Abstract Context: Established in 1997, Summa Health System’s Medical Ethics Committee (EC) serves as an educational, supportive, and consultative resource to patients/families and providers, and serves to analyze, clarify, and ameliorate dilemmas in clinical care. In 2009 the EC conducted its 100th consult. In 2002 a Palliative Care Consult Service (PCCS) was established to provide supportive services for patients/families facing advanced illness; enhance clinical decision-making during crisis; and improve pain/symptom management. How these services affect one another has thus far been (...) unclear. Objectives: This study describes EC consults: types, reasons, recommendations and utilization, and investigates the impact the PCCS may have on EC consult requests or recommendations. Methods: Retrospective reviews of 100 EC records explored trends and changes in types of consults, reasons for consults, and EC recommendations and utilization. Results: There were 50 EC consults each in the 6 years pre- and post-PCCS. Differences found include: (1) a decrease in number of reasons for consult requests (133–62); (2) changes in top two reasons for EC consult requests from ‘Family opposed to withdrawing life-sustaining treatment (LST)’ and ‘Patient capacity in question’ to ‘Futility’ and ‘Physician opposed to providing LST’; (3) changes in top two recommendations given by the EC from ‘Emotional Support for Patient/Family’ and ‘Initiate DNR Order’ to ‘Comfort Care’ and ‘Withdraw Treatment.’ Overall, 88% of recommendations were followed. Conclusion: PCCS availability and growth throughout the hospital may have influenced EC consult requests. EC consults regarding family opposition to withdrawing LST and EC recommendations for patient/family support declined. Content Type Journal Article Pages 1-16 DOI 10.1007/s10730-011-9170-9 Authors Jessica Richmond Moeller, Department of Psychiatry and Behavioral Sciences, Akron General Medical Center, 400 Wabash Ave, Akron, OH 44307, USA Teresa H. Albanese, Health Services Research and Education Institute, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Kimberly Garchar, Kent State University, 6000 Frank Ave., N.W, North Canton, OH 44720, USA Julie M. Aultman, Department of Family and Community Medicine, Northeast Ohio Medical University, P.O. Box 95, Rootstown, OH 44272, USA Steven Radwany, Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Dean Frate, Internal Medicine, Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737. (shrink)

This book investigates the metaphysical position of dual-aspect monism, with particular emphasis on the concept of meaning as a fundamental feature of the fabric of reality.

We focus here on some familiar kinds of cases of conflict between friendship and morality, and, on the basis of our account of the nature of friendship, argue for the following two claims: first, that in some cases where we are led morally astray by virtue of a relationship that makes its own demands on us, the relationship in question is properly called a friendship; second, that relationships of this kind are valuable in their own right.

Proof-theoretic reflection principles are schemas which attempt to express the soundness of arithmetical theories within their own language, e.g., ${\mathtt{{Prov}_{\mathsf {PA}} \rightarrow \varphi }}$ can be understood to assert that any statement provable in Peano arithmetic is true. It has been repeatedly suggested that justification for such principles follows directly from acceptance of an arithmetical theory $\mathsf {T}$ or indirectly in virtue of their derivability in certain truth-theoretic extensions thereof. This paper challenges this consensus by exploring relationships between reflection principles (...) and principles of mathematical and transfinite induction as well as the status of the latter with respect to various foundational characterizations of number theory. (shrink)

This paper argues that common social narratives about unhealthy eaters can cause significant damage to agency. I identify and analyze a narrative that combines a “control model” of eating agency with the healthist assumption that health is the ultimate end of eating. I argue that this narrative produces and enables four types of damage to the agency of those identified as unhealthy eaters. Due to uncertainty about what counts as healthy eating and various forms of prejudice, the unhealthy eater label (...) and its harms to agency are more likely to stick to some people than others and may reinforce patterns of oppression. I argue that fat people are especially vulnerable to this identification and the damage it can do. I then consider possible “counterstories” about unhealthy eaters, alternative narratives that might be less damaging to agency than the control narrative. I identify one promising counterstory but suggest that it may be limited when it comes to repairing damage to the agency of fat people. Overall, this paper illustrates some of the complex ways that healthism about eating affects agency, and emphasizes the ethical importance of the ways we think about and discuss eating and eaters. (shrink)

We present a formal system, E, which provides a faithful model of the proofs in Euclid's Elements, including the use of diagrammatic reasoning.

