Over the past decade, genetic tests have become available for a wide variety of disorders. As a result we are able to predict, with some degree of certainty, whether or not an individual will develop such diseases as breast cancer, Huntington's disease, polycystic kidney disease, and familial adenomatous polyposis. The ability to predict disease poses several unique ethical considerations for clinical decisionmaking regarding the provision of genetic testing. Patients must be able to comprehend the complexities of genetic testing and the (...) potential meaning of the results. Patients must consider the emotional, social, and economic consequences of revelations regarding their risk status. Also, obtaining information on risk status may have implications for persons other than the individual seeking genetic testing. (shrink)

When I was asked to contribute an essay in honor of the 150th volume in the Philosophy and Medicine series, I asked myself, what could a philosopher and clinical ethicist who has spent most of her time teaching undergraduate biomedical ethics say that could contribute to discussions? Ah, herein is the start of an essay. In this essay, and in honor of the Philosophy and Medicine series’ 150th volume and 50th anniversary in publishing, I share what I say to my (...) students in the classroom: there is a need for continued dialogue on the mutual dependence of biomedical ethics and philosophy of medicine within a global context. In what follows, I illustrate this mutual dependence of philosophy of medicine and biomedical ethics that is heralded in volumes in the Philosophy and Medicine series. I then illustrate this mutual dependence in discussions of philosophy of disease, a focus of my work for over three-plus decades now. As we celebrate the contributions of the Philosophy and Medicine series, we are reminded of its deep roots and lasting legacy in the literature. (shrink)

_Offers research on educational policies, programs, and practices for adolescent girls and young women, from both comparative and international perspectives._ This collection examines the educational policies, programs, and practices that offer and/or deny adolescent girls and young women the opportunity for change and advancement, from both comparative and international perspectives. Grounded in social and feminist theory, the essays focus on the dynamic interaction between agency and structure. The first part of the book outlines fundamental principles of public policy and provides (...) examples of their application. Part two explores, within the context of globalization, the impact of international organizations-large and small-on the local level. Part three looks at the influence of sociocultural forces on women's ability to participate in educational programs. Part four proffers innovative methodologies that demonstrate how the agency of voice within the structure of the research setting ultimately furthers our understanding of women's education. Throughout the book, the complexities in delivering and improving education for females in India, China, Kenya, the United States, and other parts of the world are revealed. (shrink)

She invites us into a world of wonder, giving voice to characters from carnivals and fairy tales: the Disappearing Girl, the Mesmerist, and Gretel. A series of Alice in Wonderland variations captures perfectly the mix of the mundane and the marvelous we would expect to hear from Alice."--BOOK JACKET.

Book reviewed in this article: Rights Talk: The Impoverishment of Political Discourse. By Mary Ann Glendon.

The rural health context in the United States presents unique ethical challenges to its approximately 60 million residents, who represent about one quarter of the overall population and are distributed over three-quarters of the country’s land mass. The rural context is not only identified by the small population density and distance to an urban setting but also by a combination of social, religious, geographical, and cultural factors. Living in a rural setting fosters a sense of shared values and beliefs, a (...) strong work ethic, self-reliance, and a tendency for close-knit extended social structures where overlapping relationships are commonplace. (shrink)

Human-wildlife conflict (HWC) is a global phenomenon with serious implications for biodiversity conservation and human well-being. Innovative solutions demand greater attention to the social factors contributing to HWC, including human thought and behavior, which can be examined through the lens of social psychology. Using the case of human-coyote conflict in North America, this study employed a mixed-methods social psychology approach to explore the potential for citizen science to serve as a tool for HWC mitigation. Quantitative surveys and interviews with volunteers (...) in a coyote-focused citizen science program in Colorado revealed that the program is positively affecting participants’ attitudes/beliefs and empowering them to take action to address conflicts in their communities. The article concludes with recommendations for future evaluative research in this area as well as ways to more generally improve social-psychology applications in wildlife conservation. (shrink)

