting with the BrainMap database, using the Emotion Ontology. We describe our objectives and technical approach to the annotation, and mention some of the challenges. (shrink)

For a long time discussion about scarce health care resource allocation was limited to allocation of medical resources, with the paradigmatic case being kidney transplants. However, a narrow focus on medical resources prevents us from seeing that there are many cases-- perhaps the majority-- in which less dramatic but equally important issues of rationing occur. The allocation of nurses' time is one such issue.

Mental and behavioral disorders represent a significant portion of the public health burden in all countries. The human cost of these disorders is immense, yet treatment options for sufferers are currently limited, with many patients failing to respond sufficiently to available interventions and drugs. High quality ontologies facilitate data aggregation and comparison across different disciplines, and may therefore speed up the translation of primary research into novel therapeutics. Realism-based ontologies describe entities in reality and the relationships between them in such (...) a way that – once formulated in a suitable formal language – the ontologies can be used for sophisticated automated reasoning applications. Reference ontologies can be applied across different contexts in which different, and often mutually incompatible, domain-specific vocabularies have traditionally been used. In this contribution we describe the Mental Functioning Ontology (MF) and Mental Disease Ontology (MD), two realism-based ontologies currently under development for the description of humanmental functioning and disease. We describe the structure and upper levels of the ontologies and preliminary application scenarios, and identify some open questions. (shrink)

The results of a recent survey of Nigerian women might give pause to opponents of female genital mutilation (FGM). One could well argue that if these Nigerian women themselves favour FGM, then it is ironically paternalistic to oppose it. Should Western feminists actually support FGM if it is what women in the South want? I argue in this commentary that such an argument rests on shaky statistical, psychological, medical, political and philosophical grounds. We should go on opposing female genital mutilation (...) with all our power. (shrink)

Landgrebe and Smith provide an argument for the impossibility of Artificial General Intelligence based on the limits of simulating complex systems. However, their argument presupposes a very contemporary vision of artificial intelligence as a model trained on data to produce an algorithm executable in a modern digital computing system. The present contribution explores what it means to be artificial. Current artificial intelligence approaches on modern computing systems are not the only conceivable way in which artificial intelligence technology might be created. (...) If there are conceivable routes by which an artificial intelligence might be developed that are not constrained in the same way as the current generation of artificial neural networks, then these might be plausible routes towards the engineered generation of artificial general intelligence that are not precluded by the Landgrebe and Smith argument against the possibility of artificial general intelligence. (shrink)

Interview by Klasien Horstman on gender and genetics. 'Unlike many gender theorists, I do not view the body as socially constructed; nor do I share postmodern and deconstructionist disquiet at the notion of a unified subject. Frankly, I think these constructions get in the way of political action and are bad for women’s rights.' -/- .

Abstract Gender and Ethics Committees: Where’s the Different Voice? -/- Prominent international and national ethics commissions such as the UNESCO Bioethics Commission rarely achieve anything remotely resembling gender equality, although local research and clinical ethics committees are somewhat more egalitarian. Under-representation of women is particularly troubling when the subject matter of modern bioethics so disproportionately concerns women’s bodies, and when such committees claim to derive ‘universal’ standards. Are women missing from many ethics committees because of relatively straightforward, if discriminatory, demographic (...) factors? Or are the methods of analysis and styles of ethics to which these bodies are committed somehow ‘anti-female’? It has been argued, for example, that there is a ‘different voice’ in ethical reasoning, not confined to women but more representative of female experience. Similarly, some feminist writers, such as Evelyn Fox Keller and Donna Haraway, have asked difficult epistemological questions about the dominant ‘masculine paradigm’ in science. Perhaps the dominant paradigm in ethics committee deliberation is similarly gendered? This article provides a preliminary survey of women’s representation on ethics committees in Eastern and Western Europe, a critical analysis of the supposed ‘masculinism’ of the principlist approach, and a case example in which a ‘different voice’ did indeed make a difference. (shrink)

