On the child’s right to bodily integrity: when is the right infringed?

This article considers two competing types of conceptions of the pre-autonomous child's right to bodily integrity. The first, which I call encroachment conceptions, holds that any physically serious bodily encroachment infringes on the child's right to bodily integrity. The second, which I call best-interests conceptions, holds that the child's right to bodily integrity is infringed just in case the child is subjected to a bodily encroachment that substantially deviates from what is in the child's best interests. I argue in this article that best-interests conceptions are more plausible than encroachment conceptions. They have more attractive implications regarding the permissibility of interventions in children's bodies that are beneficial for the child but are not medically necessary. They are better able to explain the moral distinction between cases in which an encroachment on a child's body is needed to benefit that child and cases in which an encroachment on one child's body is needed to benefit another. Finally, best-interests conceptions are more consonant than encroachment conceptions with our understanding of adults' right to bodily integrity

The case for citizen duty

This article defends a novel type of institutionalized mass deliberation: Citizen Duty. Citizen Duty would legally require every citizen to engage in one day of diverse, moderated political deliberation prior to major elections. This deliberation would realize a variety of benefits, including wiser electoral decisions and a more respectful electoral process, while avoiding the dangers of citizen deliberation. A comparison with jury duty and with non- deliberative alternatives suggests that Citizen Duty’s substantial economic and liberty costs are justified. Finally, an examination of citizen attitudes towards politics and deliberation suggests that Citizen Duty is not as quixotic as it first appears

Libertarianism, left and right

This chapter explores the libertarian account of distributive justice. It explains the self-ownership thesis and then considers criticisms relating to indeterminacy, small incursions, and enforceable duties of assistance. It then turns to questions relating to natural resources, including whether they are initially owned, the conditions under which they may be appropriated, and the right vs left libertarian debate over whether or not they should ultimately be owned in an egalitarian manner. The chapter then lays out the libertarian account of just economic activity and considers criticisms based on the role of luck, the moral limits of markets, discrimination, paternalism, unjust prices, alternative notions of freedom, the plight of the desperately poor, and market failures. The chapter then concludes by raising important topics for future research, including the moral status of minors, future people, global justice, property rights in non-divisible natural resources, and rectificatory justice

Income redistribution, body-part redistribution, and respect for the separateness of persons

This article considers the question of why labor income may be permissibly redistributed to the poor but body parts should generally not be redistributed to the sick (the body-income puzzle). It argues that solutions to this puzzle that affirm self-ownership but reject labor-income ownership are unsuccessful as are solutions that appeal to the greater welfare loss associated with body-part takings. It defends instead a solution grounded in a novel conception of respect for the separateness of persons. This conception views the sphere of individual moral authority protected by respect for the separateness of persons as encompassing both the person’s body and her labor income. And it views the negative rights that constitute this sphere as varying in strength based on their importance to the right-holder’s personal identity. Since our body parts are generally more intimately connected to our personal identity compared with moderate portions of our labor income, our separateness-based rights against the taking of our body parts are stronger. Thus, while the disadvantaged’s weighty claims to assistance can justify substantial redistribution of labor income, these claims to assistance are insufficiently robust to justify seizing even non-essential parts of others’ bodies

On the strength of children's right to bodily integrity: the case of circumcision

This article considers the question of how much weight the infringement of children's right to bodily integrity should be given compared with competing considerations. It utilises the example of circumcision to explore this question, taking as given this practice's opponents' view of circumcision's harmfulness. The article argues that the child's claim against being subjected to (presumably harmful) circumcision is neither a mere interest nor a right so strong that it trumps all competing interests. Instead, it is a right of moderate strength. Indeed, even the aggregate strength of children's rights against the practice of (presumably harmful) circumcision as a whole is not so weighty so as to always trump competing interests. The harms are not sufficiently serious to justify such a status. And the expressive wrongs associated with non-negligently benevolent harming are much less serious than those associated with intentional harming. The debate over banning circumcision thus cannot be conducted only in terms of competing rights. Competing interests, such as those that would be set back by the departure of religious citizens, should be considered as well and might plausibly justify allowing even a rights-infringing practice to continue

Can liberal egalitarians protect the occupational freedom of the economically talented?

