A response to Dodds and Jones

In response to "Surrogacy and Autonomy," by Susan Dodds and Karen Jones in this issue of Bioethics, the author concedes that only a surrogacy practice stringently regulated by good counseling, escape clauses for pregnant women, and the prohibition of profit-making agencies will save women from exploitation, but she objects to singling out women for paternalistic "protection against themselves," and to defending women's autonomy to the extent of their right to behave in ways known to harm a fetus. Dodds and Jones' concerns about attitudes toward women, genetic bias, the concept of children as property, and the harm principle generated by surrogacy contracts are answered with arguments for why surrogacy should not be illegal.     

To know or not to know? Genetic ignorance, autonomy and paternalism

This paper examines some arguments which deny the existence of an individual right to remain ignorant about genetic information relating to oneself--often referred to as 'a right to genetic ignorance' or, more generically, as 'a right not to know'. Such arguments fall broadly into two categories: 1) those which accept that individuals have a right to remain ignorant in self-regarding matters, but deny that this right can be extended to genetic ignorance, since such ignorance may be harmful to others, particularly those to whom one is genetically related (the 'harm to others objection') and 2) those which contend that, even if genetic ignorance is only self harming, it is not something to which individuals can rationally or morally claim to have a 'right' at all, since they defend their claims on autonomy-respecting grounds and ignorance is inimical to autonomy (the 'incoherence objection'). I argue that defenders of a right not to know have some plausible responses to the 'harm to others objection', they and their opponents reach an impasse in which both sides are left voicing concerns about the paternalistic implications of the other's point of view. I conclude that defenders of a right not to know would, therefore, advance their position further by analysing it in terms of values other than those of autonomy and rights.     

Putting concerns about nature in context: the case of agricultural biotechnology

Concerns about nature are playing increasingly prominent roles in a variety of social debates, including medical biotechnology, environmental protection, and agricultural biotechnology. These concerns are often simply rejected as incoherent: critics argue that there is no good account for how natural states of affairs can have moral value, and that the concept of "nature" is too multifarious and vague to be deployed in moral argument anyway. When these concerns are defended, they are frequently formulated as strong claims that make implausible ontological commitments and that ignore the linkages between these different debates. Agricultural biotechnology provides an especially challenging case study for evaluating concerns about nature. I offer a qualified defense that recognizes these concerns as conceptually linked, attends to social context at appropriate points, and overcomes the charges of incoherence. This defense supports a restrained treatment of concerns about nature in public policy: public policy can neither endorse nor dismiss them. In the case of agricultural biotechnology, this stance probably mandates some form of labeling.     

Michael Parker Banton: an appreciation of his life’s work

This article is an appreciation of the contributions to ethnic and racial studies and to British sociology in general of Michael Parker Banton. It reviews his career and also his major publications, including also arguments against him made by his principal critics and his responses to these. It points out the specificity of his contributions and argues for his unique importance in defining and developing the field of ethnic and race relations in British sociology during the second half of the twentieth century and into the present century. It also mentions his many contributions to public life.     

Waddington's widget: Hsp90 and the inheritance of acquired characters

Conrad Waddington published an influential model for evolution in his 1942 paper, Canalization of Development and Inheritance of Acquired Characters. In this classic, albeit controversial, paper, he proposed that an unknown mechanism exists that conceals phenotypic variation until the organism is stressed. Recent studies have proposed that the highly conserved chaperone Hsp90 could function as a "capacitor," or an "adaptively inducible canalizer," that masks silent phenotypic variation of either genetic or epigenetic origin. This review will discuss evidence for, and arguments against, the role of Hsp90 as a capacitor for morphological evolution, and as a key component of what we call "Waddington's widget."     

Should the health community promote smokeless tobacco (snus) as a harm reduction measure?

BACKGROUND TO THE DEBATE: The tobacco control community is divided on whether or not to inform the public that using oral, smokeless tobacco (Swedish snus) is less hazardous to health than smoking tobacco. Proponents of "harm reduction" point to the Swedish experience. Snus seems to be widely used as an alternative to cigarettes in Sweden, say these proponents, contributing to the low overall prevalence of smoking and smoking-related disease. Harm reduction proponents thus argue that the health community should actively inform inveterate cigarette smokers of the benefits of switching to snus. However, critics of harm reduction say that snus has its own risks, that no form of tobacco should ever be promoted, and that Sweden's experience is likely to be specific to that culture and not transferable to other settings. Critics also remain deeply suspicious that the tobacco industry will use snus marketing as a "gateway" to promote cigarettes. In the interests of promoting debate, the authors (who are collaborators on a research project on the future of tobacco control) have agreed to outline the strongest arguments for and against promoting Swedish snus as a form of harm reduction.     