Objectives—To assess whether UK and US health care professionals share the views of medical ethicists about medical futility, withdrawing/withholding treatment, ordinary/extraordinary interventions, and the doctrine of double effectDesign, subjects and setting–A 138-item attitudinal questionnaire completed by 469 UK nurses studying the Open University course on “Death and Dying” was compared with a similar questionnaire administered to 759 US nurses and 687 US doctors taking the Hastings Center course on “Decisions near the End of Life”.Results–Practitioners accept the relevance of concepts widely (...) disparaged by bioethicists: double effect, medical futility, and the distinctions between heroic/ordinary interventions and withholding/ withdrawing treatment. Within the UK nurses' group a “rationalist” axis of respondents who describe themselves as having “no religion” are closer to the bioethics consensus on withholding and withdrawing treatment.Conclusions—Professionals' beliefs differ substantially from the recommendations of their professional bodies and from majority opinion in bioethics. Bioethicists should be cautious about assuming that their opinions will be readily accepted by practitioners. (shrink)

In Two Minds is a practical casebook of problem solving in psychiatric ethics. Written in a lively and accessible style, it builds on a series of detailed case histories to illustrate the central place of ethical reasoning as a key competency for clinical work and research in psychiatry. Topics include risk, dangerousness and confidentiality; judgements of responsibility; involuntary treatment and mental health legislation; consent to genetic screening; dual role issues in child and adolescent psychiatry; needs assessment; cross-cultural and gender issues; (...) rational and irrational suicide; shared decision making in multi-agency teams, and the growing role of the user's voice in psychiatry. Key ethical concepts are carefully introduced and explained. The text is richly supported by detailed guides for further reading. There are separate chapters on teaching psychiatric ethics, including a sample seminar, and on writing a research ethics application. Each case history and discussion is followed by a critical commentary from a practitioner with relevant experience. Jim Birley adds a comparative international perspective on psychiatric ethics. Cartoons by Johnny Cowee provide punchy counterpoint! In Two Minds is the sister volume to the third edition of Sidney, Paul Chodoff and Steven Green's highly successful Psychiatric Ethics. In providing a bridge between theory and practice, it will be essential reading for everyone concerned with improving standards in mental health care. (shrink)

Ontologies are being developed throughout the biomedical sciences to address standardization, integration, classification and reasoning needs against the background of an increasingly data-driven research paradigm. In particular, ontologies facilitate the translation of basic research into benefits for the patient by making research results more discoverable and by facilitating knowledge transfer across disciplinary boundaries. Addressing and adequately treating mental illness is one of our most pressing public health challenges. Primary research across multiple disciplines such as psychology, psychiatry, biology, neuroscience and pharmacology (...) needs to be integrated in order to promote a more comprehensive understanding of underlying processes and mechanisms, and this need for integration only becomes more pressing with our increase in understanding of differences among individuals and populations at the molecular level concerning susceptibility to specific illnesses. Substance addiction is a particularly relevant public health challenge in the developed world, affecting a substantial percentage of the population, often co-morbid with other illnesses such as mood disorders. Currently, however, there is no straightforward automated method to combine data of relevance to the study of substance addiction across multiple disciplines and populations. In this contribution, we describe a framework of interlinked, interoperable bio-ontologies for the annotation of primary research data relating to substance addiction, and discuss how this framework enables easy integration of results across disciplinary boundaries. We describe entities and relationships relevant for the description of addiction within the Mental Functioning Ontology, Chemical Entities of Biological Interest Ontology, Protein Ontology, Gene Ontology and the Neuroscience Information Framework ontologies. (shrink)

This article, arising from a comparative European Commission project, analyses different national perspectives on bioethics issues.

This article, based on a case study, examines issues of confidentiality and family impact in a diagnosis of Huntington's disease. Genetic-based illness transcends individualistic models of patient autonomy because it also involves other family members, requiring a new approach to patient confidentiality.