The tension between external forces for better ethics in organizations, represented by legislation such as the Sarbanes–Oxley Act (SOX), and the call for internal forces represented by increased educational coverage, has never been as apparent. This study examines business school faculty attitudes about recent corporate ethics lapses, including opinions about root causes, potential solutions, and ethics coverage in their courses. In assessing root causes, faculty point to a failure of systems such as legal/professional and management (external) and declining personal values (...) (internal). We also found that faculty recommend external forces as a remedy more often than increased ethics educational coverage; we contextualize this finding with recent ethics education literature. We conclude by proposing that neither legislation nor ethics education alone are complete when addressing widespread unethical corporate acts and offer a multi-faceted approach to ethics educational opportunities. (shrink)

This conceptual paper presents a radical humanist framing of the relationship between human needs and social welfare. It draws and develops its conceptualisation of radical humanism from the early philosophical writings of Marx in which he identified the radical constitutive needs of the human species. It seeks to translate the definitive characteristics of humanity's ‘species being’ – namely consciousness, ‘work’, sociality and historical development – into overarching claims or social rights to autonomous thinking, creative activity, mutual caring and human progress. (...) It argues for a ‘needs-first ethos’ from within which critically to evaluate welfare policy and practice, and through which to conceptualise approaches that humanise rather than dehumanise. (shrink)

This volume provides a vital student resource: a collection of the essential classic and contemporary readings in metaphysics.

Newborn infants are among those most severely affected by humanitarian crises. Aid organisations increasingly recognise the necessity to provide for the medical needs of newborns, however, this may generate distinctive ethical questions for those providing humanitarian medical care. Medical ethical approaches to neonatal care familiar in other settings may not be appropriate given the diversity and volatility of humanitarian disasters, and the extreme resource limitations commonly faced by humanitarian aid missions.In this paper, we first systematically review existing guidelines relating to (...) the treatment and resuscitation of newborns in humanitarian crises, finding little substantive ethical guidance for those providing humanitarian healthcare. We next draw on paradigm cases and published literature to identify and describe some of the major ethical questions common to these settings. We divide these questions into quality of life considerations, allocation of limited resources, and conflicting cultural norms and values. We finally suggest some preliminary recommendations to guide ethical decision‐making around resuscitation of newborns and withdrawal of treatment in humanitarian settings. (shrink)

If humans have an evolved moral psychology, then we should not expect it to function in an identical way between individuals. Instead, we should expect a diversity in the function of our moral psychology between individuals that varies along genetic lines, and a corresponding diversity of moral attitudes and moral judgements that emerge from it. This is because there was no one psychological type that would reliably produce adaptive social behaviour in the highly heterogeneous environments in which our minds evolved. (...) As such, there was no single psychological type towards which evolution could gravitate. Instead we evolved a stable polymorphism of psychological types, maintained by frequency-dependent selection, each predisposed towards particular social and moral attitudes and behaviours. This can help explain the existence of moral diversity, particularly intra-cultural moral diversity, and seemingly intractable moral disagreement. (shrink)

This paper extends the discussion of business ethics by examining the issue of corruption, its definition, the solutions being proposed for dealing with it, and the ethical perspectives underpinning these proposals. The paper’s findings are based on a review of association, think-tank, and academic reports, books, and papers dealing with the topic of corruption, as well as the pronouncements, websites, and position papers of a number of important global organizations active in the fight. These organizations include the World Bank, the (...) International Monetary Fund, the Organization for Economic Co-operation and Development, Transparency International, USAID, the United Nations, the International Chamber of Commerce, the Organization of American States, and the Council of Europe. Our discussion departs from prior analyses by adopting a Foucaultian theoretical framing and by incorporating insights found in the virtue ethics literature. Implications are provided for international business organizations. (shrink)

The study of digital economies and the sociology of risk have, with few exceptions, a relationship of benign mutual neglect despite possible important connections between the two. This article aims to bridge the gap between these two fields using Beck’s theory of risk society to explore how the digital economy’s momentum of innovation is generating risks and limiting the scope of existing democratic decision-making via the power of the digital economy to create social faits accomplis outside of democratic control. Three (...) specific risks emerging from the dynamics of innovation of digital economies are discussed as vignettes to illustrate these developments: (1) the remaking of interpersonal co-presence and solitary life; (2) the growing threats of AI to intensify unemployment and inequality; and (3) the impact on the environment of an ‘always on’ and ‘always upgrading’ digital communication ecosystem. With the gap between the potential and the actual use value of the digitalization of the infrastructure of life continuing to grow, this article argues that a different relationship between digital innovation and private and public spheres needs to be established to protect the effectiveness of contemporary democracy. (shrink)

