bluuebunny/crossref_metadata_2025 huggingface dataset:
The Area of Freedom, Security, and Justice
Authors: Lenaerts Koen , Van Nuffel Piet , Corthaut Tim
Published: April 2022

This chapter evaluates the European Union's competence and substantive rules relating to the area of freedom, security, and justice. The Lisbon Treaty has brought together, in Title V of Part Three of the TFEU, ('Area of freedom, security and justice') all competences of the Union in respect of visa, asylum, immigration, judicial cooperation in civil matters, and police cooperation and judicial cooperation in criminal matters. Through its policy in these fields, the Union legislature is to ensure an 'area of freedom, security and justice with respect for fundamental rights and the different legal systems and traditions of the Member States' (Article 67(1) TFEU). The cooperation between the Member States in the area of freedom, security, and justice is based on mutual trust, on the basis of which every Member State must assume, barring exceptional circumstances, that the other Member States respect Union law and fundamental rights. The chapter traces the steps by which the Member States have gradually agreed to have recourse to supranational decision-making in matters such as the entry and residence of third-country nationals, police cooperation, and judicial cooperation in civil and criminal matters.
External Action of the Union
Authors: Lenaerts Koen , Van Nuffel Piet , Corthaut Tim
Published: April 2022

This chapter focuses on the external competences of the European Union. In Part V of the TFEU relating to 'external action by the Union', the Lisbon Treaty has brought together most of the external competences of the Union. Besides provisions on, inter alia, the common commercial policy, development cooperation, and cooperation with third countries and humanitarian aid (Articles 206 to 214 TFEU), Part V contains a legal basis for the adoption of restrictive measures against third countries and non-State entities (Article 215 TFEU) and a solidarity clause (Article 222 TFEU). However, the TFEU does not contain the provisions relating to the common foreign and security policy (CFSP), which are found in Chapter 2 of Title V of the TEU (Articles 23 to 46 TEU). The CFSP does not consist of a list of competences, but rather formulates aims and instruments with a view to pursuing a 'foreign policy' alongside and in conjunction with other external Union action. Moreover, the European Atomic Energy Community (EAEC) has a general power to conclude international agreements within the confines of the competences conferred on it by the EAEC Treaty.
The Political Institutions of the Union
Authors: Lenaerts Koen , Van Nuffel Piet , Corthaut Tim
Published: April 2022

This chapter provides an overview of the powers, composition, operation, and internal organization for each of the four 'political institutions' of the European Union: the European Parliament, the European Council, the Council, and the European Commission. According to Article 14(1) TEU, the European Parliament exercises, jointly with the Council, legislative and budgetary functions and exercises, in addition, functions of political control and consultation as laid down in the Treaties. Moreover, the European Parliament may advise and adopt resolutions pertaining to societal issues. According to Article 15(1) TEU, the European Council's tasks remain to provide the Union with the necessary impetus for its development and to define the general political directions and priorities of the Union. Meanwhile, according to Article 16(1) TEU, the Council, jointly with the European Parliament, exercises legislative and budgetary functions and carries out policy-making and coordinating functions as laid down in the Treaties. Finally, Article 17(1) TEU unequivocally declares that the European Commission is the Union institution which promotes the general interest of the Union and takes appropriate initiatives to that end.
The Member States of the Union
Authors: Lenaerts Koen , Van Nuffel Piet , Corthaut Tim
Published: April 2022

This chapter explores the role of the Member States as actors of the European Union. Within the field of action of the European Union, the national authorities remain continuously involved in the adoption, implementation, and enforcement of decisions, both within the institutions of the Union and through the exercise of their own functions. That applies to the parliamentary, executive, and judicial authorities of the Member States, both at national and sub-national level. The Union is to respect the 'fundamental structures, political and constitutional, inclusive of regional and local self-government' as part of the 'national identities' of the Member States (Article 4(2) TEU). In order to emphasize the multiple democratic foundations of the Union, the Treaties refer to the particular role of national parliaments, which 'contribute actively to the good functioning of the Union' (Article 12 TEU). Article 12 TEU specifies a number of ways in which national parliaments make that contribution, either through their participation in constituent decisions of the Union or through their involvement in the Union's decision-making and in the implementation of Union acts.
The Budgetary Procedures
Authors: Lenaerts Koen , Van Nuffel Piet , Corthaut Tim
Published: April 2022

