The determination of the best interests in relation to childhood immunisation

There are many different ethical arguments that might be advanced for and against childhood vaccinations. In this paper I explore one particular argument that focuses on the idea that such vaccinations are justifiable because they are held to be in the best interests of a particular child. Two issues arise from this idea. The first issue is how best interests are to be determined in this case. The second issue is what follows from this to justify potential interventions within the family in relation to such vaccinations. I argue that best interests must be characterised objectively in such situations and that this means that, in at least some cases, parental decision-making about vaccinating their children may be overridden.     

The determination of 'best interests' in relation to childhood vaccinations

There are many different ethical arguments that might be advanced for and against childhood vaccinations. In this paper I will explore one particular argument that focuses on the idea that childhood vaccinations are justifiable because they are held to be in the best interests of a particular child. Two issues arise from this idea. The first issue is how best interests are to be determined in the case of childhood vaccinations. The second issue is what follows from this to justify potential interventions within the family in relation to such vaccinations. I argue that best interests must be characterised objectively in such situations and that this means that, in at least some cases, parental decision-making about vaccinating their children may be overridden.     

Impact of DNA chips on haematological oncology

As the Human Genome Project hurtles towards completion, DNA microarray technology offers the potential to open wide new windows into the study of genome complexity. DNA chips can be used for many different purposes, most prominently to measure levels of gene expression (messenger RNA abundance) for tens of thousands of genes simultaneously. But how much of this data is useful and is some superfluous? Can array data be used to identify a handful of critical genes that will lead to a more detailed taxonomy of haematological malignancies and can this or similar array data be used to predict clinical outcome? It is still too early to predict what the ultimate impact of DNA chips will be on our understanding of cancer biology. There are many critically important questions about this new field that are yet unaddressed. By the publication of this article, it is hoped that the technology of DNA chips will be opened up and demystified, and that additional opportunities for creative exploration will be catalysed.     

Control of Vector-Borne Disease by Genetic Manipulation of Insect Populations: Technological Requirements and Research Priorities

The possibility of controlling vector-borne disease through the development and release of transgenic insect vectors has recently gained popular support and is being actively pursued by a number of research laboratories around the world. Several technical problems must be solved before such a strategy could be implemented: genes encoding refractory traits (traits that render the insect unable to transmit the pathogen) must be identified, a transformation system for important vector species has to be developed, and a strategy to spread the refractory trait into natural vector populations must be designed. Recent advances in this field of research make it seem likely that this technology will be available in the near future.
In this paper we review recent progress in this area as well as argue that care should be taken in selecting the most appropriate disease system with which to first attempt this form of intervention. Much attention is currently being given to the application of this technology to the control of malaria, transmitted by Anopheles gambiae in Africa. While malaria is undoubtedly the most important vector-borne disease in the world and its control should remain an important goal, we maintain that the complex epidemiology of malaria together with the intense transmission rates in Africa may make it unsuitable for the first application of this technology. Diseases such as African trypanosomiasis, transmitted by the tsetse fly, or unstable malaria in India may provide more appropriate initial targets to evaluate the potential of this form of intervention.     

Recovery of ornithine decarboxylase activity after inhibition with alpha-difluoromethylornithine.

alpha-Difluoromethylornithine is an effective inhibitor of polyamine biosynthesis because of its specificity for ornithine decarboxylase and the fact that its attachment to this enzyme is considered to be irreversible. We have found, however, that ornithine decarboxylase inactivated with this inhibitor in intact cells, as well as purified enzyme inactivated in vitro, both are capable of releasing this inhibitor and recovering enzyme activity. This reactivation can be initiated by freezing of inactivated enzyme samples in the presence of reducing agents at -7 or -20 degrees C and can be partially induced at 37 degrees C. These results reveal an unexpected lability of this enzyme-inhibitor complex that needs to be considered in future experimental designs.     

Possible mechanisms of anosognosia: a defect in self-awareness.

