18 results
The effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management programme in primary school children: results of the STARS cluster randomised controlled trial
- Tamsin Ford, Rachel Hayes, Sarah Byford, Vanessa Edwards, Malcolm Fletcher, Stuart Logan, Brahm Norwich, Will Pritchard, Kate Allen, Matthew Allwood, Poushali Ganguli, Katie Grimes, Lorraine Hansford, Bryony Longdon, Shelley Norman, Anna Price, Obioha C. Ukoumunne
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- Journal:
- Psychological Medicine / Volume 49 / Issue 5 / April 2019
- Published online by Cambridge University Press:
- 18 July 2018, pp. 828-842
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Background
We evaluated the effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management (TCM) programme as a universal intervention, given schools’ important influence on child mental health.
MethodsA two-arm, pragmatic, parallel group, superiority, cluster randomised controlled trial recruited three cohorts of schools (clusters) between 2012 and 2014, randomising them to TCM (intervention) or Teaching As Usual (TAU-control). TCM was delivered to teachers in six whole-day sessions, spread over 6 months. Schools and teachers were not masked to allocation. The primary outcome was teacher-reported Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score. Random effects linear regression and marginal logistic regression models using Generalised Estimating Equations were used to analyse the outcomes. Trial registration: ISRCTN84130388.
ResultsEighty schools (2075 children) were enrolled; 40 (1037 children) to TCM and 40 (1038 children) to TAU. Outcome data were collected at 9, 18, and 30-months for 96, 89, and 85% of children, respectively. The intervention reduced the SDQ-Total Difficulties score at 9 months (mean (s.d.):5.5 (5.4) in TCM v. 6.2 (6.2) in TAU; adjusted mean difference = −1.0; 95% CI−1.9 to −0.1; p = 0.03) but this did not persist at 18 or 30 months. Cost-effectiveness analysis suggested that TCM may be cost-effective compared with TAU at 30-months, but this result was associated with uncertainty so no firm conclusions can be drawn. A priori subgroup analyses suggested TCM is more effective for children with poor mental health.
ConclusionsTCM provided a small, short-term improvement to children's mental health particularly for children who are already struggling.
13 - When does human life begin? A theological, philosophical and scientific analysis
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- By Norman Ford, Catholic Theological College, Joanne Grainger, Australian Catholic University
- Jãnis T. Ozoliņš, Australian Catholic University, North Sydney, Joanne Grainger, Australian Catholic University, North Sydney
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- Foundations of Healthcare Ethics
- Published online:
- 21 June 2018
- Print publication:
- 08 April 2015, pp 213-227
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Summary
At the heart of many contemporary healthcare ethical debates is the question of when does human life begin. In February 2012, the prestigious Journal of Medical Ethics published an article titled ‘After birth abortion: Why should the baby live?’ by Australian ethicists Alberto Giubilini and Francesca Minerva (2012). This controversial article affirmed the authors’ position that ‘after-birth abortion’ should be morally permissible in all cases where abortion is also permissible, including cases where the newborn is not disabled. Following its publication, the large portion of international responses to the article vehemently opposed the moral premises articulated by the authors that essentially supported infanticide. However, such a controversial premise is not new in historical or ethical discourse. Infanticide – the intentional killing of an infant by the mother – has been a part of many cultural practices over the centuries, from ancient Sparta to the more recent practice of intentionally killing newborn infants due to economic, cultural or social pressures placed on mothers and families. In 1988, Australian ethicists Helga Kuhse and Peter Singer also presented the argument that infanticide may be ethically justifiable in their book Should the Baby Live? The Problem of Handicapped Infants. A theological, philosophical and scientific analysis of the question of when human life begins can present some accord, but with contemporary ethical discourse from healthcare ethicists such as Kuhse and Singer (1988, 1990), Giubilini and Minerva (2012) and Julian Savulescu, there is an increasing divergence on what was once a universally accepted norm: that human life has moral inviolability from conception. This chapter will explore this issue by presenting some of the contemporary views, including theological, philosophical and scientific perspectives, as well as the cultural and historical influences on the question of when does human life begin. A particular focus to this discussion will be from a Christian anthropological framework, with an emphasis on the moral teachings of the Catholic Church.