BackgroundFor the benefits of advance care planning to be realised during a hospital admission, the treating team must have accurate knowledge of the law pertaining to implementation of advance care directives (ACDs) and substitute decision making.AimsTo determine in a sample of Junior Medical Officers (JMOs): (1) knowledge of the correct order to approach people as substitute decision makers if a patient does not have capacity to consent to treatment; (2) knowledge of the legal validity of ACDs when making healthcare decisions (...) for persons without capacity to consent to treatment, including the characteristics associated with higher knowledge; and (3) barriers to enacting ACDs. MethodsA cross-sectional survey was conducted at five public hospitals in New South Wales, Australia. Interns, residents, registrars, and trainees on clinical rotation during the recruitment period were eligible to participate. Consenting participants completed an anonymous pen-and-paper survey.ResultsA total of 118 JMOs completed a survey (36% return rate). Fifty-five percent of participants were female and 56.8% were aged 20–29 years. Seventy-five percent of JMOs correctly identified a Guardian as the first person to approach if a patient did not have decision-making capacity, and 74% correctly identified a person’s spouse or partner as the next person to approach. Only 16.5% identified all four persons in the correct order, and 13.5% did not identify any in the correct order. The mean number of correct responses to the questions assessing knowledge of the legal validity of ACDs was 2.6 (SD = 1.1) out of a possible score of 6. Only 28 participants (23.7%) correctly answered four or more knowledge statements correctly. None of the explored variables were significantly associated with higher knowledge of the legal validity of ACDs. Uncertainty about the currency of ACDs and uncertainty about the legal implications of relying on an ACD when a patient’s family or substitute decision maker disagree with it were the main barriers to enacting ACDs.ConclusionJMOs knowledge of the legal validity of ACDs for persons without decision making capacity and the substitute decision making hierarchy is limited. There is a clear need for targeted education and training to improve knowledge in this area for this cohort. (shrink)

Twelve rats fixed with chronically indwelling electrodes for stimulation of the lateral hypothalamus were used to test for the effects of daily doses of amphetamine (2 and 4 mg/kg daily for 20 days). The rats’ rate of pressing for brain stimulation was observed 1, 4, and 23 h after injections in 5-min sessions. These doses did not reliably increase self-stimulation rates during the times of testing. During the 5 days following termination of injections, pressing rates of rats receiving amphetamine were (...) slightly less than those of rats receiving a placebo. (shrink)

In an effort to build interest in the two-year old service learning center and to fulfill its mission to integrate academic life with service in thoughtful and relevant ways, a competition was held to award developmental grants to faculty to create innovative courses incorporating service learning. The winning proposal from the business school used a business ethics course as the vehicle for formally introducing service into the business curriculum. This paper will tell the story of the intended and unintended consequences (...) of building collaboration on several levels: between generations, between college and community, between faculty and college resources, between student teams, and between theory and practice. (shrink)

"Ethical Choices in Contemporary Medicine" jettisons the standard medical ethics models of "rights" language and shows how the bioethical problems that receive attention from the media and the public are related to and are explicable in terms of the epistemological foundations of science and medicine. These epistemological concerns include how medical knowledge is established , how medical protocols are administered , how medical certainty is evaluated and medical responsibility is framed , and how medical knowledge is transmitted and how medical (...) care is allocated . The book examines the present predicaments of medicine within a broad cultural context and suggests that rational discourse and parochial ethical dialogue may be futile in the face of competing and incommensurable frameworks and agendas, attitudes and wishes. The authors show that, in the postmodern age, two interrelated issues surface when it comes to medicine. On the one hand, there is a strong critique of science and the privileges associated with the scientific discourse and, on the other, there is still a deep-seated quest for certainty in all medical matters. (shrink)

Two generations of students inspired by Harvey Mansfield come together here to demonstrate how their diverse approaches illuminate the topic of the arts of rule and speak to the wide scope of Mansfield's contributions. The essays collected here cover both ancient and modern ground. The first section covers topics such as Xenophon's question of what it is to be a gentleman, Aristotle's view of friendship, Montaigne's account of the highest good, and Montesquieu's elevation of modesty. The second section engages Machiavelli's (...) political theory and its influence on subsequent thinkers, such as Bacon, Hobbes, and Hume. Authors in the third section examine the sources, conditions, and practices of freedom in the context of modern politics, drawing on writers from Shakespeare to Tocqueville to shed light on contemporary debates. The arts of rule cover the exercise of power by princes and popular sovereigns, but they range beyond the domain of government itself, extending to civil associations, political parties, and religious institutions. Artful rule both directs the use of authority toward a specific end and posits a more comprehensive vision of the best way of life for human beings. Making full use of political philosophy and benefiting from a range of backgrounds, this collection recognizes that although the arts of rule are comprehensive, the best government is a limited one. (shrink)

