Giovanni Boniolo

Fertility preservation in cancer patients: The global framework

Cancer treatment is the most frequent cause of reduced fertility in cancer patients, with up to 80% of survivors affected. None of the established or experimental fertility preservation methods can assure parenthood, rather they may provide a future opportunity to overcome treatment induced sterility. Around 70-75% of young cancer survivors are interested in parenthood but the numbers of patients who access fertility preservation techniques prior treatment are significantly lower. Moreover, despite existing guidelines, healthcare professionals do not address fertility preservation issues adequately. Lack of time and knowledge about existing options, delay in potentially useful treatment, patients age, partnership status, existing children, sexual orientation and socioeconomic situation are the main barriers to effective fertility preservation. Patients fears, expectations and priorities shaped by personal values have to be addressed in the framework of medical necessities, realistic survival probabilities, socio-cultural environment and resources availability. We call for a need of patient centred fertility counselling within a framework that should include patients understanding of medical aspects of their cancer, realistic fertility preservation options, preferences based on personal values and goals. Optional support services could also include legal guidance, psychological and spiritual support and financial counselling.

Evolutionary Ethics and Contemporary Biology

Introduction Giovanni Boniolo and Gabriele De Anna Part I. The Limits of Evolutionary Explanations and Justifications of Ethics: 1. Is Darwinian metaethics possible (and if it is, is it well taken)? Michael Ruse 2. The descent of instinct and the ascent of ethics Giovanni Boniolo Part II. Methodological Issues Concerning Evolutionary Accounts of Ethics: 3. Are human beings parts of the rest of nature? Christopher Lang, Elliot Sober and Karen Strier 4. The nature of resemblance, homologies in the nervous system, and behavior correspondence Aldo Fasolo Part III. How Biological Results Can Help Explaining Morally Relevant Human Capacities: 5. Genetic influences on moral capacity, what genetic mutants can teach us Giovanni Boniolo and Paolo Vezzoni 6. Evolutionary pharmacology, mental disorders, and ethical behaviour Stefano Canali, Gabriele De Anna and Luca Pani 7. The biology of human culture and ethics: an evolutionary perspective Stefano Parmigiani, Gabriele De Anna, Danilo Mainardi and Paola Palanza Part IV. How Biological Results Can Help Explain Moral Systems: 8. Biology to ethics: an evolutionists view of human nature Francisco Ayala 9. Between fragile altruism and morality: human evolution and the emergence of normative guidance Philip Kitcher 10. Will genomics do more for metaphysics than Locke? Alex Rosenberg Index.

Oocyte cryopreservation beyond cancer: tools for ethical reflection

PurposeThis article offers physicians a tool for structured ethical reflection on challenging situations surrounding oocyte cryopreservation in young healthy women.MethodsA systematic literature review offers a comprehensive overview of the ethical debate surrounding the practice. Ethical Counseling Methodology (ECM) offers a practical approach for addressing ethical uncertainties. ECM consists of seven steps: (i) case presentation; (ii) analysis of possible implications; (iii) presentation of ethical question(s); (iv) explanation of ethical terms; (v) presentation of the ethical arguments in favor of and against the procedure; (vi) examination of the individual patient’s beliefs and wishes; and (vii) conclusive summary.ResultsThe most problematic aspects in the ethical debate include the distinction between medical and non-medical use of oocyte cryopreservation, safety and efficiency of the procedure, and marketing practices aimed at healthy women. Female empowerment and enhanced reproductive choices (granted oocyte cryopreservation is a safe and efficient technique) are presented as ethical arguments supporting the practice, while ethical reservations towards oocyte cryopreservation are based on concerns about maternal and fetal safety and wider societal implications.ConclusionsOocyte cryopreservation is gaining popularity among healthy reproductive age women. However, despite promised benefits it also involves risks that are not always properly communicated in commercialized settings. ECM offers clinicians a tool for structured ethical analysis taking into consideration a wide range of implications, various ethical standpoints, and patients’ perceptions and beliefs.