Online therapy sessions and other forms of digital mental health services (DMH) have seen a sharp spike in new users since the start of the COVID-19 pandemic. Having little access to their social networks and support systems, people have had to turn to digital tools and spaces to cope with their experiences of anxiety and loss. With no clear end to the pandemic in sight, many of us are likely to remain reliant upon DMH for the foreseeable future. As such, (...) it is important to articulate some of the specific ways in which the pandemic is affecting our self and world-relation, such that we can identify how DMH services are best able to accommodate some of the newly emerging needs of their users. In this paper I will identify a specific type of loss brought about by the COVID-19 pandemic and present it as an important concept for DMH. I refer to this loss as loss of perceptual world-familiarity. Loss of perceptual world-familiarity entails a breakdown in the ongoing effortless responsiveness to our perceptual environment that characterizes much of our everyday lives. To cash this out I will turn to insights from the phenomenological tradition. Initially, my project is descriptive. I aim to bring out how loss of perceptual world-familiarity is a distinctive form of loss that is deeply pervasive yet easily overlooked-hence the relevance of explicating it for DMH purposes. But I will also venture into the space of the normative, offering some reasons for seeing perceptual world-familiarity as a component of well-being. I conclude the paper with a discussion of how loss of perceptual world-familiarity affects the therapeutic setting now that most if not all therapeutic interactions have transitioned to online spaces and I explore the potential to augment these spaces with social interaction technologies. Throughout, my discussion aims to do justice to the reality that perceptual world-familiarity is not an evenly distributed phenomenon, that factors like disability, gender and race affect its robustness, and that this ought to be reckoned with when seeking to incorporate the phenomenon into or mitigate it through DMH services. (shrink)

We discuss recent progress in the development of cognitive ontologies and summarize three challenges in the coordinated development and application of these resources. Challenge 1 is to adopt a standardized definition for cognitive processes. We describe three possibilities and recommend one that is consistent with the standard view in cognitive and biomedical sciences. Challenge 2 is harmonization. Gaps and conflicts in representation must be resolved so that these resources can be combined for mark-up and interpretation of multi-modal data. Finally, Challenge (...) 3 is to test the utility of these resources for large-scale annotation of data, search and query, and knowledge discovery and integration. As term definitions are tested and revised, harmonization should enable coordinated updates across ontologies. However, the true test of these definitions will be in their community-wide adoption which will test whether they support valid inferences about psychological and neuroscientific data. (shrink)

Two general ethical problems in psychiatry are thrown into sharp relief by long term care. This article discusses each in turn, in the context of two anonymised case studies from actual clinical practice. First, previous mental health legislation soothed doubts about patients' refusal of consent by incorporating time limits on involuntary treatment. When these are absent, as in the provisions for long term care which have recently come into force, the justification for compulsory treatment and supervision becomes more obviously problematic. (...) Second, Anglo-American law does not normally allow the preventive detention of someone who may be dangerous but has not actually committed any crime. The justification for detaining a possibly dangerous user of mental health services without his or her consent can only be based on risk assessment, but this raises issues of moral luck. Is the psychiatrist who decides not to take out a supervision order for a possibly dangerous patient with an initial psychotic diagnosis morally at fault if that person harms someone in the community, or himself? Or is the psychiatrist merely unlucky? (shrink)

There has been a troublesome anomaly in the UK between cash payment to men for sperm donation and the effective assumption that women will pay to donate eggs. Some commentators, including Donald Evans in this journal, have argued that the anomaly should be resolved by treating women on the same terms as men. But this argument ignores important difficulties about property in the body, particularly in relation to gametes. There are good reasons for thinking that the contract model and payment (...) for gametes are both inappropriate, and that a model based on altruism should be applied to both sexes. (shrink)