This article considers and ultimately rejects three prominent liberal egalitarian strategies for safeguarding the occupational freedom of the economically talented. First, Dworkinian concerns regarding the envy of the talented for the less talented are shown to be insufficient to rule out occupationally coercive taxation. Second, Rawlsian arguments about the priority of basic liberties in general and freedom of occupation in particular are shown to be unsuccessful, primarily because Rawls lacks the theoretical resources to protect freedom of occupation as a basic liberty. Finally, concerns about the practical difficulty and moral undesirability of gathering the information necessary to implement occupationally coercive taxation are shown to be insufficient to rule out such taxation. The aim of the article is not to lead liberal egalitarians to reject freedom of occupation. Rather, the aim is to highlight the difficulties in protecting freedom of occupation and to motivate work on alternative liberal egalitarian strategies for safeguarding this important economic liberty. At the end of the article, a hypothesis is put forward for why occupationally coercive taxation should be rejected that appeals to the prohibition on using people as means

Glioma Through the Looking GLASS: Molecular Evolution of Diffuse Gliomas and the Glioma Longitudinal AnalySiS Consortium

Adult diffuse gliomas are a diverse group of brain neoplasms that inflict a high emotional toll on patients and their families. The Cancer Genome Atlas (TCGA) and similar projects have provided a comprehensive understanding of the somatic alterations and molecular subtypes of glioma at diagnosis. However, gliomas undergo significant cellular and molecular evolution during disease progression. We review the current knowledge on the genomic and epigenetic abnormalities in primary tumors and after disease recurrence, highlight the gaps in the literature, and elaborate on the need for a new multi-institutional effort to bridge these knowledge gaps and how the Glioma Longitudinal AnalySiS Consortium (GLASS) aims to systemically catalog the longitudinal changes in gliomas. The GLASS initiative will provide essential insights into the evolution of glioma toward a lethal phenotype, with the potential to reveal targetable vulnerabilities, and ultimately, improved outcomes for a patient population in need

A changing of the garden: evaluating the performance and ecosystem functionality of alternative oyster garden structures in residential waterways

Oyster gardening, in which hanging oyster recruitment substrates are suspended from docks, has become an increasingly common and accessible technique for coastal communities to support local oyster populations for biodiversity enhancement, habitat restoration, and ecological functions including water filtration. However, little research has been done to evaluate materials and methods for oyster garden structures regarding cost, ease of assembly, durability, and ecosystem benefits, making it difficult to scale up efforts and maximize project success and sustainability. We conducted a field experiment in a residential canal system on Sanibel Island, Florida where we deployed a variety of oyster garden structure types to evaluate their performance in oyster recruitment, durability, water filtration rate, and biodiversity. Additionally, the occurrence of Hurricane Ian during the deployment provided an opportunity to evaluate how these structures resisted severe storm events. We tested a total of five structures: (1) a conventional design made of drilled oyster shell on steel wire (shell structures); and four alternatives, (2) GROW concrete discs (disc structures); (3) jute fiber coated with calcium sulfoaluminate cement (jute structures); (4) BESE biodegradable plastic matrix panels (BESE matrix panel structures); and (5) BESE biodegradable plastic mesh bags filled with oyster cultch (bag structures). All structures survived Hurricane Ian; however, both BESE structure types ultimately disintegrated without recruiting oysters. Disc, jute, and shell wire structures demonstrated similarly high levels of durability, oyster recruitment and growth, and biofiltration. Thus, we conclude that structure type selection may be based on material and labor availability and whether cost and biodegradability are prioritized. We show that oyster gardening can provide ecosystem services, including biofiltration, in residential canal sites that have lost “natural” shoreline morphology. Investments in oyster gardening are low risk in the face of natural hazards, supporting the use of the practice in storm-prone areas. However, residential canals are prone to adverse water quality, including low dissolved oxygen, which we show may undermine oyster survival and growth in certain cases; location and season thus need to be considered for garden deployment. Our results reveal material options for providing sustainability, durability, oyster recruitment, and biodiversity for oyster gardening projects while minimizing adverse environmental impacts

Immune Reconstitution Profiling Suggests Antiviral Protection after Transplantation with Omidubicel : A Phase 3 Substudy

