50 research outputs found

    Mice lacking C1q or C3 show accelerated rejection of minor H disparate skin grafts and resistance to induction of tolerance

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    Complement activation is known to have deleterious effects on organ transplantation. On the other hand, the complement system is also known to have an important role in regulating immune responses. The balance between these two opposing effects is critical in the context of transplantation. Here, we report that female mice deficient in C1q (C1qa(−/−)) or C3 (C3(−/−)) reject male syngeneic grafts (HY incompatible) at an accelerated rate compared with WT mice. Intranasal HY peptide administration, which induces tolerance to syngeneic male grafts in WT mice, fails to induce tolerance in C1qa(−/−) or C3(−/−) mice. The rejection of the male grafts correlated with the presence of HY D(b)Uty-specific CD8(+) T cells. Consistent with this, peptide-treated C1qa(−/−) and C3(−/−) female mice rejecting male grafts exhibited more antigen-specific CD8(+)IFN-γ(+) and CD8(+)IL-10(+) cells compared with WT females. This suggests that accumulation of IFN-γ- and IL-10-producing T cells may play a key role in mediating the ongoing inflammatory process and graft rejection. Interestingly, within the tolerized male skin grafts of peptide-treated WT mice, IFN-γ, C1q and C3 mRNA levels were higher compared to control female grafts. These results suggest that C1q and C3 facilitate the induction of intranasal tolerance

    Educational and social inequalities and cause-specific mortality in Mexico City: a prospective study

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    Background: Social inequalities in adult mortality have been reported across diverse populations, but there is no largescale prospective evidence from Mexico. We aimed to quantify social, including educational, inequalities in mortality among adults in Mexico City. Methods: The Mexico City Prospective Study recruited 150 000 adults aged 35 years and older from two districts of Mexico City between 1998 and 2004. Participants were followed up until Jan 1, 2021 for cause-specific mortality. Cox regression analysis yielded rate ratios (RRs) for death at ages 35–74 years associated with education and examined, in exploratory analyses, the mediating effects of lifestyle and related risk factors. Findings: Among 143 478 participants aged 35–74 years, there was a strong inverse association of education with premature death. Compared with participants with tertiary education, after adjustment for age and sex, those with no education had about twice the mortality rate (RR 1·84; 95% CI 1·71–1·98), equivalent to approximately 6 years lower life expectancy, with an RR of 1·78 (1·67–1·90) among participants with incomplete primary, 1·62 (1·53–1·72) with complete primary, and 1·34 (1·25–1·42) with secondary education. Education was most strongly associated with death from renal disease and acute diabetic crises (RR 3·65; 95% CI 3·05–4·38 for no education vs tertiary education) and from infectious diseases (2·67; 2·00–3·56), but there was an apparent higher rate of death from all specific causes studied with lower education, with the exception of cancer for which there was little association. Lifestyle factors (ie, smoking, alcohol drinking, and leisure time physical activity) and related physiological correlates (ie, adiposity, diabetes, and blood pressure) accounted for about four-fifths of the association of education with premature mortality. Interpretation: In this Mexican population there were marked educational inequalities in premature adult mortality, which appeared to largely be accounted for by lifestyle and related risk factors. Effective interventions to reduce these risk factors could reduce inequalities and have a major impact on premature mortality. Funding: Wellcome Trust, the Mexican Health Ministry, the National Council of Science and Technology for Mexico, Cancer Research UK, British Heart Foundation, and the UK Medical Research Council Population Health Research Unit

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    Antibiotic Switch therapy is defined by the switch of intravenous antibiotic therapy to oral form. This research aimed to learn about the relationship of switch therapy toward the value of wound healing, lenght of stay and the antibiotic expenditure. The data of this cross sectional study was collected from medical record and by direct investigation to patients for their macroscopis the wound healings value. T-test was used to compared the relationship of the patient wound healings value, lenght of stay and the antibiotic expenditure between the those with and accurate switch therapy and those without it. The result showed that there was no different of wound healing value between those groups of patients (P>0,1). On the other hand, lenght of stay and antibiotic expenditure of the patient with the accurate switch therapy was cuted on the patient with the accurate switch therapy. These indicated that accuracy of switch therapy will proceed a benefit outcome to the patient with appendicitis, especially to there lenght of stay and antibiotic expenditure as well

    Developing an Observing Air–Sea Interactions Strategy (OASIS) for the global ocean