Even in the increasingly individualized American medical system, advocates of 'personalized medicine' claim that healthcare isn't individualized enough. With the additional glamour of new biotechnologies such as genetic testing and pharmacogenetics behind it, 'Me Medicine'-- personalized or stratified medicine-- appears to its advocates as the inevitable and desirable way of the future. Drawing on an extensive evidence base, this book examines whether these claims are justified. It goes on to examine an alternative tradition rooted in communitarian ideals, that of the (...) common good as a goal in medicine. (shrink)

In August 2022, only a few months before ChatGPT was released, Barry Smith, well-known contemporary philosopher, together with Jobst Landgrebe, artificial intelligence entrepreneur, published a book entitled Why Machines will Never Rule the World: Artificial Intelligence without Fear (Landgrebe and Smith 2022). In this important, dense and far-reaching work, Landgrebe and Smith argue from the mathematical theory of complex systems, and a sophisticated analysis of the capabilities of human intelligence, that AGI— at the level of human intelligence—will never be possible. (...) In broad outline, Landgrebe and Smith claim that intelligent human behaviour is a facility that develops from a complex world and for a complex world; that the complexities of the real world and our behaviour in it can never be fully specified or simulated mathematically; that digital systems can only execute what can be simulated mathematically; and that therefore human-level intelligence will never be manifested by a digital system. The present collection of articles is in response to and inspired by Landgrebe and Smith. It provides reflections from a variety of perspectives and disciplines on the possibility of AGI, as well as on the transformations that AI technology is already bringing even in its current incarnation. (shrink)

Pets are truly great companions. Some individuals feel that owning a pet can help them prepare for a growing family by giving them a taste of what it would be like to have children. This study also looks into the psychological well-being and life experiences of LGBT fur parents. Employing the Interpretative Phenomenological Analysis, the findings of this study were: (1) With the presence of fur babies, participants had the ease to overcome stressful events, especially the ones that affect their (...) mental health. With these, they have the desire to take care of their fur babies under all circumstances because they see their fur babies as family members. Fur babies are excellent sources of motivation, confidence, and happiness for fur parents. They are treated as family members because they contribute to the mental and emotional aspects of fur parents. Moreover, the majority of respondents valued their pets far more than their actual family members, however, some didn't spend as much time with their relatives and friends. This study comes to the conclusion that a stronger bond with one's dog was also linked to higher anxiety about being unloved and rejected by family members and people surrounding us, which was linked to a heavier impact on one's psychological well-being. In reality, fur parents, especially LGBT parents, offer their fur babies a lot of love and attention compared to other things. (shrink)

Consensus statement by UK teachers of medical ethics and law.

What does it mean to respect autonomy and encourage meaningful consent to treatment in the case of patients who have dementia or are otherwise incompetent? This question has been thrown into sharp relief by the Law Lords' decision in R.v Bournewood Community and Mental Health NHS Trust, ex parte L.

Editorial introduction to series of papers resulting from a European Commission Project on mental capacity.

Moral (or ethical) sensitivity is widely viewed as a foundational learning goal in engineering ethics education. We have argued in this paper is that this view of moral sensitivity cannot be readily transported from the nursing context to the engineering context on the basis of a care-analogy. The particularized care characteristic of the nursing context is decisively different from the generalized and universalized forms of care characteristic of the engineering context. Through a focus on care and maintenance, the engineering student’s (...) moral sensitivity can be refined, opening up a perceptual awakening and affectivity towards the complex nature of the engineer’s Other. This awakening is in part promoted through an understanding of the ideology of neutrality as a moment in the history engineering. Becoming aware of this ideology as an ideology can then be seen as an activity of dividing loyalties that allows for a reflexive and critical view of the biases and presuppositions inherited within the world of engineering. This process of deepening the engineering student’s moral sensitivity is perhaps as much a process of the student becoming aware of her professional world, how it shapes her understanding of herself, and what it means to be a good engineer. (shrink)