This chapter discusses the budgetary procedures in the European Union. Under Article 314 TFEU, the draft budget is established by the Commission and then subject to one reading only by the Council and the European Parliament—the two branches of the Union's budgetary authority. Since the procedure for the adoption of the budget no longer distinguishes between compulsory and non-compulsory expenditure, the European Parliament thus has the final say—together with the Council—over all expenditure. However, the budget must remain within the limits of the multiannual financial framework. The Commission implements the budget in cooperation with the Member States on its own responsibility and within the limits of the appropriations, having regard to the principles of sound financial management. Other institutions and bodies may also engage in expenditure as authorized under the budget. The implementation of the budget is framed by the Financial Regulation and any other financial rules adopted by the European Parliament and the Council, acting in accordance with the ordinary legislative procedure and after consulting the Court of Auditors, pursuant to Article 322 TFEU.
The Treaties: Primary Union Law
Authors: Lenaerts Koen , Van Nuffel Piet , Corthaut Tim
Published: April 2022

This chapter focuses on primary Union law, which consists of those provisions which were adopted directly by the Member States in their capacity as 'constituent authority', meaning in the first place the Union Treaties and the Treaties amending or supplementing them, including the Accession Treaties and the annexed Acts of Accession. Together with fundamental rights and the general principles of Union law, these Treaty provisions constitute the 'constitutional' provisions of Union law. This is because they serve as the legal basis for action on the part of the Union and unquestionably take precedence over the law of the Member States. Where Treaty provisions satisfy the test formulated by the Court of Justice for direct effect, they may as such confer rights on individuals. Primary Union law comes into being by mutual agreement between the Member States and may be amended only in accordance with the proper procedure.
Fundamental Rights and General Principles of Union Law
Authors: Lenaerts Koen , Van Nuffel Piet , Corthaut Tim
Published: April 2022

This chapter assesses the fundamental rights and general principles of Union law. According to Article 19(1) TEU, the Court of Justice and the General Court ensure that 'in the interpretation and application of the Treaties the law is observed'. Recognition of 'the law' as a source of Union law has enabled the Court of Justice to have recourse to general principles in interpreting and applying Union law. Ever since 1969, it has been clear that 'fundamental human rights [are] enshrined in the general principles of [Union] law and protected by the Court'. Article 6(3) TEU still refers to the fundamental rights guaranteed by the European Convention for the Protection of Human Rights and Fundamental Freedoms of 4 November 1950 (ECHR) or resulting from the constitutional traditions common to the Member States as 'general principles of the Union's law'. However, since the entry into force of the Lisbon Treaty, the Union also 'recognizes' the rights, freedoms, and principles set out in the Charter of Fundamental Rights of the European Union (Article 6(1) TEU), which has the same legal value as the Treaties. Hence, the Charter constitutes a source of primary Union law.
International Law
Authors: Lenaerts Koen , Van Nuffel Piet , Corthaut Tim
Published: April 2022

This chapter addresses the relationship between the European Union and international law. Article 218 TFEU lays down the procedure by which the Union concludes agreements with third countries or international organizations. Agreements concluded by the Union are binding on the Union institutions and on Member States (Article 216(2) TFEU). The provisions of such agreements form an integral part of the Union legal order from the moment they enter into force. This is in accordance with the 'monist' approach: agreements concluded by the Union form part of the Union legal order without there being any necessity to transpose them into internal provisions of Union law. Exceptionally, agreements not concluded by the Union but by the Member States also have binding force. This is so when the Union has assumed, under the Treaties, the competence previously exercised by the Member State in the field to which the agreement applies. This was the case with the General Agreement on Tariffs and Trade (GATT). An agreement concluded by the Member States is also binding on the Union when the Treaties provide that the Union must exercise its competence in accordance therewith. Examples are provided by the Geneva Convention and the Protocol relating to the status of refugees and other relevant treaties, which are binding on the Union in the matter of asylum policy (Article 78(1) TFEU).
Questioning Ratification
Authors: Lenowitz Jeffrey A.
Published: April 2022

Chapter 1 sets out the core question of the book—whether ratification should be a recommended component of the constitution-making process. First, it presents some key background concepts and terms. This involves defining a constitution, distinguishing between amending and making a new constitution, explaining democratic constitution-making and its stages, and presenting a comprehensive definition of ratification and its various types. Next, the chapter defines what is meant by a normative justification and why one is needed for ratification. This entails discussing ratification’s effects on the constitution-making process, its costs, and how the current literature on constitution-making leaves ratification unexamined. Finally, the remainder of the book is outlined.
The Unalienable Right of the Berkshire Constitutionalists
Authors: Lenowitz Jeffrey A.
Published: April 2022

This chapter develops the unique site justification, the argument that a ratification referendum should be implemented because it is the sole site through which the people, the constituent power, can materialize and create their constitution. This is the original argument made in favor of ratification by the Berkshire Constitutionalists, whose history was detailed in chapter 3. Here, their argument is carefully reconstructed from petitions, speeches, voting logs, and the relevant political philosophy dominant in Early America at the time. The chapter begins by arguing that the Constitutionalists generate their demand for a popularly created constitution by combining a form of social contractualism with a new understanding of constitutions. Next, it demonstrates how the Constitutionalists isolate constituent power to the post-drafting stage and define the right to ratify as unalienable, thereby making ratification both a necessity and only possible via a referendum. The chapter ends showing the revival of this argument in recent writings by Richard Tuck.
Legitimacy Types and Procedures
Authors: Lenowitz Jeffrey A.
Published: April 2022

