bluuebunny/crossref_metadata_2025_split huggingface dataset:
DESIGNING BABIES: MORALLY PERMISSIBLE WAYS TO MODIFY THE HUMAN GENOME1
Authors: AGAR NICHOLAS 
Published: October 2007

AbstractMy focus in this paper is the question of the moral acceptability of attempts to modify the human genome. Much of the debate in this area has revolved around the distinction between supposedly therapeutic modification on the one hand, and eugenic modification on the other. In the first part of the paper I reject some recent arguments against genetic engineering. In the second part I seek to distinguish between permissible and impermissible forms of intervention in such a way that does not appeal to the therapeutic/eugenic distinction. If I am right much of what we would intuitively call eugenic intervention will be morally acceptable. Central to my argument is an asymmetry in the way genetic engineers can influence a person's capacities on the one hand and life‐goals on the other. Forms of genetic intervention that have a high probability of producing a mismatch of life‐goals and capacities will be ruled out.
BEFORE I WAS AN EMBRYO, I WAS A PRE‐EMBRYO: OR WAS I?
Authors: JONES D. GARETH , TELFER BARBARA 
Published: October 2007

AbstractIssues surrounding human embryos are poignant and profound. Should research be conducted on them? Should they be discarded? Should they be donated to infertile couples? The Warnock Report was a landmark in providing guidelines limiting experimentation on human embryos to the first 14 days after fertilization, at which time implantation of the embryo is complete and the primitive streak has appeared.2 However, these embryological features were not considered sufficiently distinctive to bestow upon this 14‐day period a separate classification. This situation changed when, in 1986, Anne McLaren suggested the use of the terms ‘pre‐embryo’ or ‘conceptus' to designate “the entire product of the fertilized egg up to the end of the implantation stage” and the term ’embryo‘ for “that small part of the pre‐embryo or conceptus, first distinguishable at the primitive streak stage, that later develops into the foetus.”3In this paper we look critically at the term ‘pre‐embryo’, and we shall present the case for an alternative set of terms, namely, embryo‐placenta and embryo‐fetus. We consider this latter to be biologically‐based terminology, that does not have any connotation of restricted moral value as the term pre‐embryo does for some.
COMMUNITY‐EQUIPOISE AND THE ETHICS OF RANDOMIZED CLINICAL TRIALS
Authors: GIFFORD FRED 
Published: October 2007

AbstractThis paper critically examines a particular strategy for resolving the central ethical dilemma associated with randomized clinical trials (RCTs) — the “community equipoise” strategy (CE). The dilemma is that RCTs appear to violate a physician's duty to choose that therapy which there is most reason to believe is in the patient's best interest, randomizing patients even once evidence begins to favor one treatment. The community equipoise strategy involves the suggestion that our judgment that neither treatment is to be preferred (that there obtains a state of “equipoise”) is to be assessed according to a community rather than an individual standard. Thus, though a physician may personally believe that there is some reason to prefer one treatment, patients can legitimately be randomized if there remains disagreement in the community of medical professionals. Rationales in favor of this conception include the following: (i) medical knowledge is best understood as residing in the community, (ii) the judgments of others count as evidence, and so should change one's own opinion, (iii) subjects would not be better off outside the trial, and (iv) the point of any trial is the resolution of dispute in the medical community. I critically examine these rationales and argue that they are insufficient. Amongst the problems are tensions between various of these underlying rationales, and important ambiguities in just what the CE criterion is to amount to. Finally, I argue that even if use of CE was justified, it would not justify carrying out RCTs anywhere near long enough to discharge our duty to gain reliable knowledge on which to base safe and effective medical practice. Hence, we need some different justification for carrying out RCTs.
ETHICS IN A BICULTURAL CONTEXT
Authors: CAMPBELL ALASTAIR V. 
Published: October 2007