This paper operates on the premise that a systematic formulation of ‘radicality’ is a worthwhile and potentially productive exercise within political theory. However, I argue that one continues to find a latent ‘purism’ within contemporary understandings of ‘radicality’, primarily in relation to feminism, but also elsewhere. This manifests itself in the tendency to think ‘radicality’ as a function of the inherent properties of particular types of political spaces and political practices. Within feminism, for example, I argue that the ‘radicality’ of (...) a feminist politics is thought in terms of the extent to which it adheres to a specifically ‘1970s’ feminist model of autonomous mobilization. This perspective suffers from a number of conceptual problems, necessitating a formulation of a more dynamic view of radicality with which to evaluate contemporary political practices. To this end, I seek to cast radicality as a function of equivalence (drawn from Ernesto Laclau) and (especially) imagination drawn from Linda Zerilli's Arendtian-inflected feminist theory. Thinking radicality in these terms, I argue, avoids the latent purism of many existing approaches while enabling a critical engagement sensitive to the context of the practice under investigation. (shrink)

Building on recent developments in radical democratic theory, in this article we articulate and explore a fresh perspective for theorists and activists of radical democracy: a ‘living critique of domination’. Characterized by a two-fold analytical effort, a ‘living critique of domination’ calls for a radical critique of contemporary forms of power and control coupled with a reappraisal of emancipatory political experiences created by the political action of the Many. We demonstrate that this project responds to the theoretical and practical challenges (...) faced by a politics of emancipation today. Our article offers a first articulation of this living critique through a discussion of three recent political experiences, namely, the 2016 French uprising, Nuit Debout, as well as the Black Lives Matter and #MeToo movements. (shrink)

Much of the most interesting work in philosophy today is metaphysical in character. Oxford Studies in Metaphysics is a forum for the best new work in this flourishing field. OSM offers a broad view of the subject, featuring not only the traditionally central topics such as existence, identity, modality, time, and causation, but also the rich clusters of metaphysical questions in neighbouring fields, such as philsophy of mind and philosophy of science. Besides independent essays, volumes will often contain a critical (...) essay on a recent book, or a symposium that allows participants to respond to one another's criticisms and questions. Anyone who wants to know what's happening in metaphysics can start here. (shrink)

Volume 24, Issue 10, October 2024, Page 37-40.

In this mixed methods study we identify and assess ethical and pragmatic issues and dilemmas surrounding e-health technologies in the context of primary care, including what is already in the literature. We describe how primary healthcare professionals can access reliable and accurate data, improve the quality of care for patients, and lower costs while following institutional guidelines to protect patients. Using qualitative and quantitative methodologies we identify several underlying ethical and pragmatic burdens and benefits of e-health technologies. The 41 study (...) participants reported more burdens than benefits, and were generally ambivalent about their level of satisfaction with their institutions’ ehealth technologies, their general knowledge about the technologies, and whether e-health can improve team-based communication and collaboration. Participants provided recommendations to improve e-health technologies in primary care settings. (shrink)