This chapter begins the book’s investigation into the third core justification of ratification: the legitimacy justification. This is the claim that ratification should be implemented because it helps create a legitimate constitution. Like many arguments making recourse to legitimacy, references to this justification are often unhelpful because they fail to explain what legitimacy means, how it applies to constitutions, and how procedures affect it. To address this problem, the chapter first argues that in its political application, legitimacy divides into three types—moral, sociological, and legal—, though legal legitimacy collapses into sociological legitimacy when it comes to constitutions. Next, the chapter explains how a procedure can affect the actual or perceived normative status of an outcome in two ways: by having a substantive effect, changing the contents of the outcome such that it meets some independently derived normative criterion. Or by having a procedural effect, serving as the normative criterion itself that the outcome meets by virtue of resulting from the procedure. The chapter ends combining these two distinctions to produce four pathways through which constitution-making procedures might legitimate constitutions: substantive moral legitimation, substantive sociological legitimation, procedural moral legitimation, and procedural sociological legitimation.
Legitimation Device
Authors: Lenowitz Jeffrey A.
Published: April 2022

This chapter interrogates ratification’s capability of creating a legitimate constitution through the four pathways discussed in chapter 8. This involves testing the most plausible or popular arguments for each. Substantive moral legitimation and substantive sociological legitimation are treated together. Ratification might ensure that the contents of a constitution are or are perceived to be morally legitimate by, to follow Condorcet, filtering out illegitimate constitutions via rejection. Or the fear of a future veto might prevent framers form writing an illegitimate constitution in the first place. Procedural moral legitimation depictions of ratification either invoke constituent power—examined and rejected in previous chapters—or utilize consent, conceptualizing the procedure as the means through which citizens consent to a constitution and pick up obligations to obey. The chapter goes on to consider two examples of procedural sociological legitimation. The first posits that most citizens simply believe that ratification is necessary for a legitimate constitution, while the second casts ratification as a participatory moment in constitution-making and appeals to findings linking participation with beliefs in legitimate outcomes. As with previous attempts to justify ratification, these legitimacy justifications come up short. Among other things, they are theoretically implausible, assume the existence of norms that cannot be guaranteed, rely on empirical findings that are unknown or misinterpreted, and or involve morally problematic manipulation.
Beyond Individual Loci
Authors: Allendorf Fred W. , Funk W. Chris , Aitken Sally N. , Byrne Margaret , Luikart Gordon
Published: April 2022

Population genetic models become much more complex when two or more loci are considered simultaneously. Random association of the alleles (and genotypes) at two loci is called gametic equilibrium. Linkage is the primary factor that can cause the alleles at two loci to be in nonrandom association within a population. This is called gametic disequilibrium. Many other factors (e.g., genetic drift, selection, hybridization, etc.) can cause even unlinked loci to be in gametic disequilibrium. The interpretation of multilocus genotypes is becoming increasingly important in conservation because of advances in techniques to screen many loci and advances in data analysis. The ability to sequence large sections of chromosomes provides the opportunity to interpret multiple locus genetic data using entirely new conceptual approaches. It is now possible to use sequence data to identify chromosomal segments originating from different ancestral chromosomes.
Mutation
Authors: Allendorf Fred W. , Funk W. Chris , Aitken Sally N. , Byrne Margaret , Luikart Gordon
Published: April 2022

Mutations are errors in the transmission of genetic information from parents to progeny, and an understanding of mutation assists in interpreting patterns of genetic variation to inform conservation. Mutation is the source of all variation, and can be neutral, beneficial, or detrimental. Mutation rates vary across the nuclear genome, and are generally higher in animal mitochondrial genomes, but much lower in chloroplast and plant mitochondrial genomes. Mutation contributes to variation within populations, population subdivision, and the rate of recovery from bottlenecks. Mutations can be detected using genomic analysis, or through effects on morphological, physiological, or behavioral traits. The amount of standing genetic variation within populations is a balance between the gain of genetic variation from mutations and loss from genetic drift. Natural selection acts to keep mutations that have a detrimental effect on fitness from increasing in frequency, and genetic drift aids the survival of advantageous mutations.
Hybridization
Authors: Allendorf Fred W. , Funk W. Chris , Aitken Sally N. , Byrne Margaret , Luikart Gordon
Published: April 2022

