Introduction: The Ethical Challenges of Nanotechnologies

Nanotechnologies are expected to have a substantial impact on our lives in the future. However, the nanotechnology field is characterised by many uncertainties and debates surrounding the characterisation of technologies, the nature of the applications, the potential benefits and the likely risks. Given the rapid development of nanotechnologies, it is timely to consider what, if any, novel ethical challenges are posed by developments and how best to address these given the attendant uncertainties. The three articles which comprise this symposium consider the philosophical, regulatory and risk perception and communication questions that arise from this arena.     

Highlights of recent developments and trends in cancer nanotechnology research—View from NCI Alliance for Nanotechnology in Cancer

Although the incidence of cancer and cancer related deaths in the United States has decreased over the past two decades due to improvements in early detection and treatment, cancer still is responsible for a quarter of the deaths in this country. There is much room for improvement on the standard treatments currently available and the National Cancer Institute (NCI) has recognized the potential for nanotechnology and nanomaterials in this area. The NCI Alliance for Nanotechnology in Cancer was formed in 2004 to support multidisciplinary researchers in the application of nanotechnology to cancer diagnosis and treatment. The researchers in the Alliance have been productive in generating innovative solutions to some of the central issues of cancer treatment including how to detect tumors earlier, how to target cancer cells specifically, and how to improve the therapeutic index of existing chemotherapies and radiotherapy treatments. Highly creative ideas are being pursued where novelty in nanomaterial development enables new modalities of detection or therapy. This review highlights some of the innovative materials approaches being pursued by researchers funded by the NCI Alliance. Their discoveries to improve the functionality of nanoparticles for medical applications includes the generation of new platforms, improvements in the manufacturing of nanoparticles and determining the underlying reasons for the movement of nanoparticles in the blood.     

From Ethical Exceptionalism to Ethical Exceptions: The Rule and exception Model and the Changing Meaning of Ethics In German Bioregulation

Germany is an interesting case with respect to the governance of reprogenetics. It has a strong profile in the technosciences and high aims regarding the global bioeconomy, yet her regulation of human genetics, reproductive medicine and embryo research has for a long time been rather restrictive. German biopolitical exceptionalism has often been explained by reference to Catholicism and the legacy of the Nazi past. The Germans, so goes the common story, have learnt the lessons of history and translated them into unconditional respect for human dignity, which in turn translates into unconditional protection of human life, including the human embryo, and the firm repudiation of any eugenic distinction between ‘life worth to live’ and ‘life not worth to live’. This, however, is not the whole story. Alongside deontological strictness we find another strand of governing body politics and reprogenetics in Germany, the rule‐and‐exception model, running from the mid‐1970s abortion law via the 2002 Stem Cell Act to the 2011 regulation of pre‐implantation genetic diagnosis. In contrast to the former, that strongly draws on Kant and his concept of human dignity, the latter bears resemblances to Carl Schmitt's concept of state of exception. The article will show that the rule‐and‐exception model builds the exception into the rule and transforms the meaning and mandate of ethics, namely from safeguarding ethical standards to deciding about the exception. Given that the exception has now tended to become the rule, the question is whether the lessons of history will govern German reprogenetics for much longer.     

Staging Social Structures: Ritual and Social Organisation in an Egalitarian Society. The Pastoral Pokot of Northern Kenya

The pastoral Pokot of northern Kenya represent their society as highly structured by descent and age grading. Descent groups (clans, lineages) and age grades (age sets, generation sets) are depicted as bounded but related units within a complex hierarchical and coherent system, the essence of Pokot society which is staged and visualised in major rituals. This study shows that they are not important in Pokot economic exchange. The formal analysis of livestock exchange networks centred upon individuals shows that emic representations do not match actual exchange behaviour. Complementing the well-established structuralist representation of pastoral social systems, this paper investigates the agency aspect, which has been largely unexplored. It furthermore documents how social exchange is contained in the various institutions of descent and age grading. Contextualising the case historically it is shown that the pastoral Pokot developed from a fragmented clan-based agro-pastoral society in which descent was the main ordering principle for land tenure and conflict management into a more comprehensive social entity with clearly definable borders to the outside, dense internal exchange networks and strong representations of the corporateness of subgroups. The rapid adoption of mobile livestock husbandry was accompanied by the rise of widespread exchange networks and social interaction with a much wider group of unrelated actors marking the foundations of a pastoral society.     