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. Douglas Meeks, Monica Jyotsna Melanchthon, Ilie Melniciuc-Puica, Everett Mendoza, Raymond A. Mentzer, William W. Menzies, Ina Merdjanova, Franziska Metzger, Constant J. Mews, Marvin Meyer, Carol Meyers, Vasile Mihoc, Gunner Bjerg Mikkelsen, Maria Inêz de Castro Millen, Clyde Lee Miller, Bonnie J. Miller-McLemore, Alexander Mirkovic, Paul Misner, Nozomu Miyahira, R. W. L. Moberly, Gerald Moede, Aloo Osotsi Mojola, Sunanda Mongia, Rebeca Montemayor, James Moore, Roger E. Moore, Craig E. Morrison O.Carm, Jeffry H. Morrison, Keith Morrison, Wilson J. Moses, Tefetso Henry Mothibe, Mokgethi Motlhabi, Fulata Moyo, Henry Mugabe, Jesse Ndwiga Kanyua Mugambi, Peggy Mulambya-Kabonde, Robert Bruce Mullin, Pamela Mullins Reaves, Saskia Murk Jansen, Heleen L. Murre-Van den Berg, Augustine Musopole, Isaac M. T. Mwase, Philomena Mwaura, Cecilia Nahnfeldt, Anne Nasimiyu Wasike, Carmiña Navia Velasco, Thulani Ndlazi, Alexander Negrov, James B. Nelson, David G. Newcombe, Carol Newsom, Helen J. Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. Stewart, Cynthia Stokes Brown, Ken Stone, Anne Stott, Elizabeth Stuart, Monya Stubbs, Marjorie Hewitt Suchocki, David Kwang-sun Suh, Scott W. Sunquist, Keith Suter, Douglas Sweeney, Charles H. Talbert, Shawqi N. Talia, Elsa Tamez, Joseph B. Tamney, Jonathan Y. Tan, Yak-Hwee Tan, Kathryn Tanner, Feiya Tao, Elizabeth S. Tapia, Aquiline Tarimo, Claire Taylor, Mark Lewis Taylor, Bishop Abba Samuel Wolde Tekestebirhan, Eugene TeSelle, M. Thomas Thangaraj, David R. Thomas, Andrew Thornley, Scott Thumma, Marcelo Timotheo da Costa, George E. “Tink” Tinker, Ola Tjørhom, Karen Jo Torjesen, Iain R. Torrance, Fernando Torres-Londoño, Archbishop Demetrios [Trakatellis], Marit Trelstad, Christine Trevett, Phyllis Trible, Johannes Tromp, Paul Turner, Robert G. Tuttle, Archbishop Desmond Tutu, Peter Tyler, Anders Tyrberg, Justin Ukpong, Javier Ulloa, Camillus Umoh, Kristi Upson-Saia, Martina Urban, Monica Uribe, Elochukwu Eugene Uzukwu, Richard Vaggione, Gabriel Vahanian, Paul Valliere, T. J. Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- The Cambridge Dictionary of Christianity
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When Did I Begin?
- Conception of the Human Individual in History, Philosophy and Science
- Norman Ford
- Foreword by Mary Warnock
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- 03 February 2010
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- 01 December 1988
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When Did I Begin? investigates the theoretical, moral and biological issues surrounding the debate over the beginning of human life. With the continuing controversy over the use of in vitro fertilization techniques and experimentation with human embryos, these issues have been forced into the arena of public debate. The answer to the question, 'When did I begin?' draws on both scientific evidence, and on the philosophical concepts of the presence of the human individaul. As a leading theologian and moral philosopher, thoroughly conversant with modern embryology, Norman Ford, a Salesian priest, is well qualified to bridge the gap between the biological and philosophical point of view. Dr Ford argues that a human individual could not begin before definitive individuation occurs with the appearance of the primative streak about two weeks after fertilisation. While he does not specifically address any moral issues regarding the treatment of human embryos, the author views reading of this book as an essential prerequisite for such moral considerations. The implications of Dr Ford's answer to the question posed in the title will be crucially important for fully evaluating such problems as embryo experimentation and contraception, for a range of readers from embryologists and physicians to moral philosophers and theologians. The book has already stimulated considerable interest and debate, and is now available in paperback for the first time.
