Genetic therapy, identity and the person-regarding reasons

It has been argued that there can be no person-regarding reasons for practising genetic therapy, since it affects identity and causes to exist an individual who would not otherwise have existed. And there can be no such reasons for causing somebody to exist because existing cannot be better for an individual than never existing. In the present paper, both of these claims are denied. It is contended, first, that in practically all significant cases genetic therapy will not affect the identity of beings of our kind. This is so irrespective of whether, essentially, we are beings with minds or beings of a certain biological species, the human one. Second, it is contended that, even if genetic therapy were to affect our identity, there could be person-regarding reasons for conducting it, for existence can be better than non-existence for the individual.     

Genetic therapy, person-regarding reasons and the determination of identity

It has been argued for example by Ingmar Persson, that genetic therapy performed on a conceptus does not alter the identity of the person that develops from it, even if we are essentially persons. If this claim is true then there can be person-regarding reasons for performing genetic therapy on a conceptus. Here it is argued that such person-regarding reasons obtain only if we are not essentially persons but essentially animals. This conclusion requires the defeat of the origination theory, which says that personal identity is determined by the identity of the foetus from which one originates. It is argued that the origination theory is false in the special case relevant to performing genetic therapy on a conceptus for person-regarding reasons.     

The concept of precedent autonomy

Does respect for autonomy imply respect for precedent autonomy? The principle of respect for autonomy requires us to respect a competent patient’s treatment preference, but not everyone agrees that it requires us to respect preferences formed earlier by a now‐incapacitated patient, such as those expressed in an advance directive. The concept of precedent autonomy, which concerns just such preferences, is problematic because it is not clear that we can still attribute to a now‐incapacitated patient a preference which that patient never disaffirmed but can no longer understand. If we cannot make that attribution, then perhaps we should not respect precedent autonomy – after all, how can you respect patient autonomy by giving patients what they no longer want, even if they never disaffirmed those wants? I argue that whether an earlier preference can still be attributed to a now‐incapacitated patient depends on the reasons behind the preference, for a preference includes (and is not merely supported by) the reasons behind it. When the considerations that served as reasons no longer exist, neither does the preference which included those reasons. In particular, if the considerations that served as reasons for the patient exist only under conditions where the patient retains full mental capacity, then once that capacity is lost, so are those reasons and the preference based upon them. I use this analysis of precedent autonomy to ascertain the merits of various approaches to advance medical decisionmaking, including Nancy Rhoden’s approach, approaches based on a Parfitian personal identity analysis, approaches based on soft paternalism, and approaches based on the stability and longevity of preferences. Despite the apparent absurdity of respecting patient autonomy by giving patients what they no longer prefer but have never disaffirmed, I conclude with some programmatic remarks on when and why respect for (precedent) autonomy nonetheless requires us to respect former preferences.     

EXISTENCE: WHO NEEDS IT? THE NON‐IDENTITY PROBLEM AND MERELY POSSIBLE PEOPLE

In formulating procreative principles, it makes sense to begin by thinking about whose interests ought to matter to us. Obviously, we care about those who exist. Less obviously, but still uncontroversially, we care about those who will exist. Ought we to care about those who might possibly, but will not actually, exist? Recently, unusual positions have been taken regarding merely possible people and the non‐identity problem. David Velleman argues that what might have happened to you – an existent person – often doesn't merit moral consideration since the alternative person one would have been had what might have happened actually happened is a merely possible person about whom one has no reason to care. He argues that his way of thinking can eliminate the non‐identity problem. Caspar Hare argues that merely possible people have interests and are morally relevant. He argues that we can solve the non‐identity problem by rejecting the view that merely possible people are morally irrelevant. Both Hare and Velleman argue that focusing on one's de dicto rather than on one's de re children can help us avoid the non‐identity problem. I analyze the role that merely possible, nonexistent hypothetical entities ought to play in our moral reasoning, especially with regard to procreation. I refute both Velleman's and Hare's views and demonstrate the difficulties we encounter when we try to apply their views to common non‐identity cases. I conclude with the common‐sense view regarding who matters, morally: only those who do, did, or will exist.     