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    The Observing Air–Sea Interactions Strategy (OASIS) is a new United Nations Decade of Ocean Science for Sustainable Development programme working to develop a practical, integrated approach for observing air–sea interactions globally for improved Earth system (including ecosystem) forecasts, CO2 uptake assessments called for by the Paris Agreement, and invaluable surface ocean information for decision makers. Our “Theory of Change” relies upon leveraged multi-disciplinary activities, partnerships, and capacity strengthening. Recommendations from >40 OceanObs’19 community papers and a series of workshops have been consolidated into three interlinked Grand Ideas for creating #1: a globally distributed network of mobile air–sea observing platforms built around an expanded array of long-term time-series stations; #2: a satellite network, with high spatial and temporal resolution, optimized for measuring air–sea fluxes; and #3: improved representation of air–sea coupling in a hierarchy of Earth system models. OASIS activities are organized across five Theme Teams: (1) Observing Network Design & Model Improvement; (2) Partnership & Capacity Strengthening; (3) UN Decade OASIS Actions; (4) Best Practices & Interoperability Experiments; and (5) Findable–Accessible–Interoperable–Reusable (FAIR) models, data, and OASIS products. Stakeholders, including researchers, are actively recruited to participate in Theme Teams to help promote a predicted, safe, clean, healthy, resilient, and productive ocean.publishedVersio

    Developing an Observing Air–Sea Interactions Strategy (OASIS) for the global ocean

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    The Observing Air–Sea Interactions Strategy (OASIS) is a new United Nations Decade of Ocean Science for Sustainable Development programme working to develop a practical, integrated approach for observing air–sea interactions globally for improved Earth system (including ecosystem) forecasts, CO2 uptake assessments called for by the Paris Agreement, and invaluable surface ocean information for decision makers. Our “Theory of Change” relies upon leveraged multi-disciplinary activities, partnerships, and capacity strengthening. Recommendations from >40 OceanObs’19 community papers and a series of workshops have been consolidated into three interlinked Grand Ideas for creating #1: a globally distributed network of mobile air–sea observing platforms built around an expanded array of long-term time-series stations; #2: a satellite network, with high spatial and temporal resolution, optimized for measuring air–sea fluxes; and #3: improved representation of air–sea coupling in a hierarchy of Earth system models. OASIS activities are organized across five Theme Teams: (1) Observing Network Design & Model Improvement; (2) Partnership & Capacity Strengthening; (3) UN Decade OASIS Actions; (4) Best Practices & Interoperability Experiments; and (5) Findable–Accessible–Interoperable–Reusable (FAIR) models, data, and OASIS products. Stakeholders, including researchers, are actively recruited to participate in Theme Teams to help promote a predicted, safe, clean, healthy, resilient, and productive ocean

    Ocean carbon from space: Current status and priorities for the next decade

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    This is the final version. Available on open access from Elsevier via the DOI in this recordData availability: Data for Fig. 1a were generated from a free Scopus (https://www.scopus.com/) search of the terms "Ocean carbon satellite" (using All fields) in March 2022. Data from Fig. 1b and 1c were generated from the workshop registration and are available within the figure (participation number, geographical representation and gender split).The ocean plays a central role in modulating the Earth’s carbon cycle. Monitoring how the ocean carbon cycle is changing is fundamental to managing climate change. Satellite remote sensing is currently our best tool for viewing the ocean surface globally and systematically, at high spatial and temporal resolutions, and the past few decades have seen an exponential growth in studies utilising satellite data for ocean carbon research. Satellite-based observations must be combined with in-situ observations and models, to obtain a comprehensive view of ocean carbon pools and fluxes. To help prioritise future research in this area, a workshop was organised that assembled leading experts working on the topic, from around the world, including remote-sensing scientists, field scientists and modellers, with the goal to articulate a collective view of the current status of ocean carbon research, identify gaps in knowledge, and formulate a scientific roadmap for the next decade, with an emphasis on evaluating where satellite remote sensing may contribute. A total of 449 scientists and stakeholders participated (with balanced gender representation), from North and South America, Europe, Asia, Africa, and Oceania. Sessions targeted both inorganic and organic pools of carbon in the ocean, in both dissolved and particulate form, as well as major fluxes of carbon between reservoirs (e.g., primary production) and at interfaces (e.g., air-sea and land–ocean). Extreme events, blue carbon and carbon budgeting were also key topics discussed. Emerging priorities identified include: expanding the networks and quality of in-situ observations; improved satellite retrievals; improved uncertainty quantification; improved understanding of vertical distributions; integration with models; improved techniques to bridge spatial and temporal scales of the different data sources; and improved fundamental understanding of the ocean carbon cycle, and of the interactions among pools of carbon and light. We also report on priorities for the specific pools and fluxes studied, and highlight issues and concerns that arose during discussions, such as the need to consider the environmental impact of satellites or space activities; the role satellites can play in monitoring ocean carbon dioxide removal approaches; economic valuation of the satellite based information; to consider how satellites can contribute to monitoring cycles of other important climatically-relevant compounds and elements; to promote diversity and inclusivity in ocean carbon research; to bring together communities working on different aspects of planetary carbon; maximising use of international bodies; to follow an open science approach; to explore new and innovative ways to remotely monitor ocean carbon; and to harness quantum computing. Overall, this paper provides a comprehensive scientific roadmap for the next decade on how satellite remote sensing could help monitor the ocean carbon cycle, and its links to the other domains, such as terrestrial and atmosphere.European Space AgencySimons FoundationUK National Centre for Earth Observation (NCEO)UKRIAtlantic Meridional Transect ProgrammeSwiss National Science Foundatio

