Enjeux éthiques des nouvelles technologies de la reproduction : une conception de la justice à l'interface de l'éthique du "care" et de l'approche des "capabilités"

L'émergence des nouvelles technologies de la reproduction (NTR) est allée de pair avec un certain nombre de discours. Un discours promettant d'une part une extension de la palette de choix reproductifs des individus, une extension de leur liberté et de leur autonomie reproductives, dont la forme la plus extrême peut se traduire par la formule : un enfant quand je veux et comme je veux. D'autre part, un discours annonçant une série de « catastrophes » à venir, telles que l'effondrement de l'institution de la famille et la modification de l'espèce humaine. En d'autres termes, une tension entre promesses et catastrophes qui place les sociétés contemporaines face à de nombreux défis sociaux, politiques et éthiques, notamment quant à la question de la régulation de la PMA (procréation médicalement assistée) : qui peut y avoir accès ? Quelles techniques doit-on autoriser ? Ou au contraire limiter ? Tant de questions auxquelles aucune réponse simple et évidente n'existe. La diversité des réponses législatives quant à ces questions illustre cette complexité. L'éthique peut, ici, jouer un rôle fondamental. Sans toutefois prétendre donner des réponses toutes faites et facilement applicables, elle offre un espace de réflexion, le privilège de prendre une certaine distance face à des enjeux contemporains. C'est dans cette perspective que nous avons ancré ce travail de recherche en questionnant les enjeux éthiques de la PMA à partir d'une perspective de justice. Toutefois, au sein des études en bioéthique, majoritairement issues de la tradition libérale, la tension énoncée précédemment mène la bioéthique à justifier un certain nombre d'inégalités plutôt que de veiller à les dépasser. Ainsi, une évaluation de la pratique de la PMA à partir d'une perspective de la justice, exige, au préalable, une réévaluation du concept même de justice. Ce faisant, par une articulation entre l'éthique du care de Joan Tronto et l'approche des capabilités de Martha Nussbaum qui placent la vulnérabilité au coeur de la personne, nous avons proposé une conception de la justice fondée sur une anthropologie de la vulnérabilité. Cette conception nous permet d'identifier, dans le cadre de la pratique de la PMA en Suisse et en partant de la loi sur la procréation assistée (LPMA), les constructions normatives qui mènent à la non-reconnaissance et, ce faisant, à la mise à l'écart, de certaines formes de vulnérabilité : une vulnérabilité générique et une vulnérabilité socio-économique. Traitant la question de la vulnérabilité générique principalement, nos analyses ont une incidence sur les conceptions de la famille, du bien de l'enfant, de la femme et de la nature, telles qu'elles sont actuellement véhiculées par une conception naturalisée de la PMA. Répondre aux vulnérabilités identifiées, en veillant à leur donner une place, signifie alors déplacer ces conceptions naturalisées, afin que les vulnérabilités soient intégrées aux pratiques sociales et que les exigences de justice soient ainsi remplies. - The emergence of assisted reproductive technologies (ART) came along with several discourses. On the one hand a discourse promising an extension of the individuals' reproductive choices, their procreative liberty and autonomy. On the other hand a discourse announced a series of disasters to come such as the collapse of the family institution and the modification of human kind. In other words, a growing tension appears between promises and disasters and contemporary societies are facing inevitable social, political and ethical challenges, in particular with regard to the issue of ART regulation: who has access? What procedures should be authorized? Which ones should be limited? These complex questions have no simple or obvious answers. The variety of legislative responses to these questions highlights complexity. Ethics can play a fundamental role, and without claiming to give simple answers, also offer a space for reflection as well as the privilege to distance itself with regard to contemporary issues. It is in this perspective that this study questions the ethical considerations of ART in a perspective of justice. However, in previous studies in bioethics mainly following a liberal tradition, previously mentioned tension has lead bioethics to justify some inequalities instead of trying to overcome them. As a consequence, evaluating practices of ART from a perspective of justice requires to first reevaluate the concept of justice itself. In doing so we offer a conception of justice founded on the anthropology of vulnerability. This conception draws on an articulation of the ethic of care of Joan Tronto and the capability approach of Martha Nussbaum, which places vulnerability at the center of the person. This conception allows us to identify, within the framework of ARTS in Switzerland and starting with the laws of medically assisted procreation (LPMA), some normative constructions. These constructions lead to the non-recognition and the disregard of some forms of vulnerability: a generic vulnerability as well as socio-economic counterpart. Focusing mainly on the issue of generic vulnerability, our analysis has implications for the conceptions of family, the best interests of the child, woman, and nature in the way they are defined in a naturalized conception of ART. Responding to such failures by taking into account these vulnerabilities thus means to move these conceptions in order for vulnerabilities to be integrated in social practices and requirements for justice to be fulfilled.

Detection of the movement of the humerus during daily activity.