Considerations in Estimating Social and Economic Impacts of Immunotoxic Agents

To make appropriate regulatory policy decisions, the potential social and economic impacts of the policy must first be established. For environmental and occupational agents, social and economic impacts are derived from animal toxicology and, when available, human studies that serve as the base for risk-benefit analysis (RBA). Because immune function is associated with resistance to infectious disease, developing RBA for data derived from immunotoxicology studies will require determining the changes in the frequency or severity of infectious disease resulting from an exposure. Fortunately, considerable information is readily available for identifying the frequency of infectious diseases in the general population and its social and economic impacts and to assist the risk assessor when conducting RBA for immunotoxicology endpoints. The following is a brief review describing some issues in using immunotoxicity data when conducting RBA. It presents an economic methodology to determine the economic impacts of infectious diseases to society, sources where these types of information are available, and an example using a specific infectious disease, otitis media.     

The Environmental Impacts of Reuse: A Review

The fear that human consumption is causing climate change, biodiversity loss, and mineral scarcity has recently prompted interest in reuse because of the intuitive belief that it reduces new production and waste. The environmental impacts of reuse have, however, received little attention—the benefits typically assumed rather than understood—and consequently the overall effects remain unclear. In this article, we structure the current work on the topic, reviewing the potential benefits and pitfalls described in the literature and providing a framework for future research. Many products’ use‐phase energy requirements are decreasing. The relative importance of the embodied impacts from initial production is therefore growing and the prominence of reuse as an abatement strategy is likely to increase in the future. Many examples are found in the literature of beneficial reuse of standardized, unpowered products and components, and repairing an item is always found to be less energy intensive than new production. However, reusing a product does not guarantee an environmental benefit. Attention must be paid to restoring and upgrading old product efficiencies, minimizing overspecification in the new application, and considering whether more efficient, new products exist that would be more suitable. Cheap, reused goods can allow many consumers access to products they would otherwise have been unable to afford. Though socially valuable, these sales, which may help minimize landfill in the short term, can represent additional consumption rather than a net environmental benefit compared to the status quo.     

基于社会网络分析和共词分析的制药技术领域研究

目的:深入研究制药技术领域的发展态势。方法:本研究以Pub Med数据库中收录的制药技术领域研究论文为研究对象,采用社会网络分析、共词分析等定量方法,结合药学专业知识的定性分析,从论文数量年度分布、国家/地区分布及合作网络、研究主题等多个角度开展研究。结果:研究发现:第一,全球制药技术领域共有研究论文95381篇,近几年正处于快速发展阶段;第二,论文发表集中在美国、中国和日本等国家;第三,在定量分析的基础上,结合药学专业知识,共得到15个研究主题,包括点击化学、晶型药物、纳米微球药物等。结论:美国在制药技术领域处于主导地位,中国发文量已经具备一定优势,但发文量和国际影响力与美国相比还是存在较大差距;通过对制药技术领域研究主题的深入分析可以全面把握制药技术领域的研究现状和发展态势。     

The Principle of Caveat Emptor: Confidentiality and Informed Consent as Endemic Ethical Dilemmas in Focus Group Research

Informed consent and confidentiality supposedly minimize harm for research participants in all qualitative research methodologies, inclusive of one-on-one unstructured interviews and focus groups. This is not the case for the latter. Confidentiality and informed consent uniquely manifest themselves as endemic ethical dilemmas for focus group researchers. The principle of caveat emptor (let the buyer beware) may be a more useful tool for those involved in focus group research: that is, let the researcher, the participants and the ethics committee beware that the only ethical assurance that can be given to focus group participants is that there are few ethical assurances. These ethical dilemmas are not sufficiently realized in the literature, and if they are discussed, they are often dealt with within the focus group moderator’s preamble to the group discussion. This paper encourages the mandatory use of a participant information sheet sufficiently detailed to engender the participant’s active consent. Sufficient here means the participant must be made adequately aware of these endemic ethical dilemmas in advance, to allow them to consent to share responsibility for any ensuing harm. The focus group moderator is not their sole protector.     

Avoiding the Trust Deficit: Public Engagement, Values, the Precautionary Principle and the Future of Nanotechnology

Debates about the regulatory requirements surrounding the introduction of nanotechnology products have, at least in Australia, remained largely within disciplinary boundaries and industry and academic circles. This paper argues for a more interdisciplinary and inclusive upstream debate about the introduction of ethical, regulatory and legal frameworks that may avoid the loss of public trust that has characterised the introduction of many new technologies in the past. Insights from risk-perception theory and research are used to introduce the notion of risk as narrative as a framework for action. This paper suggests three main strategies for moving forward; drawing insights from the “trust gap” experiences of other new technologies; the application of the active form of the precautionary principle; and, the creation of nano-futures that meet both community and industry values through effective public engagement.     

