The possible integration of genomic sequencing (including whole‐genome and whole‐exome sequencing) into the three contexts addressed in this special report—state‐mandated screening programs, clinical care, and direct‐to‐consumer services—raises related but distinct legal issues. This essay will outline the legal issues surrounding the integration of genomic sequencing into state newborn screening programs, parental rights to refuse and access sequencing for their newborns in clinical and direct‐to‐consumer care, and privacy‐related legal issues attending the use of sequencing in newborns.

At the end of the Scholium Newton includes a long paragraph about two globes revolving around their center of gravity and held together by a tensed cord. It has been interpreted as a thought experiment (Sect. 6.2) meant to show how the properties of true circular motion defined as absolute motion can be determined in a three-dimensional empty universe. I start by showing that this reading of Newton’s example as a bona fide thought experiment is riddled with interpretation problems and (...) that it is less straightforward than so far assumed (Sect. 6.3). (shrink)

As a neonatal neurologist, I serve families facing tragic decisions in which they must balance trade-offs between death and life with profound disability. I often find myself in complex discussions about future outcome, in which families sort through in real-time what information they value most in making such a choice. Will he laugh? Will he be in pain? Will he know how much he’s loved? In this month’s feature article, Brick et al share the results of an online survey aimed (...) at assessing public views on when a life is not worth living, in an effort to inform ongoing legal and clinical debates about withdrawal of life-sustaining treatment for children. These findings raise important questions about how we define and measure outcomes that matter to parents as they make these tragic decisions. It is challenging to interpret these findings in the absence of context of how decision-making for infants occurs in real-time. The nature of this study and its objective required that cases be substantially simplified. As the authors acknowledge, the prognoses and function of the children involved in these cases were often deeply contested. Prognostic uncertainty is common for children with significant …. (shrink)

Volume 19, Issue 5, May 2019, Page 62-63.

In this article I argue that evolutionary psychological strategies for making inferences about present-day human psychology are methodologically unsound. Evolutionary psychology is committed to the view that the mind has an architecture that has been conserved since the Pleistocene, and that our psychology can be fruitfully understood in terms of the original, fitness-enhancing functions of these conserved psychological mechanisms. But for evolutionary psychological explanations to succeed, practitioners must be able to show that contemporary cognitive mechanisms correspond to those that were (...) selected for in the environment of evolutionary adaptedness, that these present-day cognitive mechanisms are descended from the corresponding ancestral mechanisms, and that they have retained the functions of the ancestral mechanisms from which they are descended. I refer to the problem of demonstrating that these conditions obtain as “the matching problem,” argue that evolutionary psychology does not have the resources to address it, and conclude that evolutionary psychology, as it is currently understood, is therefore impossible. (shrink)

This paper addresses the question of what organisms are and therefore what kinds of biological entities qualify as organisms. For some time now, the concept of organismality has been eclipsed by the notion of individuality. Biological individuals are those systems that are units of selection. I develop a conception of organismality that does not rely on evolutionary considerations, but instead draws on development and ecology. On this account, organismality and individuality can come apart. Organisms, in my view, are as Godfrey- (...) class='Hi'>Smith puts it “essentially persisters.” I argue that persistence is underpinned by differentiation, integration, development, and the constitutive embeddedness of organisms in their worlds. I examine two marginal cases, the Portuguese Man O’ War and the honey bee colony, and show that both count as organisms in light of my analysis. Next, I examine the case of holobionts, hosts plus their microsymbionts, and argue that they can be counted as organisms even though they may not be biological individuals. Finally, I consider the question of whether other, less tightly integrated biological systems might also be treated as organisms. (shrink)

Initial vaccine allocations for the coronavirus disease 2019 (COVID-19) will be limited. It is crucial to assess the ethical values associated with different methods of allocation, as well as important scientific and practical questions. This Viewpoint identifies three ethical values, benefiting people and limiting harm; prioritizing disadvantaged populations; and equal concern for all. It then explains why these values support prioritizing three groups: health care workers; other essential workers and people in high-transmission settings; and people with medical vulnerabilities associated with (...) poorer COVID-19 outcomes. In contrast, two other groups, people over 65 without medical vulnerabilities and participants in clinical research, present more complex ethical questions. This prioritization also encompasses valuing direct benefits to vaccinated individuals, indirect benefits to individuals protected from spread of infection, and indirect health and socioeconomic benefits to those protected from harm as health system and societal functioning improve. Vaccine allocation that recognizes important ethical values and avoids arbitrariness, waste, and corruption can ensure that the distribution of a COVID-19 vaccine is both fair and perceived as fair. (shrink)

Although Paton depends for his materials on virtually all of Kant's writings on moral philosophy, he makes the Grundlegung zur Metaphysik der Sitten central to his analysis. This is a wise choice and one that is defensible since Paton has set for himself the task of elucidating the categorical imperative and it is in the Grundlegung that Kant sought to grasp the supreme principle of morality and its appearance to us as a categorical imperative. Despite the fact that, as the (...) author points out on many occasions, the Grundlegung neither stresses morality from the standpoint of action, nor does it deal in detail with many significant problems, it must nevertheless always be looked upon as central to Kant's ethics just because it does deal with the supreme principle as a categorical imperative. The seemingly more authoritative Critique of Practical Reason is more definitely concerned with the larger subject of reason in its practical employment and does not deal as directly with Paton's special concern as the Grundlegung does. (shrink)

