Bioethics 

About: Bioethics is an academic journal published by Wiley-Blackwell. The journal publishes majorly in the area(s): Bioethics & Medicine. It has an ISSN identifier of 0269-9702. Over the lifetime, 2070 publications have been published receiving 40129 citations.

Some Methods for Strengthening the Common χ 2 Tests

Abstract: Since the x2 tests of goodness of fit and of association in contingency tables are presented in many courses on statistical methods for beginners in the subject, it is not surprising that x2 has become one of the most commonly-used techniques, even by scientists who profess only a smattering of knowledge of statistics. It is also not surprising that the technique is sometimes misused, e.g. by calculating x2 from data that are not frequencies or by errors in counting the number of degrees of freedom. A good catalogue of mistakes of this kind has been given by Lewis and Burke (1). In this paper I want to discuss two kinds of failure to make the best use of x2 tests which I have observed from time to time in reading reports of biological research. The first arises because x2 tests, as has often been pointed out, are not directed against any specific alternative to the null hypothesis. In the computation of x2, the deviations (fi mi) between observed and expected frequencies are squared, divided by mi in order to equalize the variances (approximately), and added. No attempt is made to detect any particular pattern of deviations (fi mi) that may hold if the null hypothesis is false. One consequence is that the usual x2 tests are often insensitive, and do not indicate significant results when the null hypothesis is actually false. Some forethought about the kind of alternative hypothesis that is likely to hold may lead to alternative tests that are more powerful and appropriate. Further, when the ordinary x2 test does give a significant result, it does not direct attention to the way in which the null hypothesis disagrees with the data, although the pattern of deviations may be informative and suggestive for future research. The remedy here is to supplement the ordinary test by additional tests that help to reveal the significant type of deviation. In this paper a number of methods for strengthening or supplementing the most common uses of the ordinary x2 test will be presented and illustrated by numerical examples. The principal devices are as follows:

Procreative beneficence: why we should select the best children.

Abstract: Eugenic selection of embryos is now possible by employing in vitro fertilization (IVF) and preimplantation genetic diagnosis (PGD). While PGD is currently being employed for the purposes of detecting chromosomal abnormalities or inherited genetic abnormalities, it could in principle be used to test any genetic trait such as hair colour or eye colour. Genetic research is rapidly progressing into the genetic basis of complex traits like intelligence and a gene has been identified for criminal behaviour in one family. Once the decision to have IVF is made, PGD has few 'costs' to couples, and people would be more inclined to use it to select less serious medical traits, such as a lower risk of developing Alzheimer Disease, or even for non-medical traits. PGD has already been used to select embryos of a desired gender in the absence of any history of sex-linked genetic disease. I will argue that: (1) some non-disease genes affect the likelihood of us leading the best life; (2) we have a reason to use information which is available about such genes in our reproductive decision-making; (3) couples should select embryos or fetuses which are most likely to have the best life, based on available genetic information, including information about non-disease genes. I will also argue that we should allow selection for non-disease genes even if this maintains or increases social inequality. I will focus on genes for intelligence and sex selection. I will defend a principle which I call Procreative Beneficence: couples (or single reproducers) should select the child, of the possible children they could have, who is expected to have the best life, or at least as good a life as the others, based on the relevant, available information.

In defense of posthuman dignity.

Abstract: Positions on the ethics of human enhancement technologies can be (crudely) characterized as ranging from transhumanism to bioconservatism. Transhumanists believe that human enhancement technologies should be made widely available, that individuals should have broad discretion over which of these technologies to apply to themselves, and that parents should normally have the right to choose enhancements for their children-to-be. Bioconservatives (whose ranks include such diverse writers as Leon Kass, Francis Fukuyama, George Annas, Wesley Smith, Jeremy Rifkin, and Bill McKibben) are generally opposed to the use of technology to modify human nature. A central idea in bioconservativism is that human enhancement technologies will undermine our human dignity. To forestall a slide down the slippery slope towards an ultimately debased 'posthuman' state, bioconservatives often argue for broad bans on otherwise promising human enhancements. This paper distinguishes two common fears about the posthuman and argues for the importance of a concept of dignity that is inclusive enough to also apply to many possible posthuman beings. Recognizing the possibility of posthuman dignity undercuts an important objection against human enhancement and removes a distortive double standard from our field of moral vision.

The Moral Obligation to Create Children with the Best Chance of the Best Life

Abstract: According to what we call the Principle of Procreative Beneficence (PB), couples who decide to have a child have a significant moral reason to select the child who, given his or her genetic endowment, can be expected to enjoy the most well-being. In the first part of this paper, we introduce PB, explain its content, grounds, and implications, and defend it against various objections. In the second part, we argue that PB is superior to competing principles of procreative selection such as that of procreative autonomy. In the third part of the paper, we consider the relation between PB and disability. We develop a revisionary account of disability, in which disability is a species of instrumental badness that is context- and person-relative. Although PB instructs us to aim to reduce disability in future children whenever possible, it does not privilege the normal. What matters is not whether future children meet certain biological or statistical norms, but what level of well-being they can be expected to have.

Vulnerability in research and health care; describing the elephant in the room?

Abstract: Despite broad agreement that the vulnerable have a claim to special protection, defining vulnerable persons or populations has proved more difficult than we would like. This is a theoretical as well as a practical problem, as it hinders both convincing justifications for this claim and the practical application of required protections. In this paper, I review consent-based, harm-based, and comprehensive definitions of vulnerability in healthcare and research with human subjects. Although current definitions are subject to critique, their underlying assumptions may be complementary. I propose that we should define vulnerability in research and healthcare as an identifiably increased likelihood of incurring additional or greater wrong. In order to identify the vulnerable, as well as the type of protection that they need, this definition requires that we start from the sorts of wrongs likely to occur and from identifiable increments in the likelihood, or to the likely degree, that these wrongs will occur. It is limited but appropriately so, as it only applies to special protection, not to any protection to which we have a valid claim. Using this definition would clarify that the normative force of claims for special protection does not rest with vulnerability itself, but with pre-existing claims when these are more likely to be denied. Such a clarification could help those who carry responsibility for the protection of vulnerable populations, such as Institutional Review Boards, to define the sort of protection required in a more targeted and effective manner.