Hybridization occurs between species or populations, and can arise from either natural or anthropogenic causes. Hybridization is important in natural evolutionary processes, but can be a harmful force reducing species identity and reproductive success. Hybridization can increase fitness through heterosis, or reduce fitness through outbreeding depression. Genetic analysis can effectively identify hybridization and has frequently used diagnostic loci that have different allele frequencies in the parents. Hybrid indices or admixture analyses use proportions of parental ancestry in individuals to identify hybrids. Hybridization contributes to decline and extinction of species through loss of reproductive potential and reduced population growth, or through genetic mixing and loss of genetically distinct populations. Determining whether hybridization is natural or anthropogenic is crucial for conservation. Protection of hybrids is often based on whether they are genetically distinct through long-term isolation or speciation, or whether they represent recent, ongoing, or anthropogenic hybridization.
Invasive Species
Authors: Allendorf Fred W. , Funk W. Chris , Aitken Sally N. , Byrne Margaret , Luikart Gordon
Published: April 2022

Invasive species have significant effects on biodiversity. Genetics provides insights important for eradication and control crucial for conservation. Invasive species can be successful despite bottlenecks because of increased genetic diversity following hybridization or multiple introductions, rapid evolutionary change, lack of natural enemies, or absence of constraints from local adaptation. Genetic and genomic analysis can identify cryptic invasive species, sources of introductions, pathways of spread, and patterns of adaptation and invasion. Bottlenecked species will have less diversity in the invasive range than in the native range, and species with multiple introductions will have greater diversity than in the native range. Genetic analysis can identify the mode of reproduction, including clonality, selfing, or parthenogenesis/apomixis. Invasive species detection is a crucial first step in determining prevalence of disease vectors. Metagenomics and metabarcoding can detect parasites and pathogens, and track the origin and transmission of parasites and infectious diseases.
Exploited Populations
Authors: Allendorf Fred W. , Funk W. Chris , Aitken Sally N. , Byrne Margaret , Luikart Gordon
Published: April 2022

There is mounting evidence that human exploitation of wild populations can lead to genetic changes that greatly increase the complexity of managing sustainable populations. Harvest can reduce the effective population size and cause loss of genetic variation by reducing population size directly and by reducing the number of migrants into local populations. Harvest tends to remove phenotypes that are most desirable, which can reduce the frequency of these phenotypes by artificial selection. Even random harvest will select for earlier sexual maturity. Harvest of wild populations can perturb genetic subdivision among populations and reduce overall productivity. The harvest of a group of individuals that is a mixture of several subpopulations can result in the extirpation of one or more subpopulations. Exploitation of wild animals and plants often depends upon augmentation through releases of translocated or captive-raised individuals. Such releases can bring about adverse genetic change to wild populations.
Population Connectivity
Authors: Allendorf Fred W. , Funk W. Chris , Aitken Sally N. , Byrne Margaret , Luikart Gordon
Published: April 2022

We discuss the roles of gene flow, genetic drift, and selection in determining the distribution of genetic variation in complex, real-world landscapes. A metapopulation is a group of populations that experience some degree of gene flow among them. Metapopulation structure can have complex effects on patterns of genetic variation within and among populations. For species that do not naturally occur in discrete habitat patches, a landscape genetics framework is more appropriate. Landscape genetics combines population genetics, landscape ecology, and spatial statistics to understand how environmental heterogeneity affects gene flow and genetic variation. Habitat loss and fragmentation have severed connectivity among populations of many formerly continuous species, isolating populations that then lose genetic variation due to reduced gene flow. Genetic rescue, the supplementation of small inbred populations with immigrants from larger more genetically diverse populations, can be used to increase genetic diversity and reduce extinction probabilities of populations isolated by habitat fragmentation.
Genetic Identification
Authors: Allendorf Fred W. , Funk W. Chris , Aitken Sally N. , Byrne Margaret , Luikart Gordon
Published: April 2022

Genetic analysis allows genetic identification of individuals, populations, and species for a range of conservation purposes, including wildlife trafficking, detecting invasive species, determining relatedness in captive breeding, and identifying community composition. Genomics provides increased power for genetic identification at individual, population, and species levels, and is a key tool in wildlife forensics. DNA barcoding using specific markers has become common for species identification, and metabarcoding of environmental or mixed samples through genomics informs community composition, diet analysis, and identifying cryptic, elusive, or rare individuals and species. Genetic identification has become prominent in wildlife forensics providing critical evidence to enable prosecutions and deter illegal wildlife activities. Multilocus genotyping allows determination of parentage and relatedness, population assignment, and origin of samples. Determination of the relatedness or parentage of individuals provides information on identification of dispersal and migration patterns, and facilitates management of captive breeding populations.
On Returning to the Walk North with Keats
Authors: Walker Carol Kyros
Published: April 2022