    n Postmoderne uitdaging aan die 'paradigmale biomediese etiek model' met verwysing na kompleksiteitsteorie

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    Thesis (MPhil)--University of Stellenbosch, 2002.ENGLISH ABSTRACT: Introduction From the postmodern ethical perspective [the postmodernist would say Jrom the ethical perspective], there is something suspicious and inherently unethical in a system of ethics supported by a comprehensive, cohesive and universal metanarrative, a set of fixed and unbending ethical rules and laws, without the ready possibility of revision [Cilliers, 1998, pp.114, 137-140; Cilliers, 2001, p. 3; Cilliers, 1995, p.125]. Based on the ideas of especially Winkler [1993, pp. 343-365] I have concluded that contemporary mainstream biomedical ethics, represented and directed by the work of Beauchamp and Childress [1994] are caught in such a crush. The primary objective of this assignment is to evaluate the 'principles' of biomedical ethics [respect Jar autonomy, beneficence, non-maleficence and justice] which were developed in their water-shed publication [Principles of Biomedical Ethics, Oxford University Press, first published in 1979, and now in a fifth edition, 2002] against a background of postmodern ethics. Methodology and conclusions I have argued that Beauchamp and Childress' conception of principlism is a contextual legalistic-philosophical response to the contemporary American situation, developed primarily from legal decisions [often litigation]. It may be regarded as acceptable practice guidelines, but represents a system of ethics without morality. I have given a concise rendering of Winkler's notion of context-based bioethics with the criticism that this also does not guarantee morality. Following that, there is a description of postmodern society in terms of complexity theory. I have indicated how the characteristics of complexity can be developed and applied contextually in bioethics. The postmodern moral society is the locus where morality develops in a non-controllable agonistic interactive process within which the postmodern moral agent unintentionally finds himself. The postmodern ethical position is not an unethical, come-as-you-may anything-goes position; it simply is not predictable, controllable, universal, rational [in a Kantian context] and eternal. Modernity, it can be argued exhibits a far greater degree of relativism. The postmodern ethical position represents a return to morality in ethics, morality of a very personal, face-to-face responsibility from which we as participants of society cannot hide. From a postmodern ethical perspective, an analysis of principlism and its underlying principles exhibits the characteristics of modernity: eternal moral rules which as such cannot be presented as morality. I have acknowleged Beauchamp and Childress' attempts at adding morality to their conception [in the 4th edition] by means of employing character ethics. They have nevertheless not made any radical changes in the format of their presentation and maintain the central and primary role of principles. I have also argued the limitations of the postmodern approach in terms of enclaves of strictly controlled modernity and artificial witholding of information in medicine which limit the free flow of information essential to the postmodern approach. My conception of complexity and the postmodern approach do not pretend to be a panacea for biomedical ethics. It attempts to redefine the meaning of morality in bioethics and questions the unbridled application of this conception of principIism. Finally I have discussed the burning issue of justice in the practice of medicine from the postmodern perspective. Do I as a person have a right to health care; what are the moral issues of dealing with 'life's lotteries'; what is the state's responsibility in health care, and: what are my personal responsibilities in health care? In contradistinction to libertarian concepts, the postmodern approach clearly argues in favour of the acceptance by the state of its role in health care [a responsibility abrogated in many societies, none more so than contemporary South-African society].AFRIKAANSE OPSOMMING: Inleiding Daar IS uit die perspektief van die postmoderne etiese standpunt [die postmodernis sou sê, uit die etiese perspektiej], iets