CULTURAL CIRCUMCISION IN EU PUBLIC HOSPITALS – AN ETHICAL DISCUSSION

The paper explores the ethical aspects of introducing cultural circumcision of children into the EU public health system.
We reject commonplace arguments against circumcision: considerations of good medical practice, justice, bodily integrity, autonomy and the analogy from female genital mutilation.
From the unique structure of patient-medicine interaction, we argue that the incorporation of cultural circumcision into EU public health services is a kind of medicalization, which does not fit the ethos of universal healthcare. However, we support a utilitarian argument that finds hospital-based circumcision safer than non-medicalized alternatives.
The argument concerning medicalization and the utilitarian argument both rely on preliminary empirical data, which depend on future validation.     

The fin whale Balaenoptera physalus (L. 1758) in the Mediterranean Sea

1. The ecology and status of fin whales Balaenoptera physalus in the Mediterranean Sea is reviewed. The species’ presence, morphology, distribution, movements, population structure, ecology and behaviour in this semi‐enclosed marine region are summarized, and the review is complemented with original, previously unpublished data. 2. Although the total size of the fin whale population in the Mediterranean is unknown, an estimate for a portion of the western basin, where most of the whales are known to live, was approximately 3500 individuals. High whale densities, comparable to those found in rich oceanic habitats, were found in well‐defined areas of high productivity. Most whales concentrate in the Ligurian‐Corsican‐Provençal Basin, where their presence is particularly noticeable during summer; however, neither their movement patterns throughout the region nor their seasonal cycle are clear. 3. Based on genetic studies, fin whales from the Mediterranean Sea are distinct from North Atlantic conspecifics, and may constitute a resident population, separate from those of the North Atlantic, despite the species’ historical presence in the Strait of Gibraltar. Fin whales are known to calve in the Mediterranean, with births peaking in November but occurring at lower rates throughout the year. They feed primarily on krill Meganyctiphanes norvegica which they capture by diving to depths in excess of 470 m. It is suggested that the extensive vertical migratory behaviour of its main prey may have influenced the social ecology of this population. 4. Known causes of mortality and threats, including collisions with vessels, entanglement in fishing gear, deliberate killing, disturbance, pollution and disease, are listed and discussed in view of the implementation of appropriate conservation measures to ensure the species’ survival in the region.     

Variation in the assessment of adequacy in cervical smears

OBJECTIVE: To assess the interobserver reproducibility of the diagnosis of 'adequacy' of cervical smears according to the Bethesda System criteria in cervical smears. STUDY DESIGN: 358 cervical smears were obtained from three Italian cytopathological centres in 1998-99. All centres provided consecutively collected smears. The cervical smears were independently and blindly assessed by four cytologists.The screening was performed using a 10x objective and an additional evaluation of the percentage of cellularity was performed using a 4x objective. RESULTS: The proportion of smears assessed by the four cytologists as 'adequate' ranged from 60% to 70%, the proportion of 'satisfactory for evaluation but limited by' ranged from 27% to 38%, and the proportion of 'inadequate smears' ranged from 2% to 4%. Full agreement in the assessment of smear adequacy was observed in 311 slides and disagreement was observed only in 47. The category 'inadequate smear' was less reliable than the other two; however, the kappa value observed was acceptable. CONCLUSION: The present study shows that it is possible to achieve a high reproducibility in the assessment of smear adequacy, at least among expert cytologists who follow the Bethesda System criteria strictly.     

Are protochordates chordates?

This paper challenges the widely accepted view that protochordates (lancelets and tunicates) should be included together with vertebrates within the monophyletic assemblage of the chordates since they share a few distinguishing characters, such as a dorsally located notochord and central nervous system (CNS). The homology of these axial structures is not supported convincingly by morphology and molecular biology. Besides, for notochord and CNS to be dorsal, the embryos of protochordates, unlike those of vertebrates, should be orientated with the blastopore coincident with the dorsal side. This embryonic orientation is never reported in other bilaterians and is inconsistent with the genetic control of the body axes. Alternatively, protochordates could be orientated just as the vertebrates according to the regulation of axial patterning. In this case, the notochord and CNS appear to be located on the ventral side. As suggested by molecular and structural data, they may correspond to the stomodaeal/ventral midline cells and CNS of gastroneuralians. This conclusion may have far-reaching implications concerning the origin of the vertebrates and the evolution of nervous systems and neural crest/placodes.  © 2006 The Linnean Society of London, Biological Journal of the Linnean Society , 2006, 87 , 261–284.     

Application of the unified species concept reveals distinct lineages for disjunct endemics of the Brassica repanda (Brassicaceae) complex

Species delimitation is an important issue in terms of conservation priorities, especially for narrow endemics under threat of extinction. The Alpine endemics Brassica repanda subsp. glabrescens and subsp. baldensis belong to a highly polymorphic species complex, although their disjunct distribution suggests favourable conditions for independent evolution. In the present study, we applied the unified species concept to test whether the endemics form distinct evolutionary lineages, both from one another and also from the remainder of the complex. Compliance with the criteria of monophyly, diagnosability, and genotypic clustering was examined, primarily by making use of amplified fragment length polymorphism data. Both endemics were indicated as monophyletic by phylogenetic analyses, and diagnostic characters were found for both taxa. Population structure analyses showed clear genetic discontinuity for each of the endemics, with little admixture among the clusters. This evidence indicates that the endemics have acquired multiple properties that satisfy each of the species criteria considered. Hence, we suggest the taxonomic recognition of B. baldensis and B. glabrescens as separate species. Comparative population genetics analyses show the lack of marked genetic structuring within either taxon, as well as low levels of heterozygosity. Conclusions on the status of threat and on recommended conservation actions are drawn. © 2012 The Linnean Society of London, Biological Journal of the Linnean Society, 2012, 106 , 482–497.     

TRIANGULAR REFLECTIVE EQUILIBRIUM: A CONSCIENCE‐BASED METHOD FOR BIOETHICAL DELIBERATION

Following a discussion of some historical roots of conscience, we offer a systematized version of reflective equilibrium. Aiming at a comprehensive methodology for bioethical deliberation, we develop an expanded variant of reflective equilibrium, which we call ‘triangular reflective equilibrium’ and which incorporates insights from hermeneutics, critical theory and narrative ethics. We focus on a few distinctions, mainly between methods of justification in ethics and the social practice of bioethical deliberation, between coherence in ethical reasoning, personal integrity and consensus formation, and between political and moral deliberation. The ideal of deliberation is explicated as a sharing of conscience within a special commitment to sincerity and openness to persuasion. Personal growth in wisdom is an indirect by‐product of the continuous practice of moral deliberation. This is explicated in the light of Sternberg's balance theory of wisdom and in the context of medicine as a profession embodying altruistic responsibilities of care in democratic and pluralistic societies.