植物花发育的分子机理研究进展

花的发育分为开花决定、花的发端和花器官的发育三个阶段。植物开花由多条途径诱导,包括光周期和光质诱导、春化作用、自主途径、赤霉素诱导、碳水化合物诱导等;植物体本身也存在着开花抑制途径。各种开花诱导途径能激活花分生组织特性基因,使茎端分生组织转变为花分生组织。花器官的发育由器官特性基因决定,这些基因的精确表达需要花分生组织特性基因的激活和多个正、负调节因子的调控;另有一类基因控制着花发育的对称性。花发育机理的研究具有重要的理论意义和广泛的应用前景。     

植物花发育的分子机理研究进展

花的发育分为开花决定、花的发端和花器官的发育三个阶段。植物开花由多条途径诱导,包括光周期和光质诱导、春化作用、自主途径、赤霉素诱导、碳水化合物诱导等;植物体本身也存在着开花抑制途径。各种开花诱导途径能激活花分生组织特性基因,使茎端分生组织转变为花分生组织。花器官的发育由器官特性基因决定,这些基因的精确表达需要花分生组织特性基因的激活和多个正、负调节因子的调控;另有一类基因控制着花发育的对称性。花发育机理的研究具有重要的理论意义和广泛的应用前景。     

Making the case for human life extension: personal arguments

In the close to medium future, the life sciences might permit a vast extension of the human life span. I will argue that this is a very desirable development for the individual person. The question whether death is a harm to the dying is irrelevant here. All it takes is that being alive is good for the living person and not being alive is not good for anyone. Thus, living persons who expect to live on happily are rationally required to want to stay alive. Eventual uncertainty whether it will be possible to be happy in the future provides no objection, but rather an incentive to try. This view, however, may be naive in assuming that persons are unchanging entities that exist separately from their psychological information. Objections have been derived from reductionistic views that value our future experiences in a way that declines with time, so that there will be a future point beyond which only negligible value accrues. If we adopt such a view, then we cannot now be concerned to have experiences beyond that point. I argue that these arguments fail to take into account all the reasons we might have to be concerned for the future and all kinds of such concern that come from them. The adoption of a plausible reductionistic account can arguably weaken our concern for the future and certainly change its quality in important ways. But this provides no objection to the desire to live forever, nor to live at all.     

OUGHT WE TO ENHANCE OUR COGNITIVE CAPACITIES?1

Ought we to improve our cognitive capacities beyond the normal human range? It might be a good idea to level out differences between peoples cognitive capacities; and some people's reaching beyond normal capacities may have some good side‐effects on society at large (but also bad side‐effects, of course). But is there any direct gain to be made from having ones cognitive capacities enhanced? Would this as such make our lives go better? No, I argue; or at least there doesn't seem to be any evidence suggesting that it would. And it doesn't matter whether we consider the question from a narrow hedonistic perspective, from a more refined hedonistic perspective, from a desire‐satisfaction view, or from some reasonable objective list view of what makes a life go well. Only an extremely perfectionist – and implausible – view of what makes our lives go well could support any direct value in cognitive enhancement. Finally, our sense of identity gives us no good reasons to enhance even our capacity to remember. So, cognitive enhancement as such would not improve our lives.     