After many years the author returns to follow Keats’s 1818 walking tour with his friend Charles Brown through the north of England to Scotland to find that though many iconic sites remain the same, much has changed, including her own perspective as she now sees Scotland as the primary destination of the travellers. The internet has come along, getting places and researching information has changed, and significantly, since the author follows the tour camera in hand, photography has moved to digital. The touchstones of the tour—Wordsworth’s home at Rydal Mount, the grave and mausoleum of Burns in St Michael’s Churchyard, Ailsa Craig on the horizon opposite Girvan, Ayrshire with Burns’s cottage, Brig o’ Doon, Kirk Alloway—all have a refreshed lustre. Following Keats’s side trip to Northern Ireland, Belfast has blossomed into a vibrant city free of armed guards at checkpoints. Oban, always busy, now has traffic signs in Gaelic and English and on the ferry to Mull, some conversations could be heard in Gaelic. The farmhouse called Derry-na-Cullen on Mull appears more skeletal and overcome with green growth. The church at Inveraray is more accessible and documented. The old Letterfinlay Inn on Loch Lochy has been landscaped without, remodelled within, and put up for sale as a five-bedroom country house. The abbey was missing from Fort Augustus. The dock from which Keats sailed home to London in Cromarty remained as he had seen it. Only the twenty-first-century beholder had changed.
‘Werry romantic…among these Mountains & Lakes’
Authors: Leask Nigel
Published: April 2022

My essay explores Keats’s ‘Cockneyism’ in the letters describing his six-week ‘northern tour’ in 1818 with Charles Brown in letters to his brother Tom and other family members, as well as to friends like Reynolds and Bailey. His tour letters and poetry are placed in the context of post-Waterloo travel accounts of Scotland, and of contemporary criticisms of the Highland tour as a commodified and Cockneyfied cliché, especially in the wake of the craze for Scott’s Highland romances. The essay considers the literary influence of Wordsworth, Burns, and Scott, although the latter is a conspicuous absence from Keats’s account. Keats’s pedestrian tour is interpreted as an exercise in masculine self-fashioning and social mobility, a distinctive cultural performance, rather than merely an episode in the poet’s creative development. Attention is paid to Keats’s accoutrements and itinerary, and new research identifies the guidebooks he consulted, as well as his relations with local people, especially in the Gaelic-speaking Highlands. Keats’s account of key sites, like Loch Lomond, Inveraray, Mull, Iona, Staffa, and Ben Nevis are explored in relation to the light-hearted tour poetry that they inspired. My essay explores how Keats negotiated this ‘beaten track’, both as a cultural and as a literary practice, anticipating the ironic sense of poetic identity that he developed in the poems of his last years.
‘Stupendous Recollolections’
Authors: Turley Richard Marggraf
Published: April 2022

Keats conceived his pedestrian tour of the Lake District and Scotland in summer 1818 as an opportunity for self-improvement through travel. Disappointed with the reception of the ‘youngster’ Endymion, Keats told friends the walking tour would not only enlarge his vision as a writer but also help him to accumulate the experience and ‘grand materials’ necessary to compose a more mature epic, Hyperion, in the Wordsworthian sublime style. Keats’s northern wayfaring did indeed catalyse personal and political development, but it also involved the poet in an uncomfortable process of self-examination and cultural recalibration. This chapter explores how at key stations in his tour—Rydal Mount, Burns’s cottage, Glasgow’s Old Bridge, the terrain around Ben Lomond—Keats’s habit of pulling different eras, histories, and geographies into superposed accumulation forced him first to wrestle with, then resist, and finally to recast official histories, both of the regions he visited and the literary figures associated with them.
Keats’s Quest
Authors: Garner Katie
Published: April 2022

This chapter investigates the influence of Keats’s knowledge of medieval romance on his travels in Scotland in 1818. Tracing allusions to Spenser’s Faerie Queene and the Arthurian legend in his tour letters and poems, it argues that the quest patterns that Keats admired in Spenser and Malory were reconfigured in his mind as he wandered in pursuit of ‘experience’. Travelling on foot through dramatic, ruin-strewn landscapes gave Keats a new sense of how romance was a live, credible register for extreme feeling. In Keats’s tour writings, medieval landscapes fuse with more recent histories, anticipating the style and tone of his later medievalist poetry.
Scotland and Keats’s Health in 1818
Authors: Ghosh Hrileena
Published: April 2022

This chapter explores Keats’s biographical circumstances during 1818 to show that they made it almost a statistical impossibility for him to emerge from that year free of a tubercular infection. Keats’s biography is read against current awareness of the conditions in which tuberculosis is most virulent, to reveal the factors that, operating in lethal combination, rendered Keats’s contraction of tuberculosis in 1818 unavoidable. These risk factors range from the circumstantial (weather), to personal decisions the consequences of which could not have been anticipated (Keats’s tour of Scotland), to contemporary medical treatments (mercury). Singly they might have been resisted, but in combination they proved lethal. As this chapter shows, it was an unfortunate conjunction of circumstances—Keats returning unwell from Scotland, then caring for his contagious brother Tom—that ensured Keats’s death sentence from pulmonary tuberculosis.
John Keats and Scottish Artists
Authors: Wootton Sarah
Published: April 2022