Mental health research faces a suite of unresolved challenges that have contributed to a stagnation of research efforts and treatment innovation. One such challenge is how to reliably and validly account for the subjective side of patient symptomatology, that is, the patient’s inner experiences or patient phenomenology. Providing a structured, standardised semantics for patient phenomenology would enable future research in novel directions. In this contribution, we aim at initiating a standardized approach to patient phenomenology by sketching a tentative formalisation within (...) the framework of an applied ontology, in the broader context of existing open-source Open Biomedical Ontologies resources such as the Mental Functioning Ontology. We further discuss a number of prevailing challenges and observations bearing on this task. (shrink)

It is well known that there is a shortage of human ova for in vitro fertilization (IVF) purposes, but little attention has been paid to the way in which the demand for ova in stem-cell technologies is likely to exacerbate that shortfall and create a trade in human eggs. Because the 'Dolly' technology relies on enucleated ova in large quantities, allowing for considerable wastage, there is a serious threat that commercial and research demands for human eggs will grow exponentially from (...) the combination of these two pressures. In the absence of legal regulation in the United Kingdom, and in the context of a globalized trade in human organs, we face a 'Wild West' situation in genetic and biotechnological research that involves human ova. (shrink)

Advances in emotion and affective science have yet to translate routinely into psychiatric research and practice. This is unfortunate since emotion and affect are fundamental components of many psychiatric conditions. Rectifying this lack of interdisciplinary integration could thus be a potential avenue for improving psychiatric diagnosis and treatment. In this contribution, we propose and discuss an ontological framework for explicitly capturing the complex interrelations between affective entities and psychiatric disorders, in order to facilitate mapping and integration between affective science and (...) psychiatric diagnostics. We build on and enhance the categorisation of emotion, affect and mood within the previously developed Emotion Ontology, and that of psychiatric disorders in the Mental Disease Ontology. This effort further draws on developments in formal ontology regarding the distinction between normal and abnormal in order to formalize the interconnections. This operational semantic framework is relevant for applications including clarifying psychiatric diagnostic categories, clinical information systems, and the integration and translation of research results across disciplines. (shrink)

We take kelp as material entities immersed in a multitude of relations with other creatures (for whom kelp serves as both nourishment and shelter) and inorganic elements of the milieu it resides in, on the one hand, and as a figuration: a material-semiotic “map of contestable worlds” that encompasses entangled threads of “knowledge, practice and power” (Haraway 1997, 11) in its local and global sense, on the other. While drawing on our field notes from the congress and feminist posthumanities and (...) environmental humanities literatures (e.g. Alaimo 2016; Åsberg & Braidotti 2018; Sandilands & Erickson 2010; Iovino & Opperman 2014) – with a special focus on the so-called blue humanities/oceanic humanities (e.g. DeLoughrey 2019) – that unpack human/nonhuman relations in the context of the current environmental crisis and the accompanying “slow violence” (Nixon 2011), we mobilise a reflection on and make a proposal for “thinking with kelp” as a multi-faceted methodology of transversal and transdisciplinary knowledge production and practices: situated (Haraway 1988), enfleshed, transcorporeal (Alaimo 2010), collaborative, and committed to an ethics of multispecies response-ability (Haraway 2008). (shrink)

'An alarming and illuminating book. The story of how we have allowed private corporations to patent genes, to stockpile human tissue, and in short to make profits out of what many people feel ought to be common goods is a shocking one. No one with any interest at all in medicine and society and how they interact should miss this book, and it should be required reading for every medical student,'--Philip Pullman.

Review of Graeme Laurie, Genetic Privacy.

