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231.
Doctor's Expertise and Managing Discrepant Information from Other Sources in Genetic Counseling: A Conversation Analytic Perspective 总被引:1,自引:0,他引:1
The study examines a recurrent interactional pattern in genetic counseling. It describes clinical geneticists' responses in
situations in which clients have presented information from other sources that is potentially discrepant with information
given by the doctor. The data consists of 12 video-recorded sessions of genetic counseling in Finland, and the method is conversation
analysis. There are two primary ways the doctors respond: either they accept the client's information as such, but show that
it is not discrepant with the doctor's information, or they reject the client's information. In the latter case they mitigate
the ‘wrongness’ of the client's information. The clinical geneticists seem to be working with a dilemma: they need to find
a balance between ensuring correct understanding of the information and showing respect for the expertise of others. A particularly
complex case is also analyzed and reflected on. 相似文献
232.
Bates BR 《Journal of genetic counseling》2005,14(6):423-434
Critics of genetic discourse are concerned that deterministic and discriminatory views of genetics are increasingly becoming
adopted. These views argue that current genetic discourse becomes a source of power whereby powerful institutions harm people
with so-called “bad” genes. This essay argues that current analyses of the power of genetics discourse are grounded in an
improper reading that disempowers patients. Deploying Michel Foucault's concept “care of the self,” this essay claims that
genetics discourse is better understood as a way that patients take on power through rhetoric rather than a force that has
power over patients. Through a close reading of the “My Family Health Portrait” program, this paper argues that patients experience
a process of “subjection” wherein they become agents of and objects of genetics discourse both. This alternative mode of analyzing
the power of genetics discourse has implications for our collective understanding of the operations of the care of the self
and the uses of genetic information that we propose. 相似文献
233.
Differences in Individual Approaches: Communication in the Familial Breast Cancer Consultation and the Effect on Patient Outcomes 总被引:1,自引:0,他引:1
This multicenter study aimed to assess (i) whether individual clinical geneticists and genetic counselors vary in their communication skills and (ii) whether this variation in communication impacts on patient outcomes, such as anxiety, depression, genetics knowledge, and satisfaction. One hundred and fifty women from high-risk breast cancer families attending their first genetic counseling consultation completed pre and post-consultation self-report questionnaires. The consultations were audiotaped and transcribed verbatim. Univariate analyses showed highly significant differences between individual clinical geneticists and genetic counselors in: facilitating understanding (p 0.001); facilitating active involvement (p 0.001); facilitating partnership building (p = 0.003); addressing emotional concerns (p 0.001); and discussing prophylactic mastectomy (p = 0.017). Multivariate linear regressions showed that this variation in communication resulted in a greater change in patients depression 4 weeks after the counseling session (p = 0.017). These findings suggest clinical geneticists and genetic counselors have achieved some standardization in communicating information, but showed diversity in their facilitation skills. Communication skills may be a useful area to explore further in this field. 相似文献
234.
Taylor PL 《Science and engineering ethics》2005,11(4):589-616
Key ethical issues arise in association with the conduct of stem cell research by research institutions in the United States.
These ethical issues, summarized in detail, receive no adequate translation into federal laws or regulations, also described
in this article. U.S. Federal policy takes a passive approach to these ethical issues, translating them simply into limitations
on taxpayer funding, and foregoes scientific and ethical leadership while protecting intellectual property interests through
a laissez faire approach to stem cell patents and licenses. Those patents and licenses, far from being scientifically and
ethically neutral in effect, virtually prohibit commercially sponsored research that could otherwise be a realistic alternative
to the federal funding gap. The lack of federal funding and related data-sharing principles, combined with the effect of U.S.
patent policy, the lack of key agency guidance, and the proliferation of divergent state laws arising from the lack of Federal
leadership, significantly impede ethical stem cell research in the United States, without coherently supporting any consensus
ethical vision. Research institutions must themselves implement steps, described in the article, to integrate addressing ethical
review with the many legal compliance issues U.S. federal and state laws create.
The opinions expressed in this article are the author’s own, and are not necessarily the opinions of others, including Children’s
Hospital Boston. Portions of earlier versions of this article were previously published by the American Bar Association and
the New York State Bar Association. 相似文献
235.