The aim of this chapter is to widen the compass of Keats’s visual legacy and to refocus attention from the painters of Southern England to the book illustrators and designers of Scotland. What follows seeks to recalibrate our understanding of the reception of Keats’s poems in art by addressing hitherto unexplored aspects of the poet’s afterlives. This chapter is divided into two sections, each focusing on a Scottish city where artists engaged with Keats’s poems within a regional context of cultural and commercial rejuvenation. The first section considers the Scottish Pre-Raphaelites, Joseph Noël Paton (1821–1901) and William Bell Scott (1811–90), both of whom had strong connections with Edinburgh and its surrounding areas. The second section focuses on artist-craftworkers, such as Talwin Morris, who self-consciously identified with a particular Scottish city at a specific historical moment, pioneering and popularizing what is now known as the Glasgow Style of the late nineteenth and early twentieth centuries.
The problematic side of precision medicine
Authors: Boniolo Giovanni
Published: April 2022

‘Molecular medicine’, ‘precision medicine’, and ‘personalized medicine’. Do these expressions indicate something different? After pragmatically solving this question and stating the meaning of ‘precision medicine’, this chapter offers an overview of some of the main issues raised by this approach to biomedical research and clinical practice. In particular, it will be focused on data deluge, biomarker validation, new clinical trials, patient-in-waiting and too much medicine, unknown genotypes and ethnic discrimination, cost of new treatments, global injustice, and patients’ lack of awareness of the proper meaning of the statistical and probabilistic results. This does not imply that we should have a dismissive or a suspicious approach to precision medicine. This our medicine: the medicine of our age. It is a medicine with great potential for improving our quality of life and the quality of life of our lineages. Yet, we have to work on it if we wish to fully realize its promises. This means also working from a philosophical point of view, both offering ethical analyses and methodological suggestions whenever required, and being willing to help in the training of the new generations of clinicians.
The precision paradox
Authors: Vogt Henrik
Published: April 2022

Precision medicine—or personalized medicine—promises greater precision and certainty in medicine. This paper highlights a ‘precision paradox’: that it may, in important ways, also create more uncertainty and imprecision. First, the aim of precision medicine is to tailor treatment to the individual. However, when the number of individuals that are seen to have a specific health problem moves towards one (n = 1), it becomes hard to employ randomized control trials or other statistically based methods. This creates uncertainty about what kind of rationality and evidence will be seen as validating what works in medicine. Just as biomedicine aims to turn personalization into science, the art of medicine resurfaces. Second, one strategy in precision medicine is to make models more complex in order to make them more accurate and thus certain. However, there is a fundamental tension between complexity and precision. Beyond a certain threshold, as more variables are included, models paradoxically become less precise. Third, in the preventive vision of precision medicine, a massive, new form of screening is proposed where DNA is sequenced, and multiple variables of human health are monitored through life. However, as each body is rendered ‘transparent’ by multiple screening technologies, there is a risk of labelling each person with multiple health problems. Contrary to its promise of medicine ‘at the right time in the right person’, precision medicine, as proposed, will paradoxically be present ‘all the time’ in ‘everybody’.
Personalized medicine and genetic newborn screening
Authors: Brusa Margherita , Dickenson Donna
Published: April 2022

Given the established success of newborn screening programmes around the world, promoters of personalized medicine envision the possibility of extending genetic analysis to bloodspots routinely collected for newborn screening. Since most of the diseases already screened for are genetic, diagnosis would be more precise. Moreover, data thus collected would merge into the creation of a repository of genetic information accessible in case of future health-related needs. The appeal of such a plan poses a series of ethical challenges related to the peculiar nature of genetic information, the involvement of babies, and the blurred boundaries of such an enterprise that extends beyond prevention, to clinical practice and research. After reviewing the key elements of the practice of newborn screening, and the increased use of genetic testing of babies, the paper analyses UK policies as a test case, considering the ethical implications of consent, solidarity and the conflict of interests involved. It is demonstrated that some forms of ‘genetic expansion’ of newborn screening amount to genetic research on minors and, consequently, must follow well-established protocols. Such screening may also violate the established legal principle that parental consent is based on the child’s best interests. Other forms of accumulation of data cannot even account for research, thus lacking scientific justification. Whether or not whole-genome screening of babies may be a promising scientific pathway, it should not threaten clinical standards of childcare in the guise of expanding a well-established public health initiative for children, without proper and agreed justification.
The revolution of personalized medicine is already upon us in rare diseases
Authors: Austin Christopher P.
Published: April 2022