Anosognosia of hemiplegia is of interest for both pragmatic and theoretical reasons. We discuss several neuropsychological theories that have been proposed to explain this deficit. Although for psychological reasons people might deny deficits, the denial hypothesis cannot account for the hemispheric asymmetries associated with this disorder and cannot explain why some patients might deny one deficit and recognize another equally disabling deficit. There is some evidence that faulty feedback from sensory deficits, spatial neglect and asomatognosia might be responsible for anosognosia in some patients. However, these feedback hypotheses cannot account for anosognosia in all patients. Although the hemispheric disconnection hypothesis is appealing, disconnection is probably only a rare cause of this disorder. The feedforward intentional theory of anosognosia suggests that the discovery of weakness is dependent on attempted action and some patients might have anosognosia because they do not attempt to move. We present evidence that supports this theory. The presence of one mechanism of anosognosia, however, does not preclude the possibility that other mechanisms might also be working to produce this disorder. Although a large population study needs to be performed, we suspect that anosognosia might be caused by several of the mechanisms that we have discussed. On the basis of the studies of impaired corporeal self-awareness that we have reviewed, we can infer that normal self-awareness is dependent on several parallel processes. One must have sensory feedback and the ability to attend to both one''s body and the space where parts of the body may be positioned or acting. One must develop a representation of the body, and this representation must be continuously modified by expectations (feedforward) and knowledge of results (feedback).     

Mathematical models, explanation, laws, and evolutionary biology

It is commonly agreed in the literature on laws of nature that there are at least two necessary conditions for lawhood--that a law must have empirical content and that it must be universal. The main reason offered for the requirement that laws be empirical is as follows: a priori statements are consistent with any imaginable set of observations, so they cannot be informative about the world and therefore they cannot provide explanations. However, we care about laws because we think that laws provide explanations and allow us to make predictions. Thus, if one of the functions of laws is to provide explanations and a priori propositions cannot fulfill this function, they cannot properly be viewed as laws. In this paper, I will aim to show that this argument for the claim that laws must be empirical does not work.     

Psittacosis in Hamilton: A case report and epidemiological study

A case report of a patient severely ill with psittacosis is presented, together with an epidemiological study of his fellow workers. This study illustrates the contagiousness of the disease and indicates that it is probably more prevalent than clinical experience suggests. Only three of the 83 persons studied who were exposed became ill enough to seek medical attention. It is important that both the physician and the public be made aware of this disease so that definitive treatment can be instituted as early as possible. Tetracycline is the drug of choice. Since this infection is widespread among many varieties of birds, and is not confined to those of the parrot family, this disease must be considered in any patient with an atypical pneumonia, especially when there has been contact with a bird. Since there is not likely to be a reinstitution of the ban on the importation of psittacine birds as domestic pets, the only alternative means of controlling outbreaks of this disease is public and physician awareness. Since some outbreaks appear to be spread from man to man, sometimes with high mortality, it is important that any patient suspected of having this disease be kept in strict isolation.     

Is the Naturalistic Fallacy Dead (and If So,Ought It Be?)

Much of modern moral philosophy argued that there are is's in this world, and there are oughts, but that the two are entirely independent of one another. What this meant was that morality had nothing to do with man's biological nature, and could not be derived from it. Any such attempt was considered to be a categorical mistake, and plain foolish. Most philosophers still believe this, but a growing group of neo-naturalist thinkers are now challenging their assumptions. Here I consider the latest work of one of them, Patricia Churchland, on what neurobiology teaches us about morality, and ask whether her challenge means that the naturalistic fallacy, as it is known, should be laid to rest. I argue that while there may be no such thing as a human trait divorced from human biology, this does not necessarily mean that our natures produce constraints that are relevant to specific moral dilemmas.     