Allogeneic hematopoietic cell transplantation (HCT) is a potentially curative treatment for hematologic malignancies and nonmalignant disorders. Rapid immune reconstitution (IR) following allogeneic HCT has been shown to be associated with improved clinical outcomes and lower infection rates. A global phase 3 trial (ClinicalTrials.gov NCT02730299) of omidubicel, an advanced cell therapy manufactured from an appropriately HLA-matched single umbilical cord blood (UCB) unit, showed faster hematopoietic recovery, reduced rates of infection, and shorter hospitalizations in patients randomized to omidubicel compared with those randomized to standard UCB. This optional, prospective substudy of the global phase 3 trial characterized the IR kinetics following HCT with omidubicel compared with UCB in a systematic and detailed manner. This substudy included 37 patients from 14 global sites (omidubicel, n = 17; UCB, n = 20). Peripheral blood samples were collected at 10 predefined time points from 7 to 365 days post-HCT. Flow cytometry immunophenotyping, T cell receptor excision circle quantification, and T cell receptor sequencing were used to evaluate the longitudinal IR kinetics post-transplantation and their association with clinical outcomes. Patient characteristics in the 2 comparator cohorts were overall statistically similar except for age and total body irradiation (TBI)-based conditioning regimens. The median patient age was 30 years (range, 13 to 62 years) for recipients of omidubicel and 43 years (range, 19 to 55 years) for UCB recipients. A TBI-based conditioning regimen was used in 47% of omidubicel recipients and in 70% of UCB recipients. Graft characteristics differed in their cellular composition. Omidubicel recipients received a 33-fold higher median dose of CD34 stem cells and one-third of the median CD3 lymphocyte dose infused to UCB recipients. Compared with UCB recipients, omidubicel recipients exhibited faster IR of all measured lymphoid and myelomonocytic subpopulations, predominantly in the first 14 days post-transplantation. This effect involved circulating natural killer (NK) cells, helper T (Th) cells, monocytes, and dendritic cells, with superior long-term B cell recovery from day +28. At 1 week post-HCT, omidubicel recipients exhibited 4.1- and 7.7 -fold increases in the median Th cell and NK cell counts, respectively, compared to UCB recipients. By 3 weeks post-HCT, omidubicel recipients were 3-fold more likely to achieve clinically relevant Th cell and NK cell counts ≥100 cells/µL. Similar to UCB, omidubicel yielded a balanced cellular subpopulation composition and diverse T cell receptor repertoire in both the short term and the long term. Omidubicel's CD34 cell content correlated with faster IR by day +7 post-HCT, which in turn coincided with earlier hematopoietic recovery. Finally, early NK and Th cell reconstitution correlated with a decreased rate of post-HCT viral infections, suggesting a plausible explanation for this phenomenon among omidubicel recipients in the phase 3 study. Our findings suggest that omidubicel efficiently promotes IR across multiple immune cells, including CD4 T cells, B cells, NK cells, and dendritic cell subtypes as early as 7 days post-transplantation, potentially endowing recipients of omidubicel with early protective immunity

Healthcare Reform and the Next Generation: United States Medical Student Attitudes toward the Patient Protection and Affordable Care Act

CONTEXT: Over one year after passage of the Patient Protection and Affordable Care Act (PPACA), legislators, healthcare experts, physicians, and the general public continue to debate the implications of the law and its repeal. The PPACA will have a significant impact on future physicians, yet medical student perspectives on the legislation have not been well documented. OBJECTIVE: To evaluate medical students' understanding of and attitudes toward healthcare reform and the PPACA including issues of quality, access and cost. DESIGN, SETTING, AND PARTICIPANTS: An anonymous electronic survey was sent to medical students at 10 medical schools (total of 6982 students) between October-December 2010, with 1232 students responding and a response rate of 18%. MAIN OUTCOME MEASURES: Medical students' views and attitudes regarding the PPACA and related topics, measured with Likert scale and open response items. RESULTS: Of medical students surveyed, 94.8% agreed that the existing United States healthcare system needs to be reformed, 31.4% believed the PPACA will improve healthcare quality, while 20.9% disagreed and almost half (47.7%) were unsure if quality will be improved. Two thirds (67.6%) believed that the PPACA will increase access, 6.5% disagreed and the remaining 25.9% were unsure. With regard to containing healthcare costs, 45.4% of participants indicated that they are unsure if the provisions of the PPACA will do so. Overall, 80.1% of respondents indicated that they support the PPACA, and 78.3% also indicated that they did not feel that reform efforts had gone far enough. A majority of respondents (58.8%) opposed repeal of the PPACA, while 15.0% supported repeal, and 26.1% were undecided. CONCLUSION: The overwhelming majority of medical students recognized healthcare reform is needed and expressed support for the PPACA but echoed concerns about whether it will address issues of quality or cost containment