Zika,contraception and the non‐identity problem

The 2016 outbreak of the Zika arbovirus was associated with large numbers of cases of the newly‐recognised Congenital Zika Syndrome (CZS). This novel teratogenic epidemic raises significant ethical and practical issues. Many of these arise from strategies used to avoid cases of CZS, with contraception in particular being one proposed strategy that is atypical in epidemic control. Using contraception to reduce the burden of CZS has an ethical complication: interventions that impact the timing of conception alter which people will exist in the future. This so‐called ‘non‐identity problem’ potentially has significant social justice implications for evaluating contraception, that may affect our prioritisation of interventions to tackle Zika. This paper combines ethical analysis of the non‐identity problem with empirical data from a novel survey about the general public's moral intuitions. The ethical analysis examines different perspectives on the non‐identity problem, and their implications for using contraception in response to Zika. The empirical section reports the results of an online survey of 93 members of the US general public exploring their intuitions about the non‐identity problem in the context of the Zika epidemic. Respondents indicated a general preference for a person‐affecting intervention (mosquito control) over an impersonal intervention (contraception). However, their responses did not appear to be strongly influenced by the non‐identity problem. Despite its potential philosophical significance, we conclude from both theoretical considerations and analysis of the attitudes of the community that the non‐identity problem should not affect how we prioritise contraception relative to other interventions to avoid CZS.     

Patients' satisfaction with prosthetic devices

The purpose of the paper was to ascertain the factors which affect the satisfaction of patients with the prosthetic therapy. The purpose of the paper was also to ascertain if there are common factors characteristic for patients dissatisfied with the prosthetic therapy although the specialist appraises it as objectively successful. 52 patients of the Clinical Institute for Rehabilitation and Orthopedic Devices were participating in the research, to which, after unsuccessful surgical-prosthetic rehabilitation, reamputation and prosthetic provision was carried out, which was appraised successful by the doctor. It was endeavored to appraise to what extent the appraisal by the doctor corresponds to patient's satisfaction. On the basis of the questionnaire elaborated specifically for this research and the statistical processing, it was concluded that where the doctor appraised the prosthetic therapy as successful, the same opinion was shared by the majority of the patients (92.3%). Patients are similarly satisfied with the function and the esthetic quality of the prosthesis (73%). The reason why 7.7% of patients are dissatisfied in cases when the doctor considers that there are no objective reasons for that should be sought in non-medical factors. The age, the education, the marital status, the income state, the size of the residence and the regional affiliation do not have a significant influence on the satisfaction of patients with the prosthesis (p > 0.05). Patients with a minor handicap achieve satisfaction with the prosthetic therapy faster, as well as the right-handed persons if the prosthesis on the right-hand extremity is in question (p < 0.05). This investigation showed that the responsibility of not wearing prosthetic aids, both orthopedic, and dental prostheses, couldn't be only neuroticism by prosthetic patients, because that connection is not statistically significant (p < 0.09).     

温抗体型自身免疫性溶血性贫血的诊治进展

自身免疫性溶血性贫血(AIHI)按照自身抗体作用于红细胞时所需的温度分为温抗体型AIHI(WAIHI)和冷抗体型AIHI(CAIHI),以WAIHI居多,并且多为继发性。WAIHI的发病与温度没有显著的相关关系,其发病是由各种原因引起的免疫机制变异,主要包括基因遗传因素、自身免疫调节异常及免疫因素等,导致针对自身红细胞的抗体产生,再与红细胞膜表面抗原结合,它是一种会使自身红细胞破坏或者缩短寿命的比较难以治疗的贫血,目前治疗AIHI首选疗法为肾上腺皮质激素(激素),有效率可达80%,大剂量静脉注射丙种球蛋白(IVIG)、输血、切除脾等方法的使用也在实践中逐渐增多,并且疗效可观。近年来对温抗体型自身免疫性溶血性贫血的诊治进展的研究越来越多。     

Descent with modification and the archaeological record

Recent years have seen major advances in our understanding of the way in which cultural transmission takes place and the factors that affect it. The theoretical foundations of those advances have been built by postulating the existence of a variety of different processes and deriving their consequences mathematically or by simulation. The operation of these processes in the real world can be studied through experiment and naturalistic observation. In contrast, archaeologists have an 'inverse problem'. For them the object of study is the residues of different behaviours represented by the archaeological record and the problem is to infer the microscale processes that produced them, a vital task for cultural evolution since this is the only direct record of past cultural patterns. The situation is analogous to that faced by population geneticists scanning large number of genes and looking for evidence of selection as opposed to drift, but more complicated for many reasons, not least the enormous variety of different forces that affect cultural transmission. This paper reviews the progress that has been made in inferring processes from patterns and the role of demography in those processes, together with the problems that have arisen.     