This book is a case of “too little, too late”: too little in that it represents voices not from the developing world as a whole but from a particular Catholic viewpoint in the Philippines, too late in that others have already gone “beyond a Western bioethics”—which, in any case, is not the unified and rigid set of principles that the authors make it out to be. The publication is a long delayed spinoff of a series of bioethics seminars held in (...) Manila and Houston under the leadership of H Tristram Engelhardt Jr, who has contributed an introduction to the volume on Western bioethics reconsidered. (As Engelhardt writes: “Like good wine, this work has come slowly into its own” (page xii). Engelhardt’s bias is evident in the phrase he uses early on in this introduction, “the customary American/western European indoctrination in …. (shrink)

The guiding premise of this chapter is that we, as teachers in higher education, must consider how the content and form of our teaching can foster inclusivity through a responsiveness to neurodiverse learning styles. A narrow pedagogical focus on lectures, textual engagement, and essay-writing threatens to exclude neurodivergent students whose ways of learning and making sense of the world may not be best supported through these traditional forms of pedagogy. As we discuss in this chapter, we, as engineering ethics educators, (...) designed and implemented a new engineering ethics exercise with which we aimed to promote inclusivity at the levels of form and content. At the content level, students were invited to critically engage with inclusivity-undermining ableist assumptions in technology development. This took shape, at the form level, through a hands-on ‘material tinkering’ workshop in which students collaboratively and creatively altered (or ‘hacked’) artifacts used in contexts of disability and healthcare, so as to operationalize values of inclusivity and accessibility. Our hunch was that this hands-on tinkering workshop would simultaneously encourage a meaningful way of engagement with these ethical issues and values, while also enacting a more inclusive learning environment by enriching the range of pedagogical activities and learning formats available to our students.As we aim to show in this chapter, we believe this hunch largely panned out – though there are clear areas for future improvement pertaining to the pilot exercise itself and the research we conducted on the exercise. We begin by offering a description of our tinkering exercise. We discuss the exercise’s source of inspiration (Sect. 16.2.1) and its implementation (Sect. 16.2.2), which is visually captured via photographic documentation. We then discuss (Sect. 16.3) how we utilized a triangulated research method to assess the pedagogical value of the exercise. After we discuss our findings, we conclude by identifying areas for future improvement (Sect. 16.4). (shrink)

The rise of personalised medicine can be seen as an extension of individualism and as a threat to the common good.

Children and young people under 18 years old should no longer be regarded as incompetent to give or withhold consent in decisions involving their health care, Recent research suggests a functional test of cognitive and emotional maturity, rather than a strict age cut-off point. However, it is often difficult to implement these recommendations in practice, not least because the law is, if anything, increasingly 'hard-line' about children's autonomy.

The feminist movement may seek democratization on a global scale, but women are still hampered by a democratic deficit in terms of economic and political power. On the other hand, global feminist networks and new expanded forms of non-territorial political space do appear to be increasing democratic participation for women.

How can we allocate scarce health care resources justly? In particular, are markets the most efficient way to deliver health services? Much blood, sweat and ink has been shed over this issue, but rarely has either faction challenged the unspoken assumption behind the claim made by advocates of markets: that efficiency advances the interests of both individuals and society. Whether markets actually do increase efficiency is arguably a matter for economists, but the deeper ethical question is whether efficiency is the (...) correct criterion, in terms of social justice and individual needs. (shrink)

In this article I evaluate a resurrected French resistance movement--to biotechnological commodification. The official French view that ‘the body is the person’ has been dismissed as a ‘taboo’ by the French political scientist Dominique Memmi . Yet France has indeed resisted the models of globalised commodification adopted in US bioechnology, as, for example, when the government blocked a research collaboration between the American firm Millennium Pharmaceuticals and a leading genomics laboratory, le Centre d’Etude du Polymorphisme Humain, on the grounds the (...) ‘French DNA’ should not be given away. -/- This example, however, itself suggests why the ‘new French Resistance’ is not altogether liberating. The absolutist conception of all bodies as belonging to the French state—indeed, as constituting the body politic —is so potentially invasive that a counter-ideology of inviolability of the body is maintained assiduously. This inviolability is defended particularly strongly against commercialisation, but only at the moment when tissue is taken from the individual subject, who is not to be paid or compensated-- although commercial enterprises who subsequently use the tissue are not similarly constrained. -/- . (shrink)

Reproductive ageing has effects on individual and public health, now and in generations to come. This volume of presentations from a conference at the Royal College of Obstetricians and Gynaecologists brings together a diverse but timely set of contributions.. in ny chapter I specifically examine the responsibilities of the College to women outside normal reproductive age.