Commercial Genetic Testing in Mainland China: Social, Financial and Ethical Issues

This paper provides an empirical account of commercial genetic predisposition testing in mainland China, based on interviews with company mangers, regulators and clients, and literature research during fieldwork in mainland China from July to September 2006. This research demonstrates that the commercialization of genetic testing and the lack of adequate regulation have created an environment in which dubious advertising practices and misleading and unprofessional medical advice are commonplace. The consequences of these ethically problematic activities for the users of predictive tests are, as yet, unknown. The paper concludes with a bioethical and social science perspective on the social and ethical issues raised by the dissemination and utilization of genetic testing in mainland China.     

我国活体器官移植伦理学问题再思考

器官移植为器官衰竭的患者带来了福音,同时也带来诸多伦理学问题,值得深思。本文从当前器官移植研究的现状及进展情况入手,对器官移植的医学、法学以及伦理学问题进行剖析与研究,同时在此基础上提出相应的建议。     

Nanotechnology and tumor imaging: seizing an opportunity

Nanoparticles, labeled with a signaling moiety for in vivo imaging, and one or more ligands for molecularly targeted specificity, hold considerable promise in oncology. Nanoparticles can serve as modular platforms, from which a wide variety of highly sensitive and specific imaging agents can be created. For example, many hundreds or thousands of atoms that provide imaging signals, such as radioisotopes, lanthanides, or fluorophores, can be attached to each nanoparticle, to form imaging agents that would provide higher sensitivity that can be obtained from agents based on small molecules. Similarly, many copies of targeted ligands can be attached to nanoparticles to markedly increase specific binding. Drugs or therapeutic isotopes can be added to create multifunctional nanoparticles. Appropriately labeled and targeted nanoparticles could lead to a paradigm change in which cancer detection, diagnosis, and therapy are combined in a single molecular complex.     

The Mushroom Crowd: Social and Political Aspects of Population Pressure

The meaning of population pressure is discussed and, with the help of a formula, its five main components (people, rate of increase of people, food-producing acreage, protein nutrition and industrialization) are analyzed.Factors which have eased population pressure in the past are considered under the headings of political violence (war and genocide), natural disaster (famine and disease), and social action (increased local protein supply, emigration, industrialization and birth control).Birth control is the first prerequisite to an easing of population pressure; the effectiveness of the Japanese and the Indian programs is discussed.The crippling burden of preventable disease, shown to be a major obstacle to the development of sophisticated industries, presents a challenge to Western medical men who so far have done little to meet it.     

Pharmacogenomics: Social, Ethical, and Clinical Dimensions

Books reviewed:
Pharmacogenomics: Social, Ethical, and Clinical Dimensions , edited by M.A. Rothstein. Hoboken, NJ: Wiley-Liss, A John Wiley & Sons, Inc. 368 pp. US$ 64.95 (hardback)     

Impacts of feral horses and deer on an endangered woodland of Kosciuszko National Park

In recent years, the impacts of rapidly increasing populations of feral horses and deer on the vegetation and stability of soils have become highly visible and widespread in Kosciuszko National Park. We investigated these impacts in the White Cypress Pine (Callitris glaucophylla Joy Thomps. & L.A.S. Johnson) – White Box (Eucalyptus albens Benth) woodlands of the lower Snowy River valley. This woodland is a component of the White Box‐Yellow Box‐Blakely's Red Gum Grassy Woodland and Derived Native Grasslands complex that is nationally listed as a critically endangered ecological community. To investigate the severity of the impacts of feral horse (Equus caballus) and deer (Dama dama and Rusa unicolor) in the valley in 2013 and 2017/18, we surveyed fenced exclosures and paired grazed plots that were first established and surveyed in 1984 and re‐surveyed in 1987. Using LFA and VAST methodologies (not used in 1987), we compared the relative response of environmental variables in plots inside and outside the exclosures in an attempt to ascertain recent herbivore impacts. While there was no evidence of horses or deer from dung surveys in 1987, in 2018, 84% of the dung was from horses, 13% from deer, 1% from rabbits and 2% from macropods. Total herbivore dung density increased fourfold since the 1987 survey. On the understanding that all plots had the same starting condition in 1984 with respect to prior herbivory, we deduce that horses and deer are having significant ecological impacts. There was a far greater cover of understorey plants and the midstorey was denser and taller inside the exclosures. Outside the exclosures, the vegetation cover was far more sparse and soil erosion was active and extensive. The total number of invertebrates captured in small pitfall traps was nearly twice as many within the exclosures compared to the grazed plots. The dense even‐aged regrowth overstorey stands of White Cypress Pine, inside and outside the exclosures, have changed little in 34 years.     