BRAIN,MIND AND MACHINE: WHAT ARE THE IMPLICATIONS OF DEEP BRAIN STIMULATION FOR PERCEPTIONS OF PERSONAL IDENTITY,AGENCY AND FREE WILL?

Brain implants, such as Deep Brain Stimulation (DBS), which are designed to improve motor, mood and behavioural pathology, present unique challenges to our understanding of identity, agency and free will. This is because these devices can have visible effects on persons' physical and psychological properties yet are essentially undetectable when operating correctly. They can supplement and compensate for one's inherent abilities and faculties when they are compromised by neuropsychiatric disorders. Further, unlike talk therapy or pharmacological treatments, patients need not ‘do’ anything for the treatment to take effect. If one accepts, as we argue here, that brain implants are unique among implantable types of devices, then this can have significant implications for what it means to persist as the same person and be the source of one's thoughts and actions. By examining two of the most common indications for DBS in current use, namely in the motor (Parkinson's Disease) and psychiatric (Major Depression) domains, we further argue that although DBS, as it is currently applied, does not necessarily represent a unique threat to personal identity and agency per se, it introduces an unprecedented ‘third party’ into the debate on these concepts. In this way, DBS can be used as a tool to begin probing, both conceptually and empirically, some of philosophy's most perennial metaphysical questions.     

Present and future in the immunodiagnosis of the animal mycoses

The problems that exist in the clinical, microbiological, and histopathological diagnosis of animal mycoses establish the necessity to investigate immunological methodologies in the diagnosis of these diseases. In this way, it may be possible to develop easy and fast techniques, allowing early detection of the disease, and efficient therapy. In our laboratory we have developed an indirect ELISA methodology to the diagnosis of aspergillosis in dog, cat, cow, sheep and birds, and dermatophytoses in dog and cat. Our results suggest this kind of technique may be useful not only in the diagnosis of animal mycosis, but in important fields as the elucidation of the fungal pathogenicity or the elaboration of effective vaccines, and with the possible application in human medicine.     

PROSPECTS FOR “GENETIC THERAPY” - CAN A PERSON BENEFIT FROM BEING ALTERED?

Mapping the human genome is an immense project with numerous objectives. Indeed, it is likely that some of its most important ramifications and applications remain as yet unglimpsed. All we can presently attempt is to focus on some of the more obvious possibilities and prepare for the problems already looming on our horizon. One such possibility is that of Prenatal Genetic Intervention (PGI), which might be said to be a therapeutic intervention on behalf of the embryonic child. In this paper, I argue that "genetic therapy" is likely to be a misnomer, and that if PGI becomes possible, we should generally resist its inclusion under the special moral duty of providing health care. "Therapy" necessarily means helping a person, while PGI -- though effecting improvements from an impersonal perspective -- will frequently not consist in directly helping any person. This is due not to the embryo not being a person, but rather to the basic philosophical problem of personal identity persisting through significant alterations -- especially the alteration of genotype. The decisive moral question then hinges on the definition of "significant" alteration. I shall examine the feasibility of drawing analogies from criteria for personal identity proposed in discussions of how persons maintain their identity across time and through physical and psychological change. Certain metaphysical aspects of human identity and individuality will be also touched upon, partly in terms derived from classical Judaism. In conclusion I argue that, regarding embryos in particular, persistence of genotype must generally be deemed a necessary condition for maintaining personal identity. Therefore, many proposals for PGI should be excluded from the notion of therapeutic intervention and thus denied the special moral status of requests for therapy.     