Notes
- Norman Ford
- Foreword by Mary Warnock
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- When Did I Begin?
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1 - Introduction
- Norman Ford
- Foreword by Mary Warnock
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- When Did I Begin?
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Summary
Interest in the beginning of the human individual: the purpose of this book
From time immemorial, people have been fascinated about the origin of the human race. Ancient myths abound. The Genesis story of Adam and Eve is known well enough. That is how the Bible represents the beginning of the human race through the direct creative intervention of God. If all we knew was that God created man and woman with the same human nature, we ourselves might not do much better than the author of Genesis when it came to depicting how this might have happened.
The theory of evolution presented a challenge to science as well as to the imagination when it was a question of explaining exactly how the first humans appeared on earth. A greater challenge was presented to philosophers and theologians when, without prejudice to their belief in the creation of the soul, they had to explain how, in pre-historic times, animal life could have been transformed into human life, a human being, a Homo. The term hominization was coined to refer to this process. The enormous leap beyond animal consciousness to typical human rational self-consciousness could only have occurred in virtue of the presence and functioning of a rational life-principle or soul. It is the soul that constitutes matter into a living human individual. Being animated by such a spiritual soul would have sufficed to change a form of animal life into a human being. Signs of this newly acquired, reflective self-awareness would have provided sufficient empirical evidence to convince any reasonable observer that the momentous change of hominization had occurred.
2 - Historical influence of Aristotle on the theory of human reproduction
- Norman Ford
- Foreword by Mary Warnock
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- When Did I Begin?
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Why a return to Aristotle?
Aristotle was not only the greatest Greek biologist and philosopher, but also the most influential in our Western civilization. For about two thousand years, since his death in 322 B.C., his teachings have formed our traditional understanding of the origin of the individual human being. From the middle of the seventeenth century his views had been on the decline. Recently, however, there has been a revival of his theory in favour of delaying the origin of the individual human being for some weeks after conception.
This is a welcome revival for a variety of reasons. Aristotle knew how to harmonize his vast empirical observations, acquired as a naturalist and biologist, with the requirements of a philosophical interpretation of the same. There is no opposition between the facts as they were known in his day and his metaphysical categories and principles. His philosophy represents one of the best examples of common-sense realism. He did not merely observe developing parts and organs in a living creature – he interpreted them philosophically as parts and organs of one developing living being. Children know that an arm is not a leg. They also know that both an arm and a leg are equally parts of the one developing individual being. The viewpoints of biology, philosophy and ordinary experience are quite compatible – they should be seen as mutually complementing each other. Not every kind of philosophy is capable of succeeding here. The Aristotelian philosophical conceptual framework facilitates the formation of an integrated perspective.
Scientists have learnt from history to appreciate the evolutionary model of thinking for their own disciplines, society and the world at large.
5 - Implantation and the beginning of the human individual
- Norman Ford
- Foreword by Mary Warnock
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- When Did I Begin?
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- 03 February 2010
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- 01 December 1988, pp 132-163
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It is now necessary to examine the stages of embryonic development after fertilization to see when the human individual begins. This will be done by way of exclusion by attempting to establish the last stage, or time, prior to which it would appear impossible, or at least implausible, for a human individual to be present in an ontological sense. In the following pages I shall first consider why it would seem that the individual human person could not be present during the early cleavage stage before the formation of the morula. In this section I will further discuss the implications of identical twinning for the beginning of the human individual, even though identical twinning can occur beyond this stage right up until implantation is almost completed. Arguments will then be presented that favour delaying hominization, or the formation of the human individual, beyond compaction and the morula stage. Next I will consider the relevance of naturally occurring short-lived parthenogenetic development that probably does occasionally occur in the human species. Finally, I shall examine evidence that suggests that the human individual could not actually exist before the formation of the blastocyst and its successful implantation in the womb about 13 days after fertilization.