Social discounting: The effect of outcome uncertainty

The purpose of the study was to determine the lowest hypothetical amount a participant would keep for himself/herself, preferring it over a reward that he/she would have shared with another individual representing various levels of past reciprocation. Other manipulated aspects were: emotional closeness of the receiver (close vs. distant person), procedure for deciding on how to share the reward (mutual decision vs. decision made by partner) and amount of reward to be shared (PLN 494 vs. PLN 49,400). It was found that preference for the reward to be shared increased as a function of reciprocity, and that it is higher when sharing with an emotionally close person, when the decision does not depend entirely on the partner, and when sharing a small reward. The effect of the level of reciprocity was the smallest when the reward was shared with an emotionally close person and the decision was mutual.     

社会认知神经科学的取向与研究进展

社会认知神经科学是社会心理学和认知神经科学相结合的新兴多学科研究领域,其强调在社会、认知与脑神经等三个层面的交互作用上去理解心理现象。前几年主要是对刻板印象、态度与态度改变、他人知觉、自我认知以及情绪与认知交互作用等方面进行了深入研究,其主要范式是应用认知神经科学的方法来验证社会心理学在这些范围内上的各种不同的理论观点,当前的研究主要集中在知觉和再认的社会标记、社会判断和归因、评价调节知觉和经验以及社会交互作用等传统的社会心理学方面,并取得了突破性进展。展望未来的研究,其将在系统准则研究发展的基础上,把当今的社会认知研究与认知神经科学在理论和方法论上整合起来,为揭示人类高级社会心理现象的神经基础,开辟一条崭新的研究道路。     

Equity, Utility, and the Marketplace: Emerging Ethical Issues of Umbilical Cord Blood Banking in Australia

Over the past decade, umbilical cord blood (UCB) has routinely been used as a source of haematopoietic stem cells for allogeneic stem cell transplants in the treatment of a range of malignant and non-malignant conditions affecting children and adults. UCB banks are a necessary part of the UCB transplant program, but their establishment has raised a number of important scientific, ethical and political issues. This paper examines the scientific and clinical evidence that has provided the basis for the establishment of UCB banks. We also discuss the major ethical issues that UCB banks raise, including ownership of cord blood, processes for obtaining consent for its collection and storage, and confidentiality. Finally, we review other concerns about commercial non-altruistic banking, including concerns about social justice, equity of access and equity of care.     

Focus: Bioethics: The Ethical Relevance of “Alternatives” in Health Care Priority Setting – The Case of Preexposure Prophylaxis (PrEP) of HIV

Preexposure prophylaxis for HIV is a drug that reduces the risk for an HIV-negative person to acquire HIV if taken prior to sex. It has been suggested that it is important for resource allocation decisions that there are alternatives (such as abstinence, masturbation, etc.) for individuals potentially benefitted by this prophylaxis. In this paper we explore this idea from an ethical perspective in relation to three notions often discussed in priority setting ethics, namely responsibility, outcomes, and severity of disease. While the relevance of alternatives may be explained in terms by responsibility-sensitive priority setting, such a view comes with several challenges. We then discuss two other ways in which this intuition could be better explained: (a) in terms of total outcome of health, and (b) in terms of severity of the condition.     

Stimulating personality: Ethical criteria for deep brain stimulation in psychiatric patients and for enhancement purposes

Within the recent development of brain-machine-interfaces deep brain stimulation (DBS) has become one of the most promising approaches for neuromodulation. After its introduction more than 20 years ago, it has in clinical routine become a successful tool for treating neurological disorders like Parkinson's disease, essential tremor and dystonia. Recent evidence also demonstrates efficacy in improving emotional and cognitive processing in obsessive-compulsive disorder and major depression, thus allowing new treatment options for treatment refractory psychiatric diseases, and even indicating future potential to enhance functioning in healthy subjects. We demonstrate here that DBS is neither intrinsically unethical for psychiatric indications nor for enhancement purposes. To gain normative orientation, the concept of “personality” is not useful – even if a naturalistic notion is employed. As an alternative, the common and widely accepted bioethical criteria of beneficence, non-maleficence, and autonomy allow a clinically applicable, highly differentiated context- and case-sensitive approach. Based on these criteria, an ethical analysis of empirical evidence from both DBS in movement disorders and DBS in psychiatric disease reveals that wide-spread use of DBS for psychiatric indications is currently not legitimated and that the basis for enhancement purposes is even more questionable. Nevertheless, both applications might serve as ethically legitimate, promising purposes in the future.