A new ambulatory technique for qualitative and quantitative movement analysis of the humerus is presented. 3D gyroscopes attached on the humerus were used to recognize the movement of the arm and to classify it as flexion, abduction and internal/external rotations. The method was first validated in a laboratory setting and then tested on 31 healthy volunteer subjects while carrying the ambulatory system during 8 h of their daily life. For each recording, the periods of sitting, standing and walking during daily activity were detected using an inertial sensor attached on the chest. During each period of daily activity the type of arm movement (flexion, abduction, internal/external rotation) its velocity and frequency (number of movement/hour) were estimated. The results showed that during the whole daily activity and for each activity (i.e. walking, sitting and walking) the frequency of internal/external rotation was significantly higher while the frequency of abduction was the lowest (P < 0.009). In spite of higher number of flexion, abduction and internal/external rotation in the dominant arm, we have not observed in our population a significant difference with the non-dominant arm, implying that in healthy subjects the arm dominance does not lie considerably on the number of movements. As expected, the frequency of the movement increased from sitting to standing and from standing to walking, while we provide a quantitative value of this change during daily activity. This study provides preliminary evidence that this system is a useful tool for objectively assessing upper-limb activity during daily activity. The results obtained with the healthy population could be used as control data to evaluate arm movement of patients with shoulder diseases during daily activity.

Extracellular protease and phospholipase C are controlled by the global regulatory gene gacA in the biocontrol strain Pseudomonas fluorescens CHA0.

Pseudomonas fluorescens strain CHA0 protects plants from various root diseases. Antibiotic metabolites synthesized by this strain play an important role in disease suppression; their production is mediated by the global activator gene gacA. Here we show by complementation that the gacA gene is also essential for the expression of two extracellular enzymes in P. fluorescens CHA0: phospholipase C and a 47-kDa metalloprotease. In contrast, the production of another exoenzyme, lipase, is not regulated by the gacA gene. Protease, phospholipase and antibiotics of P. fluorescens are all known to be optimally produced at the end of exponential growth; thus, the gacA gene appears to be a general stationary-phase regulator.

How robust are global conservation priorities to climate change?

International conservation organisations have identified priority areas for biodiversity conservation. These global-scale prioritisations affect the distribution of funds for conservation interventions. As each organisation has a different focus, each prioritisation scheme is determined by different decision criteria and the resultant priority areas vary considerably. However, little is known about how the priority areas will respond to the impacts of climate change. In this paper, we examined the robustness of eight global-scale prioritisations to climate change under various climate predictions from seven global circulation models. We developed a novel metric of the climate stability for 803 ecoregions based on a recently introduced method to estimate the overlap of climate envelopes. The relationships between the decision criteria and the robustness of the global prioritisation schemes were statistically examined. We found that decision criteria related to level of endemism and landscape fragmentation were strongly correlated with areas predicted to be robust to a changing climate. Hence, policies that prioritise intact areas due to the likely cost efficiency, and assumptions related to the potential to mitigate the impacts of climate change, require further examination. Our findings will help determine where additional management is required to enable biodiversity to adapt to the impacts of climate change

Global and local connectivity changes in schizophrenia investigated by diffusion connectome

Background: New ways of representing diffusion data emerged recently and achieved to create structural connectivitymaps in healthy brains (Hagmann P et al. (2008)). These maps have the capacity to study alterations over the entire brain at the connection and network level. This is of high interest in complex disconnection diseases like schizophrenia. In this Pathology where multiple lines of evidence suggest the association of the pathology with abnormalities in neural circuitry and impaired structural connectivity, the diffusion imaging has been widely applied. Despite the large findings, most of the research using the diffusion just uses some scalar map derived from diffusion to show that some markers of white matter integrity are diminished in several areas of the brain (Kyriakopoulos M et al (2008)). Thanks to the structural connectionmatrix constructed by the whole brain tractography, we report in this work the network connectivity alterations in the schizophrenic patients. Methods: We investigated 13 schizophrenic patients as assessed by the DIGS (Diagnostic Interview for genetic studies, DSM IV criteria) and 13 healthy controls. We have got from each volunteer a DT-MRI as well as Qball imaging dataset and a high resolution anatomic T1 performed during the same session; with a 3 T clinical MRI scanner. The controls were matched on age, gender, handedness, and parental social economic-status. For all the subjects, a low resolution connection matrix is obtained by dividing the cortex into 66 gyral based ROIs. A higher resolution matrix is constructed using 250 ROIs as described in Hagmann P et al. (2008). These ROIs are respectively used jointly with the diffusion tractography to construct the high and low resolution densities connection matrices for each subject. In a first step the matrices of the groups are compared in term of connectivity, and not in term of density to check if the pathological group shows a loss of global connectivity. In this context the density connection matrices were binarized. As some local connectivity changes were also suspected, especially in frontal and temporal areas, we have also looked for the areas where the connectivity showed significant changes. Results: The statistical analysis revealed a significant loss of global connectivity in the schizophrenic's brains at level 5%. Furthermore, by constructing specific statistics which represent local connectivity within the anatomical regions (66 ROIs) using the data obtained by the finest resolution (250 ROIs) to improve the robustness, we found the regions that cause this significant loss of connectivity. The significance is observed after multiple testing corrections by the False Discovery Rate. Discussion: The detected regions are almost the same as those reported in the literature as the involved regions in schizophrenia. Most of the connectivity decreases are noted in both hemispheres in the fronto-frontal and temporo-temporal regions as well as some temporal ROIs with their adjacent ROIs in parietal and occipital lobes.