Simonson L 《Science and engineering ethics》2005,11(4):655-658
This paper describes how the Electrical and Computer Engineering Department at South Dakota School of Mines and Technology
has chosen to integrate ethics into their curriculum. All university freshmen engineering students are introduced to ethics
through the presentation of ethical dilemmas. During this exercise, students are forced to argue both sides (‘for’ and ‘against’)
of a hypothetical ethical engineering dilemma. It provides a setting for great discussion with the desired outcome that they
learn to carefully analyze a situation before they draw conclusions. In the sophomore year, students are introduced to methods
to use the fundamental principles, the fundamental canons, and the suggested guidelines for use with the fundamental canons
of ethics when analyzing appropriate action to be taken when confronted with ethical dilemmas. We currently use the ‘sophomore’
method for seniors because the sequencing is just beginning. Next year the seniors will do more indepth analysis of ethical
case studies.
An earlier version of this paper was presented at the Fourteenth Annual Meeting, Association for Practical and Professional
Ethics, February 24–27, 2005. 相似文献
236.
Nanotechnology — A new field of ethical inquiry? 总被引:2,自引:0,他引:2
Grunwald A 《Science and engineering ethics》2005,11(2):187-201
Parallel to the public discussion on the benefits and risks of nanotechnology, a debate on the ethics of nanotechnology has
begun. It has been postulated that a new “nano-ethics” is necessary. In this debate, the — positive as well as negative —
visionary and speculative innovations which are brought into connection with nanotechnology stand in the foreground. In this
contribution, an attempt is made to discover new ethical aspects of nanotechnology in a more systematic manner than has been
the case. It turns out that there are hardly any completely new ethical aspects raised by nanotechnology. It is much rather
primarily a case of gradual shifts of emphasis and of relevance in questions which, in principle, are already known and which
give reason for ethical discussions on nanotechnology. In a certain manner, structurally novel ethical aspects arise through
the important role played by visions in the public discourse. New questions are also posed by the fact that previously separate
lines of ethical reflection converge in the field of nanotechnology. The proposal of an independent “nano-ethics”, however,
seems exaggerated. 相似文献
237.
238.
The present essay offers a sketch of a philosophy of value, what I shall here refer to as ‘ethical instrumentalism.’ My primary
aim is to say just what this view involves and what its commitments are. In the course of doing so, I find it necessary to
distinguish this view from another with which it shares a common basis and which, in reference to its most influential proponent,
I refer to as ‘Humeanism.’ A second, more general, aim is to make plausible the idea that, given the common basis, ethical
instrumentalism provides a more compelling picture of the philosophy of value than Humeanism does. 相似文献
239.
The question of the morality of war is something of an embarrassment to liberal political thinkers. A philosophical tradition which aspires to found its preferred institutions in respect for individual autonomy, contract, and voluntary association, is naturally confronted by a phenomenon that is almost exclusively explained and justified in the language of States, force and territory. But the apparent difficulties involved in providing a convincing account of nature and ethics of war in terms of relations between individuals has not prevented liberal theorists from attempting this task. This paper examines a recent attempt by Igor Primoratz to sketch out the implications of a consistent liberalism for just war doctrine and, in particular, as regards the question of who may be a legitimate target of attack in wartime. Primoratz’s paper itself is a critique of Michael Waltzer’s authoritative exposition of just war theory for failing to be sufficiently and consistently liberal. The debate between these two authors is a productive site for investigating the potential and limitations of liberal theories of just war. 相似文献
240.
Buckle S 《Theoretical medicine and bioethics》2005,26(3):175-194
The paper begins by situating Singer within the British meta-ethical tradition. It sets out the main steps in his argument for utilitarianism as the ‘default setting’ of ethical thought. It argues that Singer’s argument depends on a hierarchy of reasons, such that the ethical viewpoint is understood to be an adaptation – an extension – of a fundamental self-interest. It concludes that the argument fails because it is impossible to get from this starting-point in self-interest to his conception of the ethical point of view. The fundamental problem is its mixing the immiscible: the Humean subordination of reason to interest with the Kantian conception of reason as universal and authoritative. 相似文献