"Kissing a Baby Is Not at All Good for Him": Infant Mortality, Medicine, and Colonial Modernity in the U.S.-Occupied Philippines

Feminist scholars have begun to consider the ways indigenous practices of child rearing were and are challenged in (post)colonial discourse and practice, and how these practices have become a terrain on which definitions of nation, state, and economy are contested. In this article, I adopt a historical anthropological approach to consider how Filipino child-rearing strategies were described and stigmatized in educational, public health, and public welfare discourses in the U.S.-occupied Philippines in the early 20th century. I demonstrate how public health practices and discourses that were generated as part of a "benevolent" campaign against high rates of infant mortality were strategically used as a weapon against Filipino arguments for independence. I also consider how discourses constructing Filipino caregivers as overly indulgent were linked to metropolitan concerns about production of the "new industrial man" and were used to develop a racialized critique of the cultural practices of Filipinos.     

Hapten-specific IgE antibody responses in mice. VII. Conversion of IgE "non-responder" strains to IgE "responders" by elimination of suppressor T cell activity.

Mice of the inbred strains SJL (H-2s) and AKR (H-2k) are "non-responders" and "low-responders," respectively, in terms of their capacity to develop antibody responses of the IgE class when immunized with conventional proteins and hapten-protein conjugates under conditions optimal for eliciting IgE responses in "high-responder" mice, such as BALB/c (H-2d), to these same antigens. For example, BALB/c mice preimmunized with ASC and then challenged 7 days later with DNP-ASC develop peak augmented primary IgE anti-DNP antibody responses of 320 PCA units, whereas SJL and AKR mice develop responses which are 16-fold and 4-fold lower, respectively. However, pretreatment of the latter two strains with appropriate doses of either x-irradiation (150 R), cyclophosphamide (100 mg/kg) or ALS (150 mul) before carrier-preimmunization strikingly enhances the magnitude of IgE antibody responses in such mice to levels as high as 64-fold above those of untreated control mice of the same strains. Evidence obtained in these experiments indicates that the capacity of such maneuvers to to convert poor IgE responders to high responder status reflects elimination of nonantigen-specific suppressor T lymphocytes which are naturally present and normally function to suppress or "dampen" the IgE antibody response in a relatively selective manner. It appears that these cells modulate IgE responses by acting at least at two distinct points: 1) The most effective activity seems to be at the level of induction of carrier-specific helper T cells; 2) A second locus of inhibitory activity is more distal in the response, either impeding helper T cell-B cell cooperative interactions or suppressing B cell differentiation and/or function directly. Taken collectively, these observations demonstrate that the state of poor responsiveness of the SJL and AKR strains for the IgE antibody class is not a reflection of a genetic inability to develop IgE responses but rather a manifestation of a genetic capability to actively inhibit IgE antibody synthesis.     

From a pump handle to oral rehydration therapy: a model of translational research

Few afflictions have attracted as much attention and impacted on as many societal and biomedical areas as cholera. Dr. John Snow's studies launched the field of epidemiology, were early applications of medical cartography, and promoted the use of statistical methods in medicine. The finding that cholera was due to the ingestion of contaminated water lent to the demise of the prevalent "miasmatic theory of contagion," set the platform for the "germ theory of disease," and promoted the growth of public health concerns for water purification and sanitation. More recent attention to this disease led to the notion of "secretory diarrhea" and the translation of basic principles to the development of oral rehydration therapy and its "spin-offs" (Gatorade and Pedilyte).     

Psychophysiological components of imagery

McGuigan's neuromuscular model of information processing (1978a, 1978b, and 1989) was investigated by electrically recording eye movements (electro-oculograms), covert lip and preferred arm responses (electromyograms), and electroencephalograms. This model predicts that codes are generated as the lips are uniquely activated when processing words beginning with bilabial sounds like "p" or "b," as is the right arm to words like "pencil" that refer to its use. Twelve adult female participants selected for their high imagery ratings were asked to form images to three orally presented linguistic stimuli: the letter "p," the words "pencil" and "pasture," and to a control stimulus, the words "go blank." The following findings were significant beyond the 0.05 level: an increased covert lip response only to the letter "p," increased vertical eye activity to "p" and to the word "pencil," right arm response only to the word "pencil," and a decreased percentage of alpha waves from the right 02 lead only to the word "pasture." Since these covert responses uniquely occurred during specific imagery processes, it is inferred that they are components of neuromuscular circuits that function in accord with the model of information processing tested.     