AbstractThe distinctiveness of Bioethics in New Zealand stems in part from a renewal of emphasis on Maori rights, based on the Treaty of Waitangi, the foundation document of the New Zealand state. Increasingly, committees dealing with health research ethics and with the ethics of assisted reproductive technology have to incorporate Maori values and perspectives.
MORAL EXPERTISE: A PROBLEM IN THE PROFESSIONAL ETHICS OF PROFESSIONAL ETHICISTS
Authors: CROSTHWAITE JAN 
Published: October 2007

AbstractPhilosophers, particularly moral philosophers, are increasingly being involved in public decision‐making in areas which are seen to raise ethical issues. For example, Dame Mary Warnock chaired the ‘Committee of Inquiry into Human Fertilization and Embryology’ in the UK in 1982–4; the Philosophy Department at Auckland was commissioned by the Auckland Regional Authority to report on the ethical aspects of fluoridating the public water supply in 1990; and many of us are serving on ethics committees of various sorts. Not only are philosophers actually being called on or consulted, but many of us would argue that a philosophical contribution in such areas is essential.The involvement of moral philosophers in public policy decisions raises a question of professional ethics, viz, what role should a philosopher's own moral perspective or judgements play in the advice s/he gives, or contribution s/he makes, to public decision‐making on ethical issues. Like most problems in professional ethics, this prompts reflection on the nature of the profession, and in particular on the expertise we take moral philosophy to offer. It also prompts reflection on how processes of public decision making in ethically problematic areas should be understood. I explore these issues in this paper.
HARD TIMES, HARD CHOICES: FOUNDING BIOETHICS TODAY
Authors: GRACIA DIEGO 
Published: October 2007

AbstractThe discussions of these past twenty years have significantly improved our knowledge about the foundation of bioethics and the meaning of the four bioethical principles with concern to at least three different points: that they are organised hierarchically, and therefore not “prima facie” of the same level; that they have exceptions, and consequently lack of absolute character; and that they are neither strictly deontological nor purely teleological. The only absolute principle of moral life can be the abstract and unconcrete respect of human beings. But when determining the material content of this respect, principles become contingent and relative. Therefore, moral reasoning must have necessarily no less than three moments, one absolute but merely formal, namely respect for all human beings, and the other two relative and material. The first material moment is comprised of the four bioethical principles, divided into two levels, one private, including the principles of autonomy and beneficence, and the other one public, including those of nonmaleficence and justice. The second material moment deals with specific cases, and requires analysis of their context, including their circumstances and consequences. Only when following these steps, and therefore balancing principlism and contextualism, can moral reasoning be correct and complete.
WEIGHTING HEALTH STATES AND STRONG EVALUATION*
Authors: EDGAR ANDREW 
Published: October 2007

AbstractThe problem of public consultation over the allocation of health care resources is addressed by considering the role that quality of life measures, such as QALYs and the Nottingham Health Profile, could play. Such measures are typically grounded in social surveys, and as such may reflect public preferences for health care priorities. Using Charles Taylor's concepts of “weak” and “strong” evaluation, it is suggested that current quality of life measures are inadequate, insofar as they typically presuppose that survey respondents are mere “weak evaluators”, who express only inarticulate preferences. Respondents may, conversely, be understood as strong evaluators, with deeper visions of human nature and the good life informing their health preferences. Space is then created for such respondents to be asked to defend their preferences, and so be encouraged to reflect critically and publicly on the beliefs and prejudices that ground their view of health care priorities.
DEFINING CORE HEALTH SERVICES: THE NEW ZEALAND EXPERIENCE
Authors: CAMPBELL ALASTAIR V. 
Published: October 2007