verdags, iets inherent oneties aan 'n sisteem van etiek wat 'n enkele goed omskrewe, kohese en omvattende universele metanarratief voorhou, 'n stel vaste en onbuigsame etiese reëls en wette voorskryf en afdwing sonder om konteks en gevolge te oorweeg, en sonder die geredelike moontlikheid van revisie [Cilliers, 1998, pp.114, 137-140; Cilliers, 2001, p. 3; Cilliers, 1995, p.125]. Dit is, n.a.v. die denke van veral Winkler [1993, pp. 343-365] my oortuiging dat die hoofstroom-denke in biomediese etiek in so 'n drukgang vasgevang is, en verteenwoordig word en gerig is deur die denke van Beauchamp en Childress [1994]. Hierdie werkstuk gaan in hoofsaak daarom om Beauchamp en Childress se toepassing van die beginsels van biomediese etiek soos sedert 1979 in hul waterskeidingsboek 'Principles of Biomedical Ethics' [Vierde uitgawe, Oxford University Press, 1994; daar is nou ook 'n vyfde, 2002] uiteengesit, ontwikkel, bespreek en gepropageer [respek vir outonomie, weldadigheid, non-kwaadwilligheid en geregtigheid] teen die agtergrond van 'n postmoderne etiese beskouing te evalueer. Metodologie en gevolgtrekkings Ek het in hierdie werkstuk aangetoon dat Beauchamp en Childress se weergawe van prinsiplisme 'n kontekstuele wetlik-filosofiese reaksie op die kontemporêre Amerikaanse situasie is, hoofsaaklik uit regsaksie [dikwels litigasie] voortvloei, as goeie praktyksriglyne beredeneer kan word maar etiek sonder moraliteit verteenwoordig. Ek het 'n kort uiteensetting van Winkler se weergawe van 'n konteks-gebaseerde benadering gegee, maar aangetoon dat ook dit nie moraliteit waarborg nie. Daarop het ek 'n beskrywing van die postmoderne samelewing n.a.v. kompleksiteitsteorie gegee, en aangetoon hoe die eienskappe van kompleksiteit kontekstueelontwikkel kan word om in bioetiek toegepas te word. Die postmoderne gepostuleerde morele gemeenskap is die lokus waar moraliteit ontstaan deur 'n onbeheerbare agonistiese proses van interaktiewe wisselwerking waarby die postmoderne morele agent homself onwillekeurig betrokke vind. Die postmoderne etiese posisie is nie onetiese, lukraak, doen-soos-jy-wil relativisme nie; dit is bloot nie 'n voorspelbare, ewige, beheerbare, universele en [Kantiaans-] rasionele sisteem nie; moderniteit is [was?] in effek veel meer relativisties. Die postmoderne etiese standpunt verteenwoordig in my interpretasie 'n terugkeer tot moraliteit in etiek, moraliteit van 'n persoonlike, ingrypende, verantwoordelike aangesigtot- aangesig aard waaraan ons nie kan ontkom nie. Vanuit 'n postmoderne etiese perspektief het ek 'n analise van prinsiplisme en die individuele beginsels gemaak, en aangetoon dat hulle die eienskappe van die 'ewige morele reëls' van moderniteit openbaar en nie sonder meer as morele beredenering voorgehou kan word nie. Ek het erkenning gegee aan Beauchamp en Childress se eie pogings om dit te besweer deur karakteretiek as 'n essensiële tot hul formule toe te voeg, maar die kritiek uitgespreek dat hulle desnieteenstaande hierdie belangrike erkenning, nie bereid is om die formaat van hul aanbieding [ook in die jongste vyfde uitgawe, 2002] radikaal te wysig nie. Hulle oorbeklemtoon die beginsels steeds as sentraal en primêr. Terselfdertyd het ek die beperkings van die postmoderne benadering uitgelig, veral in terme van enklawes van streng-beheerde moderniteit in geneeskunde en 'n kunsmatige weerhouding van die vrye vloei van informasie wat kompleksiteit en die postmoderne situasie kenmerk. My konsepsie hou nie kompleksiteit en 'n postmoderne benadering voor as 'n panakeia vir biomediese etiek nie; dit dien eerder om die betekenis van moraliteit in bioetiek te herdefinieer en die kontemporêre algemene en ongekwalifseerde toepassing van hierdie weergawe van prinsiplisme te bevraagteken. Laastens het ek die brandende vraag van geregtigheid in die praktyk van geneeskunde vanuit 'n postmoderne perspektief bespreek, veral of ek as persoon kan aanspraak maak op 'n reg tot gesondheidsorg, die morele implikasies van 'life's lotteries', die staat se verantwoordelikheid in gesondheidsorg en les bes, persoonlike verantwoordelikheid in gesondheidsorg. Dit is duidelik dat 'n postmoderne benadering tot bioetiek, in teenstelling met libertêre konsepsies, die staat se rol in gesondheidsorg onderskryf ['n rol wat die staat byna universeel, en veral in Suid-Afrika, verwaarloos]

