Print Me an Organ? Ethical and Regulatory Issues Emerging from 3D Bioprinting in Medicine

Recent developments of three-dimensional printing of biomaterials (3D bioprinting) in medicine have been portrayed as demonstrating the potential to transform some medical treatments, including providing new responses to organ damage or organ failure. However, beyond the hype and before 3D bioprinted organs are ready to be transplanted into humans, several important ethical concerns and regulatory questions need to be addressed. This article starts by raising general ethical concerns associated with the use of bioprinting in medicine, then it focuses on more particular ethical issues related to experimental testing on humans, and the lack of current international regulatory directives to guide these experiments. Accordingly, this article (1) considers whether there is a limit as to what should be bioprinted in medicine; (2) examines key risks of significant harm associated with testing 3D bioprinting for humans; (3) investigates the clinical trial paradigm used to test 3D bioprinting; (4) analyses ethical questions of irreversibility, loss of treatment opportunity and replicability; (5) explores the current lack of a specific framework for the regulation and testing of 3D bioprinting treatments.     

Narrative,Self-Realization,and the Shape of a Life

Velleman, MacIntyre, and others have argued for the compositional view that lives can be other than equally good for the person who lives them even though they contain all and only the same moments, and that this is explained by their narrative structure. I argue instead for explanation by self-realization, partly by interpreting Siegfried Sassoon’s exemplary life-narrative. I decide between the two explanations by distinguishing the various features of the radial concept of narrative, and showing, for each, either that self-realization is just as good an account, or that we should prefer the self-realization account, of the composition it is supposed to explain. I conclude that, if the shape of a life matters, it matters because some shapes are self-realizations, not because they are narratives.     

Examining Psychosocial Pathways Underlying Gratitude Interventions: A Randomized Controlled Trial

Despite their unprecedented popularity, the psychological mechanisms through which gratitude journals operate are poorly understood. Also the use of gratitude journaling to enhance social relationships has been neglected in past research, despite the importance of healthy relationships for people’s happiness. This randomized controlled study examined the effect of (a) a traditional gratitude journal (fostering gratitude for daily life), and (b) an interpersonal gratitude journal (fostering gratitude for one’s existing social relationships), versus (c) an active control journal, on life satisfaction. Ninety-one participants were randomized to one of three conditions with 2-week and 1-month follow-ups. The traditional gratitude intervention (vs. control) showed improvements in friendship at immediate post-test and 1-month follow-up, and these effects were accounted for by changes in gratitude over time. Additionally, the traditional gratitude intervention (vs. control) predicted enhanced life satisfaction at follow-up, and this was serially mediated by 6 week changes in gratitude and perceived friendship quality. No such differences over time were observed between the interpersonal gratitude intervention and either the control intervention or the traditional gratitude intervention. Actively appreciating things in daily life appears to be effective in enhancing the quality of people’s social relationships, and producing sustained improvements in subjective wellbeing.     

Support groups for parents with an adult child suffering from bipolar disorder

Confronted with the disconcerting behaviour exhibited by their children, parents of bipolar patients are in severe distress. Research focuses on the study of the ‘burden’ that the pathology puts on caregivers, owing to their experience of depression, sometimes combined with the presence of hostile attitudes and negative affects. In France, parents of adult patients encounter an initial specific difficulty: they are not systematically included in the care management system. Thanks to the initiative of an association of psychiatrists and psychoanalysts, the authors set up a psychoanalytic support group for the parents of ‘bipolar’ adults. The diagnosis of a bipolar disorder is established by a psychiatrist within a medical structure. Support groups for parents do exist in France, but their experiences have not led to scientific publications on this specific topic. Existing publications focus on other types of pathology and other therapeutic approaches. In this article, we will highlight how this type of psychoanalytic support group, with operating rules based on the theoretical work of Anzieu, can help parents of patients with bipolar disorders. Group participants accepted the principle of a research study that maintained their anonymity. We collected and analysed qualitative data from the first year of the group, so we highlight the specific difficulties of these parents, faced with chronic disease. The relevance of our qualitative study also resides in the data collected over a period of time, enabling us to see the progress made, and encouraging us to reflect on the place of psychoanalytic groups for parents, as well as on the care management of this pathology.     

Interspecies transmission of emotional information via chemosignals: from humans to dogs (<Emphasis Type="Italic">Canis lupus familiaris</Emphasis>)

We report a study examining interspecies emotion transfer via body odors (chemosignals). Do human body odors (chemosignals) produced under emotional conditions of happiness and fear provide information that is detectable by pet dogs (Labrador and Golden retrievers)? The odor samples were collected from the axilla of male donors not involved in the main experiment. The experimental setup involved the co-presence of the dog’s owner, a stranger and the odor dispenser in a space where the dogs could move freely. There were three odor conditions [fear, happiness, and control (no sweat)] to which the dogs were assigned randomly. The dependent variables were the relevant behaviors of the dogs (e.g., approaching, interacting and gazing) directed to the three targets (owner, stranger, sweat dispenser) aside from the dogs’ stress and heart rate indicators. The results indicated with high accuracy that the dogs manifested the predicted behaviors in the three conditions. There were fewer and shorter owner directed behaviors and more stranger directed behaviors when they were in the “happy odor condition” compared to the fear odor and control conditions. In the fear odor condition, they displayed more stressful behaviors. The heart rate data in the control and happy conditions were significantly lower than in the fear condition. Our findings suggest that interspecies emotional communication is facilitated by chemosignals.     