AbstractThe New Zealand health service has been extensively changed over the past four years, with the introduction of Jour new Regional Health Authorities, required to purchase services on behalf of the Government from a range of providers. In order to ensure fairness across the four regions a Core Services Committee has been set up to define which services must be purchased. However, no clear agreement has emerged about a “core” and no list, either positive (inclusions) or negative (exclusions) has been defined. Instead general criteria have been suggested and steps have been taken to consult the community on their priorities. This paper describes seven workshops run by the author in an effort to discover how the community would reach decisions on the rationing of scare resources. The outcome of these workshops is that there is virtually no community support for an approach based on the social utility of individuals in need.
REPRODUCTIVE TECHNOLOGIES IN DEVELOPING COUNTRIES
Authors: MACKLIN RUTH 
Published: October 2007

AbstractAre there any ethical concerns about reproductive technologies that are specific or unique to developing countries? Three ethical concerns often mentioned specifically in regard to developing countries are (1), the “overpopulation argument”; (2) the limited resources argument; and (3) the ethical problem of poorly trained practitioners offering their services to unsuspecting and uninformed infertile individuals or couples. Each argument is explored in some detail, with the conclusion that ethical problems do, in fact, exist but are not unique to developing countries. Nevertheless, the difficulties relating to reproductive technologies are likely to be greater in developing countries than in developed ones because of limited resources and a larger number of poor people residing there.
ORGAN TRANSPLANTATION: CONTEMPORARY SUNNI MUSLIM LEGAL AND ETHICAL PERSPECTIVES
Authors: EBRAHIM ABUL FADL MOHSIN 
Published: October 2007

AbstractThe problems that organ transplantation poses to the Muslim mind may be summarized as follows: firstly, a muslim believes that whatever he owns or possesses has been given to him as an amānah (trust) from Alla¯h. Would it not be a breach of trust to give consent for the removal of parts of one's body, while still alive, for transplantation to benefit one's child, sibling or parent? Secondly, the Sharā'ah (Islamic Law) emphasizes the sacredness of the human body. Would it not then be an act of aggression against the human body, tantamount to its mutilation, if organs were to be removed after death for the purpose of transplantation?In this paper I attempt to illustrate how the Muslim jurists have tried to resolve the dilemma of Muslims by providing them with certain guidlines based on the original sources of Islam, namely, the Qur'n and the Prophetic tradition. In order to assist the followers of other religious traditions to grasp the gravity of the problem posed by organ transplantation to the Muslim mind, I begin by discussing the opinions of Muslim jurists on the issue of utilization of human parts. Thereafter, I touch upon the resolutions taken by the various Islamic Juridical Academies on the issue in question. Finally, I shed light upon the inclusion of organ donation in a Muslim Will and the enforceable nature of such a will
PRESIDENTIAL ADDRESS: IS THE SANCTITY OF LIFE ETHIC TERMINALLY ILL?
Authors: SINGER PETER 
Published: October 2007

AbstractOur growing technical capacity to keep human beings alive has brought the sanctity of life ethic to the point of collapse. The shift to a concept of brain death was already an implicit abandonment of the traditional ethic, though this has only recently become apparent. The 1993 decision of the British House of Lords in the case of Anthony Bland is an even more decisive shift towards an ethic that does not ask or seek to preserve human life as such, but only a life that is worth living. Once this shift has been completed and assimilated, we will no longer need the concept of brain death. Instead we can face directly the real ethical issue: when may doctors intentionally end the life of a patient?
WHEN DID YOU FIRST BEGIN TO FEEL IT? — LOCATING THE BEGINNING OF HUMAN CONSCIOUSNESS
Authors: BURGESS J. A. , TAWIA S. A. 
Published: October 2007