The paper’s principal claim to originality lies in its deployment of Deleuze and Guattari’s concept of the ‘refrain’ in thinking the ‘resingularization’ of photography in the context of new media ecologies and the promise of what Guattari calls a ‘post-media era’. The paper itself constitutes a refrain and is structured according to the three moments of any refraining. Firstly, a refrain is a spatio-temporalization, a way of marking out space, keeping time and assembling and activating subjectivity. At its most rudimentary, (...) it is the establishment of a momentary centre, a point of order amidst chaos. We can conceive this in terms of the originary ‘cut’ of the photographic flash which – as in a familiar trope in horror films in which the flash of a camera guides the protagonist through a menacing darkness – illuminates one’s milieu, the spot on which one stands, and dispels the evils which gather on all sides. This flash is a singularity which, in rupturing darkness, does not merely constitute a representative image but is, as Guattari might say, a ‘vector of subjectivation’. Secondly, the refrain circumscribes a territory, a circle of control, ethos, interiority or home. Our media are architecture, part of the congealing and hardening of territory. Here emerges an ‘incorporeal Universe’ which signs itself ‘Photography’. We approach photographic territorialization principally in terms of genre. Photographic genres are refrains become clichés, habits, fictions which uncritically sustain and abet the ravages of capitalistic subjectivity. Adhering, photographically, to these affective algorithms – creatively reacting in the belief that There Is No Alternative – is to generatively maintain the existence of a virtually stable territory. It is this territory that, we insist, requires estrangement through the amplification of its moments of uncertainty. The third moment of the refrain is precisely the exacerbation of its instability, its transformation into a ‘music’ which is the cracking open of the territory to the world and its opening out onto futurity and alterity. We conceive this in two ways. On the one hand, the opening of the photographic refrain can be understood in terms of the ontology of mediation. Rather than a freezing of the moment, the photographic image is in and of the middle, medial – that is, it constitutes an event of interruptive time, the construction of an interval which is excessive and untimely. Here, we heed recent calls for a new ethics of photographic practice which understands and takes responsibility for the process of mediation ‘from within the process itself’. On the other hand, the opening of the photographic refrain can be understood in connection with the subjective pluralism which is the excess of the social. We are plural, polyphonic subjects, comprising affective communities which exist in relation to a ‘constellation of Universes’, at the intersection of refrains which variously harness anti-chaotic forces and can be resingularized and opened onto the forces of the future. Along lines intimated by Guattari, we commend the collective reappropriation and resingularization of photography in order to escape its impasse, to reflexively trigger ‘an existential agglomeration’. Mediation itself offers the promise of a ‘post-media era’ in which we liberate the creativity and virtuality of media in order to ‘bifurcate existence’, realizing the possibility of new constellations of Universes and an autopoiesis of subjectivity. Tapping into such excess requires a pedagogy of excess, too. For us, to respond ethically to the new powers of mediation means respecifying photography as a collective endeavour, beyond the principles of ‘self expression’ and ‘independence’ which have long dominated photography education. It also means going beyond the conventions of genre and ‘socially-engaged’ practice, not simply through the usual judgement and denunciation of territory but through its falsification. As we see it, photography’s ‘fabulatory function’ is to both make perceptible and betray the ‘working forces’ of territorial refrains, to both activate and ‘fail to satisfy’ them. Indeed, it is in this sense that photography might become a transversal tool with which to think the artistic and social simultaneously. (shrink)

This book provides practical and research-based chapters that offer greater clarity about the particular kinds of teacher reflection that matter and avoids talking about teacher reflection generically, which implies that all kinds of reflection are of equal value.

Excessive boredom and the inevitability of experiencing a very bad event are two commonly cited objections to the desirability of individual immortality. It isn’t clear, however, that these objections hold weight in the context of group lives—like the lives of reading groups or labor unions. I argue that this intuition is correct: neither of the objections to an immortal individual life apply to the life of an immortal group. In the end, we may not be able to wish immortality for (...) ourselves, but we can and often should desire that good group lives go on forever, both for the sake of the group and the individuals that constitute them. Indeed, participation in immortal (or very long-lasting) groups is one way to add meaning to life. (shrink)

Low-carbon innovation is usually depicted as an exemplar of pursuit of the common good, in both mainstream policy discussion and the emerging orthodoxy of transition studies. Yet it may emerge as a key means of intensifying inequality. We analyse low-carbon innovation as a social and political process through the prism of differential risk-classes, focusing on the pivotal global case of emergence of the Chinese middle-class in seaboard megacities, especially regarding the profound challenges of urban e-mobility transition. This approach shows emergence (...) of this still-forming sociopolitical grouping as tightly and complementarily coupled with the assembling of innovations that meaningfully tackle global risks, such as climate change, while also intensifying existing inequalities. Misrecognition of the duality of low-carbon innovations as both moral technologies and as relatively expensive consumer products has the potentiality to be a key mechanism of this process, thereby serving to reproduce, constitute and legitimize inequalities in novel and unexpected ways. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:American Journal of Philology 124.4 (2003) 613-616 [Access article in PDF] KONSTANTINOS KAPPARIS. Abortionin the Ancient World. London: Duckworth, 2002. viii + 264 pp. Cloth, £40. In his introduction, Kapparis states that he has tried to "produce a 'readable and synthesized' treatment of the available evidence, without losing sight of time and place" (5). In this book Kapparis does collect, in English, most of the sources and results of (...) the work that has been done on abortion in the ancient world since the publication of Enzo Nardi's Procurato aborto nel mondo Greco-Romano (Milan, 1971), and most of the conclusions collected at the end of each chapter I find unobjectionable. To this extent, this is a useful book. However, the general tenor and the organization of the discussion within each chapter does, I think, lose sense of time and place, especially in the case of classical Athens, which is the main focus of Kapparis's interest.Rather than treating each culture chronologically, Kapparis presents the material in six main chapters: (1) "Methods of Abortion"; (2) "