This article examines the way in which some biomedical ethicists have constructed sexually transmitted AIDS as a significant threat to women's health. We demonstrate that the familiar claim that‘women are the fastest growing group'— whether of HIV-infected or of AIDS patients — is misleading because it obscures the distinction between proportional rate of growth and absolute increase. Feminist ethicists have suggested that misogyny of a male dominated health care system has led to underreporting of women AIDS cases in order to (...) support these feminists’claim of AIDS being a real threat to women's health. Given the apparent rarity of tertiary transmissions of AIDS, the assertion that most or even many women are at significant risk for AIDS seem wrong. Particularly disturbing in this campaign is the fact that the theme of‘risky sex’has been extended all the way to lesbians, even though their risk to acquire AIDS sexually is non-existent to minuscule. We argue that actual harm is done to women by this exaggeration of their risk of contracting AIDS sexually. The scare has led to misappropriations of scarce health care funds. AIDS disproportionately affects women who inject drugs, and who suffer other diseases, poverty and malnutrition. It would have been better to concentrate health care efforts in this area instead of‘educating’women not at risk for AIDS how to prevent the acquisition of this disease. Unjustifiable AIDS anxiety has been created in women and has resulted in millions of unnecessary HIV-tests, and many broken relationships. This anxiety has inevitably reduced the pleasure of having sex for many women. We reject the kind of‘victim ideology’that lies at the heart of this strategy which has, unfortunately, been supported by a number of influential feminist ethicists. (shrink)

This article examines the way in which some biomedical ethicists have constructed sexually transmitted AIDS as a significant threat to women's health. We demonstrate that the familiar claim that‘women are the fastest growing group'— whether of HIV‐infected or of AIDS patients — is misleading because it obscures the distinction between proportional rate of growth and absolute increase. Feminist ethicists have suggested that misogyny of a male dominated health care system has led to underreporting of women AIDS cases in order to (...) support these feminists’claim of AIDS being a real threat to women's health. Given the apparent rarity of tertiary transmissions of AIDS, the assertion that most or even many women are at significant risk for AIDS seem wrong. Particularly disturbing in this campaign is the fact that the theme of‘risky sex’has been extended all the way to lesbians, even though their risk to acquire AIDS sexually is non‐existent to minuscule. We argue that actual harm is done to women by this exaggeration of their risk of contracting AIDS sexually. The scare has led to misappropriations of scarce health care funds. AIDS disproportionately affects women who inject drugs, and who suffer other diseases, poverty and malnutrition. It would have been better to concentrate health care efforts in this area instead of‘educating’women not at risk for AIDS how to prevent the acquisition of this disease. Unjustifiable AIDS anxiety has been created in women and has resulted in millions of unnecessary HIV‐tests, and many broken relationships. This anxiety has inevitably reduced the pleasure of having sex for many women. We reject the kind of‘victim ideology’that lies at the heart of this strategy which has, unfortunately, been supported by a number of influential feminist ethicists. (shrink)

We evaluate three of Geary's claims, finding that (1) there is little evidence for sex differences in object- vs. person-orientation; (2) sex differences in competition, even if biologically caused, lead to sex differences in mathematics only given a certain style of teaching; and (3) sex differences in mental rotation, though real, are not well explained in a sociobiological framework or by the proximate biological variables assumed by Geary.