The human individual not present during the early cleavage stage
Possibility of identical twinning during the early cleavage stage
It is important to bear in mind that the development of eutherian mammalian embryos differs quite significantly from that of amphibians. Of crucial importance for the former is the prior formation of extra-embryonic tissues and membranes (e.g. placenta), whereas the latter have no such need.
Preface
- Norman Ford
- Foreword by Mary Warnock
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Why did I write this book?
As a lecturer in moral philosophy and in the philosophy of the human person, it has always been important for me to know when a human person begins. In cases of rape it was necessary to know how long after the attack it was morally permissible to attempt to prevent a human embryo originating as a result of violence. This knowledge was crucial in differentiating morally between actions that prevented conception and those whose effect was really abortifacient. It became more pressing for me to be sure of my grounds on this issue once the freezing of human embryos began in some programmes of in vitro fertilization. Community debates in the media on the moral status of the human embryo convinced me of the necessity to inquire further into this question. Living in Melbourne provided the motivation and opportunities to learn the relevant scientific facts of early human embryology for a proper philosophical consideration of the question.
I had always believed, and taught for over 15 years, the commonly held traditional view that a human person begins once the process of fertilization is completed, i.e. once the pronuclei of the sperm and egg mix together. This gives rise to a single-cell human embryo, a zygote, whose genetic individuality and uniqueness remain unchanged during normal development. From that point on, cell divisions and differentiation are programmed for the organization and growth of the same developing human individual already present in the zygote.
Foreword
- Norman Ford
- Foreword by Mary Warnock
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- Book:
- When Did I Begin?
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- 01 December 1988, pp ix-x
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Summary
It is a pleasure and a privilege to introduce Norman Ford's book. When I was chairman of the Committee of Enquiry on Human Fertilisation and Embryology, which reported in 1984, I tried hard to deter members of the Committee from asking the question When does Life Begin?. I thought it an ambiguous and misleading question. The answers to it could be unhelpfully various. Eggs, sperm, even individual cells, could all be said to be human and alive. As I saw it, we had to concentrate on the question when human life becomes morally and legally important. When do we have to ensure that human embryos are given the full protection of the law? At what stage in the development of the embryo should it be a criminal offence to use it for purposes of research? These were the pragmatic questions we tried to answer, in order to give advice to future legislators.
Norman Ford, in contrast, insists on raising the question when does an individual human being come into existence. He is interested in, and learned about, the old enigma of ‘ensoulment’. But he is determined that the answers to such questions must be based on knowledge. He therefore examines the development of the human embryo immediately after fertilisation, using the knowledge that embryology now gives us.
As long as there is a possibility of two embryos, or none, developing from the loose conglomeration of cells that forms from the fertilised egg, he is not prepared to regard this conglomeration as a single entity.
4 - Fertilization and the beginning of a human individual
- Norman Ford
- Foreword by Mary Warnock
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- When Did I Begin?
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- 03 February 2010
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- 01 December 1988, pp 102-131
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Summary
Having established that a human being must be both an ontological individual and a living ontological individual, it now remains to reflect philosophically on the relevant scientific evidence to determine when these two criteria are first satisfied in the species Homo sapiens. It would be wise to begin with a brief review of the pertinent biological facts from fertilization onwards. There is broad agreement amongst embryologists concerning these facts. Disagreements arise among both biologists and philosophers when it comes to interpreting the scientific data in relation to the beginning of a new human individual.
Fertilization
At fertilization there begins a new, genetically unique, living individual, when the sperm and the ovum lose their separate individualities to form a single living cell, a zygote. Fertilization is not a momentary event but a process that may last up to 20–24 hours, beginning with the first contact of the sperm with the plasma membrane of the secondary oocyte (ovum) and finishing with the mixing of the maternal and paternal chromosomes (syngamy) to constitute the zygote. After the process of fertilization is completed the ovum becomes the single–cell pre-implanted zygote prior to its first mitotic division (cleavage) into two smaller identical daughter cells. The term ‘zygote’ is sometimes used to refer to the product of conception for a few days or even a fortnight. In this book I shall use ‘zygote’ to refer only to the diploid cell that results from the completion of fertilization.