Cosmetic psychopharmacology and the President's Council on Bioethics

Advances in neuroscience and biotechnology have heightened the urgency of the debate over "cosmetic psychopharmacology," the use of drugs to enhance mood and temperament in the absence of illness. Beyond Therapy: Biotechnology and the Pursuit of Happiness (2003), the report of the President's Council on Bioethics, has criticized the use of cosmetic psychopharmacology. The Council claimed that cosmetic psychopharmacology will necessarily lead to "severing the link between feelings of happiness and our actions and experiences in the world," but it provided no satisfactory arguments to support this claim and ignored the possibility that cosmetic psychopharmacology might actually enhance the link between happiness and experience. The Council's arguments against cosmetic psychopharmacology depend heavily on the mistaken belief that Prozac and similar antidepressants are mood brighteners in healthy subjects. The empirical evidence, however, clearly indicates that these drugs are not forms of cosmetic psychopharmacology, thus negating much of the Council's arguments. The use of pharmaceutical agents to enhance mood or personality in normal individuals should not be rejected a priori. Instead, the effects of each agent on the individual and on society must be weighed using sound ethical reasoning and the best evidence available.     

Healthy Bodies,Toxic Medicines: College Students and the Rhetorics of Flu Vaccination

This article examines flu vaccination beliefs and practices produced during a survey of undergraduate students in Spring 2012 (IRB#10-732). This research uses the methods of rhetorical analysis — or the study of persuasive features and arguments used in language — to examine statements respondents made regarding flu and flu vaccine. In these responses, students generated unique categories of arguments about the perceived dangers of flu vaccination, including the assertion that vaccines cause disease (including illnesses and conditions other than flu), that vaccines are toxic medicines, and that vaccines carry unknown, population-wide risks that are inadequately acknowledged. This study provides insight into vaccination beliefs and rationales among a population at risk of flu (college students) and suggests that further study of this population may yield important keys to addressing flu vaccine concerns as expressed by college students. Rhetorical analysis also offers a useful set of methods to understanding vaccination beliefs and practices, adding to existing methods of study and analysis of vaccination practices and beliefs in medicine and public health.     

Maya mobile medicine in Guatemala: the "other" public health

Maya mobile medical providers in highland Guatemala and the goods and services that they offer from "soapboxes" on street corners, local markets, and on buses exemplify an important yet underinvestigated domain of localized health care, one that I refer to as the "other" public health. This medical and linguistic examination of traveling medical salespeople calls for a reconsideration (on a global scale) of what has come to be understood as "public health," arguing that "othered," local forms of public health that are often overlooked by anthropologists as "nontraditional" and delegitimized by bio-medicine as nonscientific merit serious consideration and investigation. This ethnography of marginalized forms of public health offers global insights into emerging heterodoxical forms of public health care that contest bio-medical authority and challenge our preexisting definitions of what counts as "access," wellness seeking, and even health care itself.     

Scenario analysis of the future of medicines.

Planning future policy for medicines poses difficult problems. The main players in the drug business have their own views as to how the world around them functions and how the future of medicines should be shaped. In this paper we show how a scenario analysis can provide a powerful teaching device to readjust peoples'' preconceptions. Scenarios are plausible, not probable or preferable, portraits of alternative futures. A series of four of alternative scenarios were constructed: "sobriety in sufficiency," "risk avoidance," "technology on demand," and "free market unfettered." Each scenario was drawn as a narrative, documented quantitatively wherever possible, that described the world as it might be if particular trends were to dominate development. The medical community and health policy markers may use scenarios to take a long term view in order to be prepared adequately for the future.     

Non-song acoustic communication in migrating humpback whales (Megaptera novaeangliae)

Humpback whales are renowned for the complex structured songs produced by males. A second, relatively understudied area of humpback acoustic communication concerns un-patterned sounds known as "social sounds," produced by both males and females. These include vocalizations as well as sounds produced at the surface of the water as a result of surface behaviors ( e.g. , breaching, pectoral slapping). This study describes a portion of the non-song social sound repertoire of southward migrating humpbacks in Australian waters, and explores the social relevance of these sounds. On migration, humpback whales travel in social groups of varying compositions. These social groups are not stable in that humpback whales continually change group composition by splitting from, or joining with, other groups. The results of this study suggest that "breaching" and "slapping" have a communicative function. Other sounds such as "underwater blows" and "cries" were heard mainly in competitive groups while other low-frequency sounds such as "grumbles,""snorts,""thwops," and "wops" may function in intra- or inter-group communication. Particular sounds ("grunts,""groans," and "barks") were almost exclusive to joining pods suggesting a role in social integration. Social sounds in humpbacks may have specific social and behavioral functions relating to social group composition, and the mediation of interactions between these social groups.     