Ethical choices in Contemporary Medicine rejects the standard medical ethics model of "rights" language and shows that the bioethical problems that receive attention from the media and public are explicable in terms of the epistemological foundations of science and medicine... The authors examine present concerns about medicine in terms of cultural context and suggest that, given the conflicting frameworks, agendas, and attitudes, it may be necessary to go beyond rational, parochial, ethical dialogue. They show that two interrelated issues surface in (...) evaluations of medicine: on the one hand, there is a strong critique of science and the privileges associated with scientific discourse; on the other, there is a deep-seated quest for certainty in all medical matters. (shrink)

This paper analyzes the struggle for women’s suffrage in Kuwait to determine how and why it was successful. The research highlights two paradoxical findings: first, democratic progress occurred despite the pacifying and hindering effects of modernization; second, it was supported more strongly and effectively by Kuwait's autocratic executive than the democratically elected Kuwaiti parliament. We delineate two psychological factors that were connected to the climax of the struggle as they were experienced and acted upon by a relatively small number of (...) Kuwaiti middle- and upper-class women: transformative events and the tying of struggle goals to self-esteem. We examine these factors in the context of interaction between chaotic political circumstances and the new strategy and tactics that suffragists employed in the last phase of their struggle. The analytic approach involves process tracing, field research, interviews, and longitudinal analysis of primary and secondary sources. (shrink)

Mary Anne Warren investigates a theoretical question that is at the centre of practical and professional ethics: what are the criteria for having moral status? That is: what does it take to be an entity towards which people have moral considerations? Warren argues that no single property will do as a sole criterion, and puts forward seven basic principles which establish moral status. She then applies these principles to three controversial moral issues: voluntary euthanasia, abortion, and the status of (...) non-human animals. (shrink)

The question “How is breast cancer evaluated?” raises a host of considerations, including ones about the role of values in clinical concepts, the kinds of clinical values in medical thinking, and the extent to which our evaluations of clinical phenomenon provide clinical certainty. What we find is that, initially, breast cancer is a treatment warrant and appears to fit the view of a clinical entity that is value-neutral. But things are not as simple as one would initially think. Upon reflection, (...) descriptions and explanations of breast cancer are nested in evaluative frames of reference through which they are seen, interpreted, and acted upon. Clinical evaluations of breast cancer are complex and involve appeals to functional, instrumental, aesthetic, and ethical values. As a consequence, clinicians and patients face the recognition that clinical evaluations of breast cancer are to some extent uncertain, and a healthy sense of skepticism provides a check against an idealized sense of evaluation in breast cancer medicine. (shrink)

Philosophically speaking, the question “What are the ethical implications of understanding breast cancer?” raises a host of issues, including informed consent, risk assessment, and access to breast cancer care. What we find is that, initially, there are adequate guidelines for informed consent, adequate efforts to develop risk assessment measures, and a decent level of access to breast cancer care in the United States. But things can be improved from an ethical standpoint. Upon reflection, the informed consent process would benefit from (...) a more explicit discussion of uncertainty in breast cancer medicine and the ways breast cancer patients make decisions about their care. Risk assessments would benefit from a more personalized approach. Access to breast cancer care could be improved by continued studies of the diverse forces that limit access to proper breast cancer care. (shrink)

Philosophically speaking, breast cancer is an integrative phenomenon. The descriptive, explanatory, evaluative, and social dimensions of breast cancer mutually define and situate each other within particular contexts. Descriptions, observations, or the “facts” of breast cancer are ordered around explanatory assumptions and claims. Further, the descriptive and explanatory dimensions of breast cancer are nested in evaluative or prescriptive judgments, including those objects that are assigned significance and those actions that are seen to be appropriate and warranted in order to achieve certain (...) goals. Still further, the descriptive, explanatory, and evaluative dimensions of breast cancer are socially located. There is no timeless or noncontextual account of breast cancer, or at least there is no such interpretation available to humans. Breast cancer is an intersectional, contextual, and personalized phenomenon. (shrink)

The question “How is breast cancer explained?” raises a host of explanatory issues, including ones about the method we use to explain breast cancer, the etiology of breast cancer, and the extent to which our explanations of breast cancer provide clinical certainty. What we find is that, initially, it appears that medicine explains breast cancer using an empirical methodology that grants certain claims. But things are not as simple as one would initially think. Upon reflection, explanations of breast cancer are (...) not simply empirical. Causal accounts of breast cancer are not typically modeled on a simple cause–effect relation. Given this, clinicians and patients must face the recognition that clinical explanations of breast cancer are probabilistic and a healthy sense of skepticism provides a check against an idealized sense of certain knowledge about breast cancer. (shrink)

