Clinical whole-genome sequencing (WGS) promises to deliver faster diagnoses and lead to better management of care in the NICU. However,several disability rights advocates have expressed concern that clinical use of genetic technologies may reinforce and perpetuate stigmatization of and discrimination against disabled persons in medical and social contexts. There is growing need, then, for clinicians and bioethicists to consider how the clinical use of WGS in the newborn period might exacerbate such harms to persons with disabilities. This article explores ways to extend these concerns to clinical WGS in neonatal care. By considering these perspectives during the early phases of expanded use of WGS in the NICU, this article encourages clinicians and bioethicists to continue to reflect on ways to attend to the concerns of disability rights advocates, foster trust and cooperation between the medical and disability communities, and forestall some of the social harms clinical WGS might cause to persons with disabilities and their families.
Recent evolutionary perspectives on guilt tend to focus on how guilt functions as a means for the individual to self-regulate behavior and as a mechanism for reinforcing cooperative tendencies.While these accounts highlight important dimensions of guilt and provide important insights into its evolutionary emergence, they pay scant attention to the large empirical literature on its maladaptive effects on individuals. This paper considers the nature of guilt, explores its biological function, and provides an evolutionary perspective on whether it is an individual-level or group selected trait. After surveying philosophical and psychological analyses of guilt, we consider which psychological mechanisms underlie the capacity to experience and act from guilt and whether they point to an emergence of guilt in early humans or to guilt having a longer phylogenetic history. Because guilt is a distinctively social emotion, we then examine its contemporary role in social and legal contexts, which may provide clues to its original biological function. Finally, we provide the outlines of two evolutionary explanations for guilt. We argue that group selection may have promoted the capacity to experience guilt, but that under certain conditions there may have been a positive individual selection force as well.
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