Personalized medicine remains an aspirational future state for the majority of diseases, but is the present state for rare diseases. As a result, the principles, practices, potential, and perils of personalized medicine are currently being realized in rare disease medicine, and we can look through the lens of rare disease at present and see the future for common disease personalized medicine. Personalized medicine endeavours to use in-depth genetic and environmental data to define a genotype–phenotype pairing that is based in definable physiological dysfunction and predicts treatment with a high likelihood of positive response. Rare diseases are defined and managed in just this way today. The experience of rare diseases suggests both exhilarating medical promise, and sobering operational and ethical realities, for personalized medicine of common diseases. Rare disease/personalized medicine can be just as effective as anticipated. But current medical systems, drug development, treatment, and payment paradigms are not well-suited to personalized medicine, and all will require adaptations for its promise to be realized.
Personalized medicine and disorders of consciousness
Authors: Fins Joseph J.
Published: April 2022

When scholars write about personalized medicine, most refer to the interpretation of molecular biomarkers for the development of therapeutics tailored to an individual’s disease. By moving beyond pathological phenotypes to better characterize disease and guide treatment, next-generation personalized medicine moves more deeply into the biology of the malady to refine diagnostics at a genotypic, or molecular level. By understanding the unique biology of an individual’s disease, in most cases a malignancy, personalized therapies can be directed against specific biological targets. This focus maximizes therapeutic effect, decreases the variance of therapeutic response through more accurate diagnostic classification, and minimizes side-effects. This chapter suggests another domain where the metaphor of personalized medicine is apt and considers its application to the emerging diagnostics, therapeutics, and neuroethics informing the care of patients with disorders of consciousness. These conditions comprise a range of brain states that span coma, the vegetative, and minimally conscious states. Each of these states has behavioural and biological characteristics that warrant review and consideration for our discussion of personalized medicine. As in other domains of personalized medicine, patients presenting similarly at the bedside may have meaningful differences in their underlying neural circuitry. These distinctions, or the discordance between observed phenomenology and unobserved neurobiology, may have normative implications for the diagnosis and treatment of these conditions.
Thoughtful genomics
Authors: Reardon Jenny
Published: April 2022

Many people hope for a future in which genomics and its offspring (i.e. personalized medicine) achieve their promises: new cures and longer and better lives for all. However, for that to come to pass, this chapter argues that the field must support meaningful, thoughtful speech about that which it does. It provides an account of the history of genomics that brings to light the choices made by architects of genomics to set to one side important questions about the meaning of their endeavours. For decades the field focused on creating data and tools, a project they understood as separate from forging knowledge and meaning. As a result, genomics became susceptible to inadvertently and unreflectively fostering racial and capitalist logics that exclude many from its benefits. Drawing upon the work of Hannah Arendt, the chapter presents a model of thoughtfulness capable of fostering a genomics more able to respond to the needs and cares of a more diverse range of lives. It argues that cultivating this kind of response-able, thoughtful genomics should be the field’s next milestone.
Genetics, genetic profiles, and Jewish law
Authors: Weissinger Yehoshua , Barilan Yechiel Michael
Published: April 2022

Because Jewish law is a positive legal system, it has tended to tolerate actions not specifically prohibited by pre-modern laws, such as genetic technology. Jewish law and culture even embrace medical technologies. But Jewish ethics and its interaction with Jewish law follow naturalistic reasoning. Jewish morality warns against abuse of the positive legal system by acts and intentions that are immoral but technically licit. Jewish morality is censorious with attempts to predict personal future; Jewish law is quite restrictive in relation to the dissemination of personal information, even when truthful. The chapter shows how Judaism’s treatment of personal information might bear on the evolving ethics and law of information technologies on private and genetic data.
Eliot’s Nerves
Authors: Jagger Jasmine
Published: April 2022

This chapter argues that T. S Eliot’s poetic composition between 1909 to 1922 dramatizes his nervous inner states as a young man. It furthers criticism by Christopher Ricks (2003), Robert Crawford (1987, 2015) and Anthony Cuda (2004), builds on thinking by Adam Phillips (1994) and Frank Kermode (2010), and develops studies of literary nervousness by Tom Lutz (1991), Shelley Trower (2013), and Phillipa Lewis (2016). Tracking a nervous poetics in Eliot’s drafts in connection with his life-writing, it adds to criticism by singling out nervousness, for the first time, as a source for, and dramatization within, Eliot’s writing.
Disease Epidemiology in Natural Systems
Authors: Foufopoulos Johannes , Wobeser Gary A. , McCallum Hamish
Published: April 2022