ABSTRACTIn this paper we attempt to sharpen and to provide an answer to the question of when human beings first become conscious. Since it is relatively uncontentious that a capacity for raw sensation precedes and underpins all more sophisticated mental capacities, our question is tantamount to asking when human beings first have experiences with sensational content. Two interconnected features of our argument are crucial. First, we argue that experiences with sensational content are supervenient on facts about electrical activity in the cerebral cortex which can be ascertained through EEG readings. Second, we isolate from other notions of a‘functioning brain’that which is required to underpin the view that a cortex is functioning in a way which could give rise to rudimentary conscious experiences. We investigate the development in the human fetus of the anatomical and chemical pathways which underpin (immature) cortical activity and the growth and maturation of the electrical circuitry specifically associated with sensational content in adult experience. We conclude (tentatively) that a fetus becomes conscious at about 30 to 35 weeks after conception; an answer based on a careful analysis of EEG readings at various stages of cortical development. Finally, we survey the possible ethical ramifications of our answer.
THE ARGUMENT FROM TRANSFER
Authors: MUNTHE CHRISTIAN 
Published: October 2007

ABSTRACTUtilitarian arguments on bioethical issues regarding human reproduction typically start with the view that it is wrong, other things being equal, not to procreate when this would have resulted in an additional being with a life worth living. The paper takes this view for granted and examines the common utilitarian claim that overpopulation and destitution in the world mean that, in practice, this obligation to procreate, other things being equal, often turn into a (categorical) obligation not to procreate. A version of this argument is defended— a version called the argument from transfer — according to which, rather than having additional children and care for them in order to make them happy, many people in the West ought to abstain from procreation and take care of destitute children already existing. The reasoning leading up to this conclusion raises some philosophical questions, seldom discussed in connection with bioethics, which indicate that the argument from transfer, although supporting the claim above, cannot neutralise the obligation to create mare happy people as easib as assumed by utilitarians. It is argued that the argument from transfer may place many people facing the choice of procreation in a peculiar moral dilemma.
KILLING, LETTING DIE AND THE BARE DIFFERENCE ARGUMENT
Authors: PERRETT ROYW. 
Published: October 2007

ABSTRACTI believe that there is no intrinsic moral difference between killing and letting die. That is, there is no difference that depends solely on the distinction between an act and an omission. I also believe that we can reasonably establish this thesis by appeal to the Bare Difference Argument. The form of this argument involves considering two imaginary cases in which there are no morally relevant differences present, save the bare difference that one is a case of killing and one a case of letting die. But in the pair of cases under consideration this bare difference makes no moral difference. Hence it cannot be that the bare difference between killing and letting die is in itself a morally important difference.Winston Nesbitt has recently argued that the Bare Difference Argument fails because “the examples produced typically possess a feature which makes their use in this context illegitimate, and that when modified to remove this feature, they provide support for the view which they were designed to undermine”. I argue that Nesbitt misunderstands the logic of the Bare Difference Argument and that accordingly his objections are mistaken.
MODIFIED INFORMED CONSENT IN A VIRAL SEROPREVALENCE STUDY IN THE CARIBBEAN
Authors: COX CHERYL , MACPHERSON C.N.L. 
Published: October 2007

ABSTRACTAn unlinked seroprevalence study of HIV and other viruses was conducted on pregnant women on the Caribbean island of Grenada in 1994. Investigators were from both the developed world and the Grenadian Ministry of Health (MOH). There was then no board on Grenada to protect research subjects or review ethical aspects of studies. Nurses from the MOH were asked to verbally inform their patients about the study, md request that patients become subjects of the study and give blood for screening. If consent was given nurses took blood and administered a survey about each subjects’knowledge of HIV transmission routes. Nurses shared a spoken dialect and cultural heritage with prospective subjects and were probably more effective than. foreign researchers at informing subjects. Informed consent was obtained with a simplified consent form supplemented by conversation with each prospective research subject. Facilitating discussion between people with common cultural backgrounds helps apply the Western approach to informed consent to communities in the developing world. Researchers must disclose all information to nurses or other mediators, and ensure that nurses disclose as much information as possible to prospective subjects. So modiJied, informed consent maintains respect for persons and becomes applicable and relevant to various cultures.
PRACTICE GUIDELINES, PATIENT INTERESTS, AND RISKY PROCEDURES
Authors: ROSS ISOBEL A. 
Published: October 2007