    Value, utility and autonomy : a moral-critical analysis of utilitarian positions on the value of prenatal life

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    Thesis (PhD)--University of Stellenbosch, 2005.ENGLISH ABSTRACT: Problem statement For utilitarians, human beings have intrinsic moral significance based on only two acquired characteristics: sentience, or the ability to suffer, and psychological personhood. Sentience is the entrance-requirement for moral significance, but does not justify a "right to life" claim; at most a "right" not to suffer. Personhood, described as some sort of self-conscious awareness with a concept of the future, may justify a "right to life" claim. However, since personhood is absent in prenatal beings, and only develops some time after birth, the implication is that such beings have little moral significance and may, for instance, be killed "at will". The moral problem that I address in this dissertation is to investigate, assess and evaluate the utilitarian position on the moral status or value of prenatal life. Methodology and results I firstly, on the basis of an extensive literature study, make a detailed analysis of the utilitarian position with reference to a number of themes that I have identified in their argument. This is followed by a critical philosophical evaluation of the utilitarian position, based on six particular arguments: • Utilitarianism is philosophically incoherent. It over-simplifies the moral argument in claiming that consequences are all that matter morally. Its underlying moral theory is at odds with moral claims contained in contemporary notions of human rights and individual justice. It ignores the moral significance of special obligations to special groups. • Utilitarianism potentially has unacceptable consequences. It IS inherently discriminatory and may lead to legitimate "slippery slope" fears. • Utilitarianism clashes with our fundamental moral intuitions on the value of prenatal life. These intuitions are cherished in most world religions. • Contrary to the utilitarian position, speciesism is inevitable to the human condition, especially argued from a position of existential phenomenology. Self- constitution, simultaneous constitution of the world as we know it, and the very possibility of morality are possible only within a particular notion of speciesism. • The potentiality of pre-persons to develop into persons cannot be as convincingly ignored as is done by the utilitarian. • There is a basic and underlying need and intuition to protect vulnerable human beings, of which pre-persons are exemplars. These notions clash with utilitarian theory. As an alternative, I introduce, set out and evaluate a two-phased position on the moral significance of pre-personal human life, a position of respectfulness of prenatal and pre-personal human life based upon its humanity, potentiality and separation-viability. This leads, firstly, to the conclusion of a graded, sliding scale conception of human prepersonal moral significance in line with the level of development and with the actuation of potentiality. Secondly, it leads to the conclusion that the advent of separationsurvivability (viability) is a morally significant cut-off point beyond which the human fetus may "normally" have a justifiable right to the continuation of its life. In as far as the application of my argument is concerned, I develop a "moderate" position with reference to the abortion debate. Whilst I recognize that all human prenatal beings of which it can be argued that they have a reasonable chance to develop their intrinsic potentiality, i.e., to become full-fledged persons, should have the opportunity to do so, I also recognize that neither this position, nor the complexities of life make it possible to hold "absolute" positions on the justifiability of abortion. I explore this extremely problematic notion in the text. That having been said, the advent of separation-survivability may imply a "moral cut-off point", beyond which termination is only rarely justified. I argue that I find no moral hindrance to wellmotivated research on human pre-embryos and stem cells.AFRIKAANSE OPSOMMING: Probleemstelling