WHEN DOES POTENTIALITY COUNT? A COMMENT ON LOCKWOOD

Michael Lockwood's essay, "Warnock v. Powell (and Harradine): when does potentiality count?," and Hare's response are two of three articles in this issue of Bioethics discussing potentiality and its implications for experimentation with human embryos. (See also Stephen Buckle's "Arguing from potential.") Hare responds to Lockwood's arguments on potential, an embryo's "interests," and what obligations these interests entail. In Hare's view, the interests are those of the grown person the embryo (or fetus or neonate) will become. In formulating regulations on embryo research, legislators ought to be concerned chiefly with the interests of the persons who may come into existence, grading harms differently for gametes, embryos, fetuses, and neonates, and balancing these against the expected good from the experiments.     

Genetics providers and the family covenant: connecting individuals with their families

As genetic testing becomes more commonplace, medicine will likely face both family and individual demands for access to, and control of, test result information. Past research has emphasized confidentiality concerns of the individual and contrasted these claims with the "need to know" by others to avoid harm. These confidentiality concerns, based on individual self-interest, are challenged by a singularly important aspect of genetic testing-familial responsibility. As patients are often motivated to obtain genetic testing by an array of "other-directed" considerations toward their own family (such as love, fiduciary responsibility, gratitude, etc.), an accounting of these concerns is warranted. Understanding the relevance of family relationships and obligations facilitates a fuller informed consent for genetic testing. Genetic counselors and geneticists engaging in genetic counseling can account for the concerns of both individuals and their families using the family covenant-a helpful, innovative model to address proactively boundaries of privacy and information sharing within the family. This model focuses on two areas of discussion: (1) the demarcation of the boundaries of confidentiality; and (2) the definition of "family." The family covenant helps genetics providers consider what information "should" be confidential, and with respect to whom.     

Inference problems in population genetics: DNA sequences, restriction endonucleases and ascertainment sampling

A major trend of population genetics theory in the 1970s was the increased emphasis on inductive arguments, based on observed genetic data, rather than on deductive arguments based on theory and models. This occurred in part because the deductive theory had largely fulfilled its role of describing evolution as a genetic process, and in part because of the increasing amounts of data available on the genetic constitution of natural populations. Inference procedures raise difficulties not present in the deductive theory. Often conditional arguments are necessary since the data often must fulfil some condition to be observed. Different inference procedures, having different efficiencies, apply for data from different apparatuses. Care must be taken in deciding what it is that the inference concerns. These problems are illustrated by reference to restriction endonuclease techniques and ascertainment sampling.     

Adjustable set point: to honor Harold T. Hammel.

The value of a regulated variable in the absence of external perturbation stabilizes at the set point of the system. This set point is an information input that may be determined by an external signal to which the regulated variable is compared or may be determined by the structural characteristics of the system itself. In the case of temperature regulation the actual internal temperature is compared with the set point "wanted" by the organism. The activating signal for the regulatory responses, the "error signal," is the difference between the actual temperature and the set point. When an error signal is detected, the organism produces the available corrective responses. Yet, the notion of thermoregulatory set point has been challenged recently. Such a questioning entails that both fever and anapyrexia are useless concepts. This minireview examines the available arguments and data and concludes that to abandon the concepts of set point, fever, and anapyrexia is premature, at best.     

RETRACING LIBERALISM AND REMAKING NATURE: DESIGNER CHILDREN,RESEARCH EMBRYOS,AND FEATHERLESS CHICKENS

Liberal theory seeks to achieve toleration, civil peace, and mutual respect in pluralistic societies by making public policy without reference to arguments arising from within formative ideals about what gives value to human life. Does it make sense to set aside such conceptions of the good when it comes to controversies about stem cell research and the genetic engineering of people or animals? Whether it is reasonable to bracket our worldviews in such cases depends on how we answer the moral questions that the use of these biotechnologies presuppose. I argue that the moral language of liberal justice – of rights and duties, interests and opportunities, freedom and consent, equality and fairness – cannot speak to these underlying concerns about what the human embryo is, why the natural lottery matters to us, and whether ‘animal nature’ is worth preserving. I conclude that liberal theory is incapable of furnishing a coherent or desirable account to govern the way we use our emerging powers of biotechnology.