Guidelines on embryo storage prioritise 'respect for the embryo' above the wishes of the women whose labour and tissue have gone into creating the embryo in the first place, effectively making women and the female body disappear. In this article I draw a parallel between this phenomenon relating to embryo storage and other instances of a similar phenomenon that I have called 'the lady vanishes', particularly in stem cell and 'mitochondrial transfer' research. I suggest that a modified property regime could (...) protect women's interests in embryo storage, making a parallel with the Yearworth case, in which it was recognised that men had limited but actionable interests in their stored sperm.. (shrink)

Until very recently the question of who owns embryonic or fetal tissue was of limited importance to clinicians, but advances in stem cell research have made such tissue commercially valuable. This chapter examines the legal and ethical basis of claims to property in embryonic or fetal tissue, taking a critical stance.

Whilst India has been debating how to regulate 'surrogacy' the UK has undergone a major consultation on increasing the amount of 'expenses'paid to egg 'donors', while France has recently finished debating its entire package of bioethics regulation and the role of its Biomedicine Agency. Although it is often claimed that there is no alternative to the neo-liberal, market-based approach in regulating (or not) reproductive medicine--the ideology prevalent in both India and the UK--advocates of that position ignore the alternative model offered (...) by France's tighter regulation, as well as its overarching concern with protecting the vulnerable and ensuring social justice. Whilst the concepts underpinning the French model of regulation also have their provenance in Western political philosophy and not in the developed world, they embody a very different attitude and suggest that there is indeed an alternative to letting the market decide. However, even in France that alternative is highly contested. (shrink)

How can intellectuals who oppose the illegitimate war in Iraq come to similar terms with the U.S. neoconservatives, and their unrepentant British collaborators, who have stranded us in it? In the Tempest, Shakespeare’s most political play, comedy though it is meant to be, intellectuals are warned not to consider themselves guiltless. But how can those who marched against the war, or who tried to speak truth to power in other ways, be guilty of its misuses? Surely this is too harsh (...) a view of the role of the public intellectual. What choice did Prospero really have? He was exiled, hapless, stranded. What choice do intellectuals who are against the war have? We, too, are powerless. Aren’t we? (shrink)

How heavily should ethical considerations weigh in allowing or disallowing genetic patents? The concept of 'ordre public' can be useful in offsetting a simple utilitarian view.

What should we do about children and young people who want to be tested for incurable, adult onset, genetic disorders? In particular, what should a general practitioner do if he or she believes the young person is competent to decide, but the regional genetics unit refuses to test anyone under 18? In this article I discuss such a case (drawn from actual practice, but anonymised), and consider the arguments for and against allowing the young person to be tested in terms (...) of good practice, case and statute law, empirical evidence, and ethics. (shrink)

Payment for eggs used in stem cell research puts women at unacceptable risk and encourages exploitative commodification of the female body. Thanks to the development of induced pluripotent stem cells, however, we no longer face a choice between good science and good ethics.

Speculative enhancement technologies are premised on the notion that I have a duty to be the best Me I can possibly be. This article takes a sceptical look at that claim.

Should we do whatever science lets us do? This short introduction in the 'All That Matters' series shows how developments in biotechnology, such as genetics, stem cell research and artificial reproduction, arouse both our greatest hopes and our greatest fears. Many people invest the new biotechnology with all the aspirations and faith once accorded to religious salvation. But does everyone benefit equally from scientific progress? This book argues that although we've entered new scientific territory, there is no need to jettison (...) our existing moral sense. By discussing a range of real-life cases, it equips readers to make up their own minds on these important questions. Good science and good ethics needn't be contradictory. (shrink)