Each spermatozoon and ovum is an individual, a living cell, distinct from the mother and father. In due time, these separate individuals fuse to form the fertilized ovum.
Appendixes
- Norman Ford
- Foreword by Mary Warnock
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- When Did I Begin?
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- 01 December 1988, pp 183-186
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Caption for Appendixes I, II, III
Development of an ovarian follicle containing an oocyte, ovulation, and the phases of the menstral cycle are illustrated. Development begins at fertilization, about 14 days after the onset of the last menstruation. Cleavage of the zygote in the uterine tube, implantation of the blastocyst, and early development of the embryo are also shown. The main features of developmental stages in human embryos are illustrated. (From K. Moore, The Developing Human: Clinically Oriented Embryology. Philadelphia: W. B. Saunders, 3rd edn, 1982, with slight modifications from colour to black and white.)
Glossary
- Norman Ford
- Foreword by Mary Warnock
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- When Did I Begin?
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3 - Criteria for being a human individual
- Norman Ford
- Foreword by Mary Warnock
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- When Did I Begin?
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- 01 December 1988, pp 65-101
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Ordinary knowledge of human individuals
Our knowledge of things in the world is at first global and generic before progressing to become more specific. Most of our ordinary knowledge is expressed by predicating something of an object. This is usually called the logical subject. Thus when I say ‘The cat is black’, I know something about ‘the cat’ that is the logical subject of the statement. The logical subject refers to something that exists in the world of experience of the speaker. This ability to refer to something as really given in our world is the simplest form of knowledge that we have, e.g. ‘The cat .…’ Admittedly, this sort of knowledge does not tell us very much unless we say something else, i.e. predicate something about it thereby expanding our knowledge of it. If we can only refer to something and are unable to know anything more about it, we can say that it is there or here. For example, ‘There's a cat’ or ‘A cat is here’ or, at least, ‘Something is here’.
The knowledge involved in our ability to refer to an object is indeed imperfect, but it is knowledge of a sort that serves as a starting point for acquiring more knowledge about it. Our ability to refer to things is the launching pad for all our further intellectual explorations. Crucial to the building up of knowledge is our ability to differentiate between the various objects encountered in our experience. This enables them to become the logical subjects of our thoughts without running the risk of constant confusion. In ordinary discourse we say something about what we refer to or talk about.
Index
- Norman Ford
- Foreword by Mary Warnock
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- When Did I Begin?
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- 01 December 1988, pp 214-217
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Contents
- Norman Ford
- Foreword by Mary Warnock
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- When Did I Begin?
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- 01 December 1988, pp v-viii
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6 - The human individual begins after implantation
- Norman Ford
- Foreword by Mary Warnock
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- When Did I Begin?
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- 01 December 1988, pp 164-182
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Distinctive development of eutherian mammalian embryos
The use of experimental methods to increase knowledge of the early stages of eutherian mammalian development had to wait until the middle of the twentieth century. Mammals are viviparous and consequently their embryos could not survive for long outside the uterine environment until the techniques of tissue culture became available. Much progress has been made over the last 30 years. Perhaps in the future it will become possible for a mouse embryo to develop to term artificially outside the womb. For the present, early mammalian embryology might better be termed ‘pre-embryology’ since it concentrates more on the formation of the extraembryonic membranes. These develop during the preimplantation stage and provide support and nutrition for the embryo proper that is only formed subsequently. The case of amphibian embryos is quite different because they do not need extraembryonic membranes, the placenta in particular. It has been relatively easy to study their developmental stages from the start right through to term. Accordingly, it would be quite misleading to apply to the development of eutherian mammalian embryos what properly applies only to amphibian embryos.
Regionalization and symmetry begin soon after fertilization in monospermic amphibians like frogs and toads. The grey crescent appears in the animal pole opposite the point of entry of the sperm and marks the future dorsal side of the amphibian. The first cleavage is vertical and divides the egg into right and left halves. The next cleavage is at right-angles to the first and separates the ventral and dorsal halves.
Frontmatter
- Norman Ford
- Foreword by Mary Warnock
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- When Did I Begin?
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- 01 December 1988, pp i-iv
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