Some things are living and some are not. Under the heading “living things” come entities at various levels of biological organization. Some are called “organisms.” However, the term “organism” does not pick out organismal entities uniformly—that is, among all the things that are considered to be whole living systems, some are regarded as indisputably organisms, and others are accorded only qualified organismic status. Perhaps this is because it is not clear why some biological systems should count as organisms and others (...) should not. (shrink)

Despite the frivolous note implied in the popular expression, ‘The Greeks had a word for it’, the literal truth is that they did! Time and again we find reflected in the terminology developed by these ancient seekers after wisdom, an attention to important distinctions and a faithfulness to the details of actual experience which are truly remarkable. The Greek thinkers had, as every classical scholar and student of Greek philosophy knows, a finely developed philosophical language, one sensitive no less to (...) the unusual, pregnant experience than to the familiar details of ordinary life. (shrink)

Some decades ago in his intriguing book on Jonathan Edwards, Perry Miller used to great effect the device of supposing a two-fold biography of Edwards, an external one consisting of the historical record embracing the major events of his life and times, and an internal one aimed at an interpretation of the mind of Edwards and the development of his thought.

There is an undercurrent to be detected in Anselm's record of the meditative experience that issued in the Ontological Argument and, although it points to a profound and perennial problem in the interpretation of religion, this undercurrent has been largely ignored. The Argument, as is well known, moves entirely within the medium of reflective meaning focused on the idea of God and, unlike the cosmological arguments of later theologians, it makes no appeal whatever to a principle of causality or to (...) the discovery of a sufficient reason for finite existence. Anselm seems to have had his own sense of what one may call the unadulterated rationalism of the Argument when, in his own words, he wondered, ‘if perhaps it might be possible to find one single argument that for its proof required no other save itself, and that by itself would suffice to prove that God really exists’. Here we are entirely within that inner chamber of the mind so dear to the Augustinian tradition, a mind from which one is to exclude all thought save that of God. The task of the one who reflects is to penetrate the inner meaning of this thought in order to discover what it implies beyond what is evident on the surface. With such an eminently rational or logical aim occupying the centre of attention, it is quite understandable that the presence of another, and quite opposed, concern should have been overlooked - Anselm's concern, namely, to transcend, as it were, the medium of thought itself, and enter into the presence of God. The reason that this concern introduces a tension in the search for a proof is that the realization of presence would seem to render proof superfluous, while the inference in an argument - especially one moving towards existence – inevitably suggests, in some sense and to some degree, the absence of what is sought for. (shrink)

The U.S. FDA has issued emergency use authorizations for monoclonal antibodies for non-hospitalized patients with mild or moderate COVID-19 disease and for individuals exposed to COVID-19 as post-exposure prophylaxis. One EUA for an oral antiviral drug, molnupiravir, has also been recommended by FDA’s Antimicrobial Drugs Advisory Committee, and others appear likely in the near future. Due to increased demand because of the Delta variant, the federal government resumed control over the supply and asked states to ration doses. As future variants (...) with increased infectivity and/or severity emerge, further rationing may be required. We identify relevant ethical principles and priority groups for access to therapies based on an integrated approach to population health and medical factors. Using priority categories to allocate scarce therapies effectively operationalizes important ethical values. This strategy is preferable to the current approach of categorical rules based on vaccination, immunocompromise status, or older age, or the ad hoc consideration of clinical risk factors. (shrink)

This paper makes a plea for more reflexive attempts to develop and anchor the emerging concept of responsible research and innovation. RRI has recently emerged as a buzzword in science policy, becoming a focus of concerted experimentation in many academic circles. Its performative capacity means that it is able to mobilise resources and spaces despite no common understanding of what it is or should be ‘made of’. In order to support reflection and practice amongst those who are interested in and (...) using the concept, this paper unpacks understandings of RRI across a multi-disciplinary body of peer-reviewed literature. Our analysis focuses on three key dimensions of RRI that remain particularly opaque. A total of 48 publications were selected through a systematic literature search and their content was qualitatively analysed. Across the literature, RRI is portrayed as a concept that embeds numerous features of existing approaches to govern and assess emerging technologies. Our analysis suggests that its greatest potential may be in its ability to unify and provide political momentum to a wide range of long-articulated ethical and policy issues. At the same time, RRI’s dynamism and resulting complexity may represent its greatest challenge. Further clarification on what RRI has to offer in practice—beyond what has been offered to date—is still needed, as well as more explicit engagement with research and institutional cultures of responsibility. Such work may help to realise the high political expectations that are attached to nascent RRI. (shrink)

Intuitionism is most commonly defined in terms of various strong epistemological and metaphysical presuppositions, e.g., that true moral principles are synthetic a priori propositions, known by some special faculty of moral reflection, and the like. I shall not here be concerned with such views. Rather my focus will be upon the program for normative investigation which I have elsewhere argued is implicit in the intuitionists’ writings and which I take to be intuitionism's salient characteristic.