Modelling as a tool

Conclusion The three examples mentioned, illustrate some kinds of mathematical modelling. These were all models of isolated sub-systems. The impression may exist that it is not yet possible to model the total algal assemblage. This possibility however, depends on the aim of the model. When the aim is to predict the maximum biomass, the model of LOS (1980) can be used. When prediction of the actual biomass as well as the transition states from one maximum to the other is aimed, there is still work to be done. The same applies when one wants a model that predicts zooplankton and fish too.In general the aim determines the kind of model. A multidisciplinary team of physicians, chemists, biologists and mathematicians have to build it.     

Can abstractions be causes?

The Empiricist or Lockean view says natural kinds do not exist objectively in nature but are practical categories reflecting use of words. The Modern, Ostensive view says they do exist, and one can refer to such a kind by ostention and recursion, assuming his designation of it is related causally to the kind itself. However, this leads to a problem: Kinds are abstract repeatables, and it seems impossible that abstractions could have causal force. In defence of the Modern view, I suggest we can think of kinds as — or as like — ecological niches existing in nature, which are causally effective by virtue of the fact that they predictively determine (some) properties of the things that happen to occupy them.     

Lysogenicity as a tool for bacteriophage typing ofSalmonella Paratyphi B

Summary and Conclusions The serological identity of the phage produced by a spontaneously lysogenic strain ofS. paratyphi B depends on the bacterial type of that particular strain. The frequency of the phenomenon of spontaneous lysogenicity is such, in the case ofS. paratyphi B, that it can be utilised as a tool for typing.It is clear, however, that the possibilities of the method are limited. Firstly, types exist that do not as a rule produce bacteriophages. Secondly, alysogenic strains may exist of types that as a rule are lysogenic.Therefore the method can be utilised only together with, and as a check upon, a system of phage reactions.In Holland the types Kampen and Leeuwarden are frequent types, that can readily be recognised by the identity of the phages they produce. This is sufficient to justify the use of the method.The relation shown between true lysogenicity and bacterial types may be of theoretical interest. Perhaps it will be possible in this way to relate every existing phage to a bacterial type. The theoretical aspects will, however, be discussed elsewhere.     

Objectivity and Illusion in Evolutionary Ethics: Comments on Waller

In this paper I argue that any adequate evolutionary ethical theory needs to account for moral belief as well as for dispositions to behave altruistically. It also needs to be clear whether it is offering us an account of the motivating reasons behind human behaviour or whether it is giving justifying reasons for a particular set of behaviours or, if both, to distinguish them clearly. I also argue that, unless there are some objective moral truths, the evolutionary ethicist cannot offer justifying reasons for a set of behaviours. I use these points to refute Waller's claims that the illusion of objectivity plays a dispensable role in Ruse's theory, that my critique of Ruse's Darwinian metaethics is built on a false dilemma, that there is nothing to be distressed about if morality is not objective, and that ethical beliefs are subject to a kind of causal explanation that undermines their objectivity in a way that scientific beliefs are not.     

Human organisms begin to exist at fertilization

Eugene Mills has recently argued that human organisms cannot begin to exist at fertilization because the evidence suggests that egg cells persist through fertilization and simply turn into zygotes. He offers two main arguments for this conclusion: that ‘fertilized egg’ commits no conceptual fallacy, and that on the face of it, it looks as though egg cells survive fertilization when the process is watched through a microscope. We refute these arguments and offer several reasons of our own to think that egg cells do not survive fertilization, appealing to various forms of essentialism regarding persons, fission cases, and a detailed discussion of the biological facts relevant to fertilization and genetics. We conclude that it is plausible, therefore, that human organisms begin to exist at fertilization – or, at the very least, that there are grounds for thinking that they existed as zygotes which do not apply to the prior egg cells. While this does not entail that human persons begin to exist at this point, it nevertheless has considerable significance for this latter question.