Rates and pattern of evolution among Cretaceous radiolarians: relations with global paleoceanographic events

We present a new approach for analyzing the turnover rates of Cretaceous radiolarians recorded in pelagic sequences of western Tethys, The analysis of major extinction-radiation events and the fluctuation of diversity are compared with major paleoceanographic events and variation of diversity in dinoflagellates, calcareous nannoplankton and ammonites. There is an extraordinary correlation between biotic changes and sea level changes, temperatures, O, C and Sr isotopes, phosphorus accumulation rates and anoxic episodes. This reveals a predominantly abiotic control on the evolution of radiolarians. The rate of turnover and the diversity through time of two major orders of radiolarians (nassellarians and spumellarians) exhibits (1) the quasi-parallelism of their diversity curves, excluding a direct competition between them, (2) greater resistance of spumellarians to extinction during the early stage of extinction intervals and (3) a stronger post-extinction recovery of nassellarians. Evolutionary rates of radiolarians can be a good means of monitoring global environmental changes and allowing us to understand more clearly the relationship between plankton evolution, climate and pale oceanographic processes.

The prosecution service function within the spanish criminal justice system

The Spanish judicial system is independent and headed by the Supreme Court. Spain has a civil law system. The criminal procedure is governed by the legality principle--by opposition to the opportunity or expediency principle--which implies that prosecution must take place in all cases in which sufficient evidence exists of guilt. Traditionally, the role of the PPS in Spain has been very limited during the investigative stage of the process. That stage is under the responsibility of the Examining Magistrate (EM). Since the end of the 1980s, a series of modifications has been introduced in order to extend the functions of the PPS. In 1988, the PPS received extended competences which allow them to receive reports of offenses. Upon knowing of an offense (reported or known to have been committed), the PPS can initiate the criminal proceeding. The PPS is also allowed to lead a sort of plea bargain under a series of restrictive conditions and only for some offenses. At the same time, the PPS received extended competences in the juvenile justice criminal proceeding in 2000. With all this said, the role of the PPS has not changed radically and, during the investigative stage of the process, their main role remains the presentation of the accusation, playing a more active role during the trial stage of the proceeding. In this article the national criminal justice system of Spain is described. Special attention is paid to the function of the PPS within this framework and its relationship to police and courts. The article refers to legal provisions and the factual handling of criminal cases.

Suicide after successful deep brain stimulation for movement disorders.

The authors observed a high rate of suicide (6/140 patients, 4.3%) in a large cohort of patients with movement disorders treated with deep brain stimulation (DBS). Apparent risk factors included a previous history of severe depression and multiple successive DBS surgeries, whereas there was no relationship with the underlying condition, DBS target, electrical parameters, or modifications of treatment. Paradoxically, all patients experienced an excellent motor outcome following the procedure. The authors propose that patients at high risk for suicide should be excluded from DBS surgery.

A convex optimization framework for global tractography

In this article we present a novel approach for diffusion MRI global tractography. Our formulation models the signal in each voxel as a linear combination of fiber-tract basis func- tions, which consist of a comprehensive set of plausible fiber tracts that are locally compatible with the measured MR signal. This large dictionary of candidate fibers is directly estimated from the data and, subsequently, efficient convex optimization techniques are used for recovering the smallest subset globally best fitting the measured signal. Experimen- tal results conducted on a realistic phantom demonstrate that our approach significantly reduces the computational cost of global tractography while still attaining a reconstruction quality at least as good as the state-of-the-art global methods.

Global GacA-steered control of cyanide and exoprotease production in Pseudomonas fluorescens involves specific ribosome binding sites.

The conserved two-component regulatory system GacS/GacA determines the expression of extracellular products and virulence factors in a variety of Gram-negative bacteria. In the biocontrol strain CHA0 of Pseudomonas fluorescens, the response regulator GacA is essential for the synthesis of extracellular protease (AprA) and secondary metabolites including hydrogen cyanide. GacA was found to exert its control on the hydrogen cyanide biosynthetic genes (hcnABC) and on the aprA gene indirectly via a posttranscriptional mechanism. Expression of a translational hcnA'-'lacZ fusion was GacA-dependent whereas a transcriptional hcnA-lacZ fusion was not. A distinct recognition site overlapping with the ribosome binding site appears to be primordial for GacA-steered regulation. GacA-dependence could be conferred to the Escherichia coli lacZ mRNA by a 3-bp substitution in the ribosome binding site. The gene coding for the global translational repressor RsmA of P. fluorescens was cloned. RsmA overexpression mimicked partial loss of GacA function and involved the same recognition site, suggesting that RsmA is a downstream regulatory element of the GacA control cascade. Mutational inactivation of the chromosomal rsmA gene partially suppressed a gacS defect. Thus, a central, GacA-dependent switch from primary to secondary metabolism may operate at the level of translation.