Deliberation and Democracy

Where deliberative democracy is discussed and where it is recalled how it has been formulated in the contemporary debate and how this debate has failed to consider who (in particular Aristotle) discussed it previously.

Zsyntax: A formal language for molecular biology with projected applications in text mining and biological prediction

We propose a formal language that allows for transposing biological information precisely and rigorously into machine-readable information. This language, which we call Zsyntax (where Z stands for the Greek word ζωή, life), is grounded on a particular type of non-classical logic, and it can be used to write algorithms and computer programs. We present it as a first step towards a comprehensive formal language for molecular biology in which any biological process can be written and analyzed as a sort of logical “deduction”. Moreover, we illustrate the potential value of this language, both in the field of text mining and in that of biological prediction.

Libertarian paternalism and health care policy: a deliberative proposal

Cass Sunstein and Richard Thaler have been arguing for what they named libertarian paternalism (henceforth LP). Their proposal generated extensive debate as to how and whether LP might lead down a full-blown paternalistic slippery slope. LP has the indubitable merit of having hardwired the best of the empirical psychological and sociological evidence into public and private policy making. It is unclear, though, to what extent the implementation of policies so constructed could enhance the capability for the exercise of an autonomous citizenship. Sunstein and Thaler submit it that in most of the cases in which one is confronted with a set of choices, some default option must be picked out. In those cases whoever devises the features of the set of options ought to rank them according to the moral principle of non-maleficence and possibly to that of beneficence. In this paper we argue that LP can be better implemented if there is a preliminary deliberative debate among the stakeholders that elicits their preferences, and makes it possible to rationally defend them.

Rethinking Medical Humanities

This paper questions different conceptions of Medical Humanities in order to provide a clearer understanding of what they are and why they matter. Building upon former attempts, we defend a conception of Medical Humanities as a humanistic problem-based approach to medicine aiming at influencing its nature and practice. In particular, we discuss three main conceptual issues regarding the overall nature of this discipline: (i) a problem-driven approach to Medical Humanities; (ii) the need for an integration of Medical Humanities into medicine; (iii) the methodological requirements that could render Medical Humanities an effective framework for medical decision-making.

A logic of non-monotonic interactions

Article history: In this paper, which is part of the Zsyntax project outlined in Boniolo et al. (2010) (2) ,w e provide a proof-theoretical setting for the study of context-sensitive interactions by means of a non-monotonic conjunction operator. The resulting system is a non-associative variant of MLLpol (the multiplicative polarised fragment of Linear Logic) in which the monotonicity of interactions, depending on the context, is governed by specific devices called control sets. Following the spirit of Linear Logic, the ordinary sequent calculus presentation is also framed into a theory of proof-nets and the set of sequential proofs is shown to be sound and complete with respect to the class of corresponding proof-nets. Some possible biochemical applications are also discussed.

The four faces of omission

In this paper, the ontological, terminological, epistemological, and ethical aspects of omission are considered in a coherent and balanced framework, based on the idea that there are omissions which are actions and omissions which are non-actions. In particular, we suggest that the approach to causation which best deals with omission is Mackies INUS conditional proposal. We argue that omissions are determined partly by the ontological conditional structure of reality, and partly by the interests, beliefs, and values of observers. The final upshot is that moral judgments involved in cases of omissions cannot be grounded on, but are the ground for judgments about what INUS conditions count as omissions.

The Role of Mathematics in Physical Sciences and Dirac’s Methodological Revolution

In our paper, avoiding any strong metaphysical commitment on the world, we face the topic of the interplay between mathematics and physics by starting from a semiotic approach. It will be shown that it allows us to insert in a unitary and coherent framework answers to questions such as: Why mathematics is physics? What is the role of mathematics in physics? Why is mathematics effective in physical sciences? In the second part of the paper, and by utilizing what discussed in the first one, we analyse what we call Dirac’s methodological revolution, according to which to do good and new physics we must first work on good and promising mathematics. Finally, we exemplify Dirac’s methodological revolution by recalling the role of the mathematical theory of simple spinors in constructing new perspectives for theoretical physics.