Utilitariste huldig sterk omlynde standpunte oor die waarde van lewe. Hulle redeneer dat menslike (inderwaarheid, alle lewende) wesens slegs op grond van twee eienskappe intrinsieke morele waarde kan verwerf: sentiëntisme, d.i. die vermoë om lyding te ervaar, en persoonstatus. Sentiëntisme is 'n bepalende vereiste vir morele status, maar regverdig nie 'n "reg op lewe"-aanspraak nie. Persoonsyn, verstaan as 'n vorm van selfbewustheid tesame met 'n bewuste belang by die voortsetting van eie bestaan, mag wel so 'n aanspraak regverdig. Voorgeboortelike (en "voorpersoonlike") wesens is egter nie persone nie; hulle word eers (aansienlik) ná geboorte volwaardige persone. Die implikasie is dat sulke wesens weinig morele status het, en byvoorbeeld, na willekeur gedood mag word. Die morele probleem wat ek in hierdie dissertasie aanspreek is om die utilitaristiese beskouing ten opsigte van die morale status of waarde van voorgeboortelike lewe krities-filosofies te ondersoek en te evalueer. Metodologie en gevolgtrekkings Eerstens maak ek na aanleiding van 'n gedetaileerde literatuurstudie 'n in-diepte analise van van die utilitaristiese posisie aan die hand van 'n aantal temas wat ek in hul argument geïdentifiseer het. Daarna volg 'n krities-filosofiese evaluasie van die utilitaristiese posisie, aan die hand van ses argumente: • Utilitarisme is filosofies onsamehangend. Dit oorvereenvoudig die morele argument deur voor te gee dat gevolge al is wat moreel saakmaak. Die onderliggende utilitaristiese teorie bots met die morele eise vervat in kontemporêre sienings van menseregte en geregtigheid. Dit negeer die morele belangrikheid van spesiale verpligtinge teenoor spesiale belangegroepe. • Utilitarisme het potensieelonaanvaarbare gevolge. Dit IS inherent diskriminerend en kan lei tot onkeerbare glybaan ("slippery slope")-argumente. Utilitarisme bots met ons fundamentele morele intuïsies betreffende die waarde van voorgeboortelike lewe. Hierdie intuïsies word onder meer ondersteun deur die meeste hoofstroom godsdienste. • Spesiësisme is, in kontras met die utilitaristiese beskouing, onafwendbaar vir ons selfverstaan as mense, soos aangetoon kan word met 'n beroep op die eksistensiële fenomenologie. Self-konstituering, gelyktydige konstituering van die wêreld van die mens, en selfs die moontlikheid van moraliteit is slegs moontlik vanuit' n bepaalde spesiësistiese beskouing. • Die potensialiteit van "pre-persone" om tot volwaardige persone te ontwikkel kan nie, soos die utilitaris doen, sonder meer geïgnoreer word nie. • Daar is 'n basiese en onderliggende morele eis om swak en weerlose menslike wesens te beskerm. Hierdie idees bots lynreg met utilitaristiese teorie. As 'n alternatief tot die utilitaristiese beskouing, ontwikkel ek 'n twee-fase posisie betreffende die morele waarde van voorgeboortelike menslike lewe. Ek noem hierdie posisie agting vir voorgeboortelike en voor-persoonlike menslike lewe gebaseer op die menslikheid, potensialiteit en oorleefbaarheid van prenatale mense. Dit lei, eerstens, tot die gevolgtrekking van 'n gegradeerde glyskaal konsepsie van voor-persoonlike menslike morele waarde, min of meer parallel aan die vlak van ontwikkeling en die ontwikkeling van potensialiteit. Tweedens lei dit tot die gevolgtrekking dat die ontwikkeling van lewensvatbaarheid 'n moreel-beduidende afsnypunt is waarna die menslike fetus "normaalweg" aanspraak kan maak op 'n reg dat sy lewe voortgesit moet word. In soverre dit die toepassing van my argument betref, ontwikkel ek 'n "gematigde" posisie vis-á-vis aborsie. Ek redeneer dat alle menslike voorgeboortelike wesens wat 'n redelike kans het dat hul intrinsieke potensialiteit verder sal ontwikkel, die geleentheid daartoe gegun behoort te word. Ek aanvaar ook dat nog hierdie beskouing, nog die kompleksiteit van die menslike bestaan "absolute" posisies moreel regverdig. Die problematiek en inherente spanning tussen hierdie oënskynlik-opponerende posisies word in die teks bespreek. Nogtans beskou ek die ontwikkeling van lewensvatbaarheid as 'n moreel insiggewende afsnypunt waarna terminasie net in buitengewone omstandighede moreel regverdigbaar is
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