Parasitic organisms are extremely common in nature and display a wide range of life history characteristics. While there are many ways to organize this diversity, one categorization increasingly used in recent years is the differentiation between microparasites (mostly unicellular organisms with simple life cycles) and macroparasites (mostly multicellular parasites with complex life cycles). This chapter discusses the differences between these groups, as well as the distinctions between the various types of between-host transmission. Furthermore, we introduce the concept of basic reproductive number (R
0), and explain how it pertains to the spread of infection in natural ecosystems. Lastly we discuss how the outcome of an infection can be shaped by a variety of factors relating broadly to host biology, pathogen characteristics, and prevailing environmental conditions.
Capture, Restraint, and Euthanasia of Target Species
Authors: Foufopoulos Johannes , Wobeser Gary A. , McCallum Hamish
Published: April 2022

Despite advances in noninvasive data collection, the practice of capturing wildlife provides a wealth of information and remains a fundamental component of wildlife disease and conservation studies. Six principal considerations are discussed in the context of capturing wild animals for disease sampling, including: whether the captured animals are representative of the entire population and whether the biological samples are indicative of the physiology rather than the capturing method; whether capture techniques will influence the animal’s subsequent behavior or endanger the investigators; whether the chosen sampling frequency and magnitude are representative of the host population demographics and disease dynamics; and finally, how the capturing and sampling process can be continually improved.
The Environmental Context of Wildlife Disease
Authors: Foufopoulos Johannes , Wobeser Gary A. , McCallum Hamish
Published: April 2022

The environmental context of an infectious disease refers to those infection determinants that are neither a feature of the causative agent nor a characteristic of the host population. They define what is also termed the “ecological niche” of the disease. Understanding the relationship between an infection and the surrounding environment in a quantitative fashion can be very useful, particularly because it can help predict disease occurrence and even elucidate parasite life cycle and mode of transmission. Because different processes determine disease occurrence at different spatial scales it is often important to conduct these investigations across multiple spatial and temporal scales. In this chapter we analyze various aspects of the environmental context of infection and discuss multiple case studies where this approach has been applied successfully to a broad range of parasitic organisms.
Agent and Disease Detection—Laboratory Methods
Authors: Foufopoulos Johannes , Wobeser Gary A. , McCallum Hamish
Published: April 2022

Accurate, reliable detection of infectious agents, as well as the resulting disease is critical for many aspects of wildlife management. This usually requires laboratory examination of specimens, either from animals found sick or dead in the field, or collected from live animals for testing. The planning and implementation of the sampling—starting with specimen collection, through analysis of the specimens, to interpretation of the test results—are extremely important for overall quality of the study, and should be done collaboratively, involving both wildlife biologists and laboratory diagnosticians. The choice of diagnostic test(s) to be used is central to the process, as it determines the type of sample to be collected, how samples are handled, and the conclusions that can be drawn from the test results. Often, however, owing to the relative rarity of wildlife disease analyses, and because of the variation stemming from host species physiology, wildlife tests are not as well validated as for domesticated animals. When this occurs, interpretation of results may be flawed. This chapter reviews the methodological steps required to establish an effective and unbiased wildlife disease testing protocol.
Preventing New Disease Occurrences
Authors: Foufopoulos Johannes , Wobeser Gary A. , McCallum Hamish
Published: April 2022

Distribution and occurrence of most infectious diseases in nature are limited by geophysical, ecological, or physiological barriers. Disease emergence occurs when such barriers are breached, most often through human activities—effective prevention of disease outbreaks therefore requires an understanding of both the nature of the barriers and the processes that render them ineffective. In this chapter we discuss the management of the main anthropogenic activities that lead to the breaching of natural disease barriers. Such activities include: importation and escape or release of exotic pets; feral domesticated animals; introduced disease vectors; importation of infectious fomites; and the intentional translocation and release of wildlife. Also important, but rarely addressed, is the introduction of susceptible hosts into an area of a preexisting disease leading to a disease outbreak. Lastly we discuss how environmental disruption and degradation alone can lead to disease emergence and how prevention of such disruption can aid effective disease management. Assessment of the danger of disease emergence following a human activity has four components: hazard identification; risk assessment; risk management; and risk communication.
Disease Elimination and Eradication
Authors: Foufopoulos Johannes , Wobeser Gary A. , McCallum Hamish
Published: April 2022

This chapter explores the various aspects of disease control, elimination, and eradication. To eliminate a disease, several requirements must be fulfilled. A thorough understanding of agent transmission is needed, as well as the ability to interrupt this transmission. Effective surveillance of the population through diagnostic tools with appropriate sensitivity and specificity is also necessary. Intervention success depends on the factors of elimination: spatial distribution of the disease, intensity of infection, and time. Elimination can be achieved through manipulation of the host, the pathogen, or the environment. Host manipulation is mostly possible through culling or vaccination, while manipulation of environmental factors can also be very effective. As a last resort, establishing an isolated, uninfected “insurance” population of the host may be necessary. While completely eradicating a given disease is difficult and near impossible, management and partial elimination can often be achieved through appropriate methods.