This chapter considers a number of reasons to reflect on how breast cancer is understood in Western medicine. These include that breast cancer serves as a prominent nosology and nosography in medicine which affects a significant number of women, commands a large portion of financial resources, serves as the focus of numerous policies and laws, provides a glimpse into history, calls out for clarification, and carries ethical implications. In the analysis, breast cancer offers a case study in philosophy of medicine (...) for purposes of asking questions about the nature of breast cancer, how we know it, and how we treat it. The chapter outlines the investigation, highlighting the major questions that are raised along the way. (shrink)

This inquiry shows that breast cancer is not an object simply to be discovered. It is a family of diseases. It is an evolving notion that provides structure and significance to patient narratives and clinical reality within social contexts. In the end, philosophy teaches us a number of lessons about how to understand and treat breast cancer and how to navigate the uncertainty of breast cancer diagnosis, prognosis, and treatment. Alternatively, breast cancer teaches us a number of philosophical lessons about (...) our understanding of nature, knowledge, and what and how we value. The hope is that a fruitful dialogue between philosophy and medicine continues. This is not just an academic wish; it is a personal one for anyone who has been diagnosed with breast cancer. (shrink)

The question “What is breast cancer?” raises a host of descriptive issues in philosophy, including ones about the nature, make-up, and reducibility of reality. What we find is that, initially, breast cancer appears to fit the description of a clinical entity that is real, composed of physical matter, and reducible to its parts. But things are not as simple as one would initially think. Upon reflection, breast cancer is a physical condition framed within prevailing contexts of reference. It is an (...) idea through which clinical facts are seen and interpreted. It is a systematic condition not simply reducible to the sum of its parts. Breast cancer is “real,” but perhaps not real in the way we might initially think. (shrink)

The question “How is breast cancer a social phenomenon?” raises a host of issues, including ones about the collaboration, medicalization, commodification, and politicalization of breast cancer. What we find is that initially our understanding of breast cancer appears to be insulated from social, nonmedical, economic, and political forces. But things are not as simple as one would initially think. Upon reflection, breast cancer is a collaborative endeavor, one framed by formal and informal social forces. Breast cancer is medicalized, commodified, and (...) politicalized. The medicalization of breast cancer is found in cases of labeling a breast phenomenon as “carcinoma” or “cancer” when it is not. The commodification of breast cancer comes about through endowing it with economic and commercial value. The politicization of breast cancer comes about through endowing breast cancer with political agency, as found in debates about breast cancer policy and law. (shrink)

By a potential person I shall mean an entity which is not now a person but which is capable of developing into a person, given certain biologically and/or technologically possible conditions. This is admittedly a narrower sense than some would attach to the term ‘potential'. After all, people of the twenty-fifth century, if such there will be, are in some sense potential people now, even though the specific biological entities from which they will develop, i.e. the particular gametes or concepti, (...) do not yet exist. For there do exist, in the reproductive capacities of people now living and in the earth's resources, conditions adequate to produce these future people eventually, provided of course that various possible catastrophes are avoided. Indeed, in some sense of ‘potential’ there have been countless billions of potential people from the beginning of time. But I am concerned not with such remote potentialities but with currently existing entities that are capable of developing into people. (shrink)

The past 25 years have seen an upsurge of interest in the figure of Mary Magdalene, whose image has been transformed through feminist scholarship from penitent prostitute to prominent disciple of Jesus. This article documents another, non-academic, interpretation of Mary Magdalene – the image of Mary as goddess or embodiment of the female divine. The most influential proponent of this view is Margaret Starbird, who hypothesizes that Mary was both Jesus’ wife and his divine feminine counterpart. (...) The author suggests that feminist theologians/thealogians should be aware of this popular understanding of Mary; and consider what it is about Mary Magdalene as the sacred feminine/bride of Jesus/sophia that captures the public imagination in a way that other feminist christologies do not. (shrink)