Matching Items (3)
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- All Subjects: Medical Ethics
- All Subjects: Psychopaths
- Creators: Marchant, Gary
Description
ABSTRACT Whole genome sequencing (WGS) and whole exome sequencing (WES) are two comprehensive genomic tests which use next-generation sequencing technology to sequence most of the 3.2 billion base pairs in a human genome (WGS) or many of the estimated 22,000 protein-coding genes in the genome (WES). The promises offered from WGS/WES are: to identify suspected yet unidentified genetic diseases, to characterize the genomic mutations in a tumor to identify targeted therapeutic agents and, to predict future diseases with the hope of promoting disease prevention strategies and/or offering early treatment. Promises notwithstanding, sequencing a human genome presents several interrelated challenges: how to adequately analyze, interpret, store, reanalyze and apply an unprecedented amount of genomic data (with uncertain clinical utility) to patient care? In addition, genomic data has the potential to become integral for improving the medical care of an individual and their family, years after a genome is sequenced. Current informed consent protocols do not adequately address the unique challenges and complexities inherent to the process of WGS/WES. This dissertation constructs a novel informed consent process for individuals considering WGS/WES, capable of fulfilling both legal and ethical requirements of medical consent while addressing the intricacies of WGS/WES, ultimately resulting in a more effective consenting experience. To better understand components of an effective consenting experience, the first part of this dissertation traces the historical origin of the informed consent process to identify the motivations, rationales and institutional commitments that sustain our current consenting protocols for genetic testing. After understanding the underlying commitments that shape our current informed consent protocols, I discuss the effectiveness of the informed consent process from an ethical and legal standpoint. I illustrate how WGS/WES introduces new complexities to the informed consent process and assess whether informed consent protocols proposed for WGS/WES address these complexities. The last section of this dissertation describes a novel informed consent process for WGS/WES, constructed from the original ethical intent of informed consent, analysis of existing informed consent protocols, and my own observations as a genetic counselor for what constitutes an effective consenting experience.
ContributorsHunt, Katherine (Author) / Hurlbut, J. Benjamin (Thesis advisor) / Robert, Jason S. (Thesis advisor) / Maienschein, Jane (Committee member) / Northfelt, Donald W. (Committee member) / Marchant, Gary (Committee member) / Ellison, Karin (Committee member) / Arizona State University (Publisher)
Created2013
Description
Noninvasive prenatal testing using cell-free fetal DNA (CffDNA) testing is a rapidly developing area in prenatal diagnosis. Fetal genetic testing can occur with a simple maternal blood sample, since CffDNA can be found in maternal plasma. Thus, no harm is caused to mother or fetus to obtain this genetic information, providing significant benefits for those users. How the test should be integrated in existing prenatal programs has yet to be seen. CffDNA testing is an exciting technology and has attracted attention from many stakeholders, yet the lack of regulation and guidance has left legal, ethical, and social questions unanswered. This paper outlines a number of those issues expressed in the present literature on the matter.
ContributorsVeeder, Shaylynn Lee (Author) / Marchant, Gary (Thesis director) / Robert, Jason (Committee member) / Milleson, Valerye (Committee member) / Barrett, The Honors College (Contributor) / School of Social Transformation (Contributor) / School of Politics and Global Studies (Contributor) / Sandra Day O'Connor College of Law (Contributor) / Department of Psychology (Contributor)
Created2014-05
Description
This dissertation engages with the philosophical, psychological, and scientific literature on two important topics: empathy and human enhancement. My two broad goals are to clarify the role of empathy in ascriptions of responsibility and to consider how enhanced empathy might alter those ascriptions.
First, I argue that empathy is best thought of as a two-component process. The first component is what I call the rational component of empathy (RCE). RCE is necessary for moral responsibility as it allows us to put ourselves in another's shoes and to realize that we would want help (or not to be harmed) if we were in the other's place. The second component is what I call the emotive component of empathy (ECE). ECE is usually an automatic response to witnessing others in distress. Expanding on Michael Slote's view that moral distinctions track degrees of empathy, I argue that it is ECE that varies in strength depending on our relationship to specific people.
Second, I argue that in order to achieve Peter Singer's goal an "expanding circle" of care for all human beings, it will be necessary to use some form of artificial empathy enhancement. Within this context, I try to show that empathy enhancement is 1) a reasonably foreseeable possibility within the next decade or so, and 2) morally defensible.
Third, I argue that philosophers who argue that psychopaths are not morally responsible for their actions are mistaken. As I see it, these philosophers have erred in treating empathy as a singular concept and concluding that because psychopaths lack empathy they cannot be held morally responsible for their actions. The distinction between RCE and ECE allows us to say that psychopaths lack one component of empathy, ECE, but are still responsible for their actions because they clearly have a functional RCE.
Fourth, I paint a portrait of the landscape of responsibility with respect to the enhanced empath. I argue that the enhanced empath would be subject to an expanded sphere of special obligations such that acts that were previously supererogatory become, prima facie, morally obligatory.
First, I argue that empathy is best thought of as a two-component process. The first component is what I call the rational component of empathy (RCE). RCE is necessary for moral responsibility as it allows us to put ourselves in another's shoes and to realize that we would want help (or not to be harmed) if we were in the other's place. The second component is what I call the emotive component of empathy (ECE). ECE is usually an automatic response to witnessing others in distress. Expanding on Michael Slote's view that moral distinctions track degrees of empathy, I argue that it is ECE that varies in strength depending on our relationship to specific people.
Second, I argue that in order to achieve Peter Singer's goal an "expanding circle" of care for all human beings, it will be necessary to use some form of artificial empathy enhancement. Within this context, I try to show that empathy enhancement is 1) a reasonably foreseeable possibility within the next decade or so, and 2) morally defensible.
Third, I argue that philosophers who argue that psychopaths are not morally responsible for their actions are mistaken. As I see it, these philosophers have erred in treating empathy as a singular concept and concluding that because psychopaths lack empathy they cannot be held morally responsible for their actions. The distinction between RCE and ECE allows us to say that psychopaths lack one component of empathy, ECE, but are still responsible for their actions because they clearly have a functional RCE.
Fourth, I paint a portrait of the landscape of responsibility with respect to the enhanced empath. I argue that the enhanced empath would be subject to an expanded sphere of special obligations such that acts that were previously supererogatory become, prima facie, morally obligatory.
ContributorsGurney, David (Author) / McGregor, Joan (Thesis advisor) / Brake, Elizabeth (Committee member) / Marchant, Gary (Committee member) / Tsosie, Rebecca (Committee member) / Arizona State University (Publisher)
Created2016