The Good Immigrant Worker: 2013 US Senate Bill 744, Color-Blind Nativism and the Struggle for Comprehensive Immigration Reform

We explore immigration politics in the contemporary USA through analysis of the political framing of 2013 US Senate Bill 744, especially among its supporters. SB 744 is a bipartisan comprehensive immigration reform proposal that called for the largest overhaul of the immigration system in more than 25 years; it was passed in June 2013 by the US Senate but blocked in the House. Through analysis of the 2012–2013 textual content of the official websites and blogs of six US immigration lobby organizations from across the political spectrum, we offer a typology of political framings of comprehensive immigration reform. Drawing on popular anti-immigrant rhetoric, organizations with an agenda of immigration restriction and deterrence battled against the bill. On the other side, supporters of the bill ranged from business coalitions to immigrant rights groups, an assortment of interests that was reflected in the variety of arguments advanced in favor of the bill. Despite the far more fragmented character of pro-SB 744 discourse in comparison to that advanced by the opposition, our investigation suggests the ongoing and contested formation of a strategic pro-SB 744 framing that centered on the “good immigrant worker,” a “race-blind” trope that melds US nationalist narratives of immigration with an ethos of neoliberalism that upholds individual merit and market value to create a notion of “deservingness” that affirms the worth of immigrants as diligent workers.     

Enhancing theory of mind in behavioural variant frontotemporal dementia with transcranial direct current stimulation

Behavioural variant frontotemporal dementia (bvFTD) is a form of frontotemporal degeneration characterized by early changes in personality, emotional blunting, and/or loss of empathy. Recent research has highlighted that these features may be at least partially explained by impairments in the theory of mind (ToM; i.e., the ability to understand and predict other people’s behaviour by attributing independent mental states to them). The aim of this randomized, double-blind, placebo-controlled study was to test the hypothesis that transcranial direct current stimulation (tDCS) over the medial frontal cortex (MFC) selectively enhances communicative intention processing, a specific ToM ability. Using a single-session online design, we administered a ToM task that measures the ability to represent other people’s private and communicative intentions during active or sham tDCS to 16 bvFTD patients. To assess the impact of dementia on performance on the ToM task, we included 16 age-matched healthy volunteers who were asked to perform the entire experimental ToM task. BvFTD is characterized by an impairment in the comprehension of both communicative and private intentions relative to a healthy control group and by a disproportional impairment in communicative intention compared with private intention processing. Significant and selective accuracy improvement in the comprehension of communicative intentions after active stimulation was observed in patients with bvFTD. This is the first study that analyses ToM ability in patients with bvFTD using tDCS stimulation. Our findings could potentially contribute to the development of an effective, noninvasive brain stimulation treatment of ToM impairments in patients with bvFTD.     

Incongruent Names: A Theme in the History of Chinese Philosophy

This essay is meant to shed light on a discourse that spans centuries and includes different voices. To be aware of such trans-textual resonances can add a level of historical understanding to the reading of philosophical texts. Specifically, we intend to demonstrate how the notion of the ineffable Dao 道, prominently expressed in the Daodejing 道德經, informs a long discourse on incongruent names (ming 名) in distinction to a mainstream paradigm that demands congruity between names and what they designate. Thereby, we trace the development of the idea of the ineffable Dao quite differently from modern mystical interpretations. We show how, in an early Chinese context, it first gives rise to a sociopolitical critique of the incongruity underlying socially constructed names in the Zhuangzi 莊子, then to a discourse on the incongruity between moral virtues and names in Xuanxue 玄學 philosophy, and eventually to Sengzhao’s 僧肇 claim that a perceived congruence of names with things does not entail actual congruence between names and reality.     

Trust within Limits

Abstract

There have two recent challenges to the orthodoxy that ‘X trusts Y to ø’ is the fundamental notion of trust. Domenicucci and Holton maintain that trust, like love and friendship, is fundamentally two-place. Paul Faulkner argues to the more radical conclusion that the one-place ‘X is trusting’ is explanatorily basic. I argue that ‘X trusts Y in domain D’ is the explanatorily basic notion. I make the case that only by thinking of trust as domain-specific can we make sense of the relationships between trust and belief in goodwill, trust and distrust, and trust and trustworthiness. In addition, by modeling trust as essentially domain-specific we can account for the way in which wise trust in others is finely discriminating.     

Reducing behavioural risk factors for cancer: An affect regulation perspective

Nearly half of all cancer deaths are attributable to preventable causes, primarily unhealthy behaviours such as tobacco use, alcohol use and overeating. In this review, we argue that people engage in these behaviours, at least in part, as a means of regulating their affective states. To better understand why people engage in these behaviours and how researchers might design interventions to promote the selection of healthier methods for regulating affect, we propose a conceptual model of affect regulation. We synthesise research from both the stress and coping tradition as well as the emotion and emotion regulation tradition, two literatures that are not typically integrated. In so doing, we indicate where researchers have made headway in understanding these behaviours as affect regulation and note how our model could be used to structure future work in a way that would be particularly advantageous to cancer control efforts.