Compulsory moral bioenhancement should be covert

Some theorists argue that moral bioenhancement ought to be compulsory. I take this argument one step further, arguing that if moral bioenhancement ought to be compulsory, then its administration ought to be covert rather than overt. This is to say that it is morally preferable for compulsory moral bioenhancement to be administered without the recipients knowing that they are receiving the enhancement. My argument for this is that if moral bioenhancement ought to be compulsory, then its administration is a matter of public health, and for this reason should be governed by public health ethics. I argue that the covert administration of a compulsory moral bioenhancement program better conforms to public health ethics than does an overt compulsory program. In particular, a covert compulsory program promotes values such as liberty, utility, equality, and autonomy better than an overt program does. Thus, a covert compulsory moral bioenhancement program is morally preferable to an overt moral bioenhancement program.     

Connecting ORC and heterochromatin: why?

Considerable evidence connects heterochromatin or silenced chromatin with the Origin Recognition Complex (ORC) which is needed for initiation of DNA replication. In this review we consider biological forces that might be served by this connection. The prevailing view in the literature is that ORC recruits heterochromatin. This seems paradoxical because a replication initiator, ORC, would be recruiting factors which seem to oppose replication by forming inaccessible chromatin structures. Here we suggest a different view, that heterochromatin recruits ORC to facilitate replication of hard-to-replicate heterochromatic regions. We consider how existing data can be reconciled with this viewpoint, and we consider the biological predictions that arise from this perspective     

Continuous deep sedation at the end of life and the 'natural death' hypothesis

Surveys in different countries (e.g. the UK, Belgium and The Netherlands) show a marked recent increase in the incidence of continuous deep sedation at the end of life (CDS). Several hypotheses can be formulated to explain the increasing performance of this practice. In this paper we focus on what we call the 'natural death' hypothesis, i.e. the hypothesis that acceptance of CDS has spread rapidly because death after CDS can be perceived as a 'natural' death by medical practitioners, patients' relatives and patients. We attempt to show that the label 'natural' cannot be unproblematically applied to the nature of this end-of-life practice. We argue that the labeling of death following CDS as 'natural' death is related to a complex set of mechanisms which facilitate the use of this practice. However, our criticism does not preclude the view that CDS may be clinically and ethically justified in many cases.     

Specific PCR primers directed to identify cryI and cryIII genes within a Bacillus thuringiensis strain collection.

In this paper we describe a PCR strategy that can be used to rapidly identify Bacillus thuringiensis strains that harbor any of the known cryI or cryIII genes. Four general PCR primers which amplify DNA fragments from the known cryI or cryIII genes were selected from conserved regions. Once a strain was identified as an organism that contains a particular type of cry gene, it could be easily characterized by performing additional PCR with specific cryI and cryIII primers selected from variable regions. The method described in this paper can be used to identify the 10 different cryI genes and the five different cryIII genes. One feature of this screening method is that each cry gene is expected to produce a PCR product having a precise molecular weight. The genes which produce PCR products having different sizes probably represent strains that harbor a potentially novel cry gene. Finally, we present evidence that novel crystal genes can be identified by the method described in this paper.     

Safety, identity and consent: a limited defense of reproductive human cloning

Some opponents of reproductive human cloning have argued that, because of its experimental nature, any attempt to create a child by way of cloning would risk serious birth defects or genetic abnormalities and would therefore be immoral. Some versions of this argument appeal to the consent of the person to be conceived in this way. In particular, they assume that if an experimental reproductive technology has not yet been shown to be safe, then, before we use it, we are morally obligated to get either the actual consent or the presumed consent of the person to be conceived. In this article, I attempt to explain the appeal of such consent-based arguments as deriving from a mistaken view of personal identity. I then argue that since this view is false, such arguments are unsound. Finally, I argue that even if reproductive cloning is unsafe, it may still be morally permissible in some circumstances.     