ABSTRACTA clinical scenario is described where an anaesthetist is concerned about the seemingly high risk/benefit ratio relating to laparoscopic versus standard inguinal hernia operations. Some options for further action by the anaesthetist are introduced. The remainder of the paper explores the question of who can legitimately assess the acceptability of risk/benefit ratios, and defends the use of practice guidelines at the expense of so called clinical freedom. It is argued that respect for persons is not breached by limiting the treatment options offered to patients to those therapies which have a‘reasonable’risk/benefit ratio. This‘reasonableness’is context dependent, and should be properly decided by those with expertise in the field.
A Response to M. Stone: ‘How not to Measure the Efficiency of Public Services (And How One Might)’
Authors: Cooper W. W. , Ray Subhash C. 
Published: October 2007

SummaryThis is a response to Stone’s criticisms of the Spottiswoode report to the UK Treasury which was responding to the Treasury’s request for improved methods to evaluate the efficiency and productivity of the 43 police districts in England and Wales. The Spottiswoode report recommended uses of data envelopment analysis (DEA) and stochastic frontier analysis (SFA), which Stone critiqued en route to proposing an alternative approach. Here we note some of the most serious errors in his criticism and inaccurate portrayals of DEA and SFA. Most of our attention is devoted to DEA, and to Stone’s recommended alternative approach without much attention to SFA, partly because of his abbreviated discussion of the latter. In our response we attempt to be constructive as well as critical by showing how Stone’s proposed approach can be joined to DEA to expand his proposal beyond limitations in his formulations.
Lichen planus patients and stressful events
Authors: Manolache L , Seceleanu‐Petrescu D , Benea V 
Published: October 2007

AbstractPurpose  To evaluate the possible role of stress before the onset/extension of lichen planus.Patients and method  Forty‐six outpatients with lichen planus were enrolled. The design was a case‐control study (controls had skin diseases with low psychosomatic component). Stressful situations were evaluated using Holmes and Rahe's social readjustment rating scale.Results  Lichen planus had an incidence of 0.36% among dermatological conditions. In the lichen planus group, there was a female predominance (76%) and a median age around 50 years. More than 67% of cases experienced at least one stressful event, compared with 21% of controls (χ2 = 17.58, P < 0.001). The odds ratio was 7.44. There was a borderline significant difference in the mean number of stressful events between lichen planus patients and controls (P = 0.06). We divided the situations described by Holmes and Rahe into three categories: family, personal, and job or financial problems. The presence of major life events was significant different in patients and controls (P = 0.005). Family matters were described by 43.6% of lichen planus patients, statistically significant compared with controls (P = 0.002). In almost 25% of cases of lichen planus, ‘the stressful event’ was represented by the illness or death of someone dear. ‘Personal problems’ seemed to be important compared with controls (P = 0.04), exams representing 25% of these matters. There was no difference between the patients and controls regarding the importance of job or financial changes.Conclusion  Stressful situations, especially related to family, may have a role in the onset and extension of lichen planus lesions.
From Dare I say … ? to I dare say: a case example illustrating the extension of the use of Talking Mats to people with learning disabilities who are able to speak well but unwilling to do so
Authors: Bell Dorothy M. , Cameron Lois 
Published: October 2007

Accessible summary

Sometimes people are worried about saying things to staff even if they are usually  good at talking.
Sometimes they think if they say something then someone might blame them.
It can help to use picture symbols to help you say what you want.
Symbols help you remember what you have said because the pictures are there in  front of you.
This article tells you how these picture symbols in Talking Mats work.
It also tells you how one woman was helped to say what she wanted.

AbstractThis article presents the case of a woman with mild learning disability and with good verbal and expressive language ability. However, she was unable to explore verbally with her clinical psychologist issues concerning her low mood and to discuss strategies to address this. Talking Mats provided a low‐tech communication framework to help the woman think about the issues and express her views. This article explores this approach and the woman’s response and considers the advantages of using Talking Mats in such cases.