Quantitation of autophagy by luciferase release assay

Autophagy is a cellular process that has been defined and analyzed almost entirely by qualitative measures. In no small part, this is attributable to the absence of robust quantitative assays that can easily and reliably permit the progress of key steps in autophagy to be assessed. We have recently developed a cell-based assay that specifically measures proteolytic cleavage of a tripartite sensor protein by the autophagy protease ATG4B. Activation of ATG4B results in release of Gaussia luciferase from cells that can be non-invasively harvested from cellular supernatants. Here, we compare this technique to existing methods and propose that this type of assay will be suitable for genome-wide functional screens and in vivo analysis of autophagy.     

Activation of stress-responsive promoters by ionizing radiation for deployment in targeted gene therapy

Radiotherapy is one of the principal modalities of cancer treatment, but the delivery of a curative dose of ionizing radiation (IR) to the tumour is frequently limited by the need to protect the normal tissues within the irradiated area from radiation damage. This problem could be circumvented if tumour cells could be selectively sensitized to killing by IR. One way to achieve this goal would be to transduce the tumour cells with expression vectors carrying toxin genes under the control of promoters that are inactive unless induced by IR. For this approach to be successful, two parameters must be met: (i) the expression vector has to be delivered to the tumour or its immediate vicinity (e.g. its vasculature) and (ii) the promoter driving the expression of the toxin gene has to have negligible basal activity, yet has to be activated by clinically-achievable doses of IR. Several vectors that fulfil these criteria are currently reaching clinical trials. In this review, we examine the response of mammalian cells to IR, and the current status of radiation-induced suicide gene therapy that is dependent on this response.     

Adaptation and speciation: what can F(st) tell us?

A useful way of summarizing genetic variability among different populations is through estimates of the inbreeding coefficient, F(st). Several recent studies have tried to use the distribution of estimates of F(st) from individual genetic loci to detect the effects of natural selection. However, the promise of this approach has yet to be fully realized owing to the pervasive dogma that this distribution is highly dependent on demographic history. Here, I review recent theoretical results that indicate that the distribution of estimates of F(st) is generally expected to be robust to the vagaries of demographic history. I suggest that analyses based on it provide a useful first step for identifying candidate genes that might be under selection, and explore the ways in which this information can be used in ecological and evolutionary studies.     

COMPETENCE,PRACTICAL RATIONALITY AND WHAT A PATIENT VALUES

According to the principle of patient autonomy, patients have the right to be self‐determining in decisions about their own medical care, which includes the right to refuse treatment. However, a treatment refusal may legitimately be overridden in cases where the decision is judged to be incompetent. It has recently been proposed that in assessments of competence, attention should be paid to the evaluative judgments that guide patients' treatment decisions. In this paper I examine this claim in light of theories of practical rationality, focusing on the difficult case of an anorexic person who is judged to be competent and refuses treatment, thereby putting themselves at risk of serious harm. I argue that the standard criteria for competence assess whether a treatment decision satisfies the goals of practical decision‐making, and that this same criterion can be applied to a patient's decision‐guiding commitments. As a consequence I propose that a particular understanding of practical rationality offers a theoretical framework for justifying involuntary treatment in the anorexia case.     

Multiple features contribute to efficient constitutive splicing of an unusually large exon

Vertebrate internal exons are usually between 50 and 400 nt long; exons outside this size range may require additional exonic and/or intronic sequences to be spliced into the mature mRNA. The mouse polymeric immunoglobulin receptor gene has a 654 nt exon that is efficiently spliced into the mRNA. We have examined this exon to identify features that contribute to its efficient splicing despite its large size; a large constitutive exon has not been studied previously. We found that a strong 5′ splice site is necessary for this exon to be spliced intact, but the splice sites alone were not sufficient to efficiently splice a large exon. At least two exonic sequences and one evolutionarily conserved intronic sequence also contribute to recognition of this exon. However, these elements have redundant activities as they could only be detected in conjunction with other mutations that reduced splicing efficiency. Several mutations activated cryptic 5′ splice sites that created smaller exons. Thus, the balance between use of these potential sites and the authentic 5′ splice site must be modulated by sequences that repress or enhance use of these sites, respectively. Also, sequences that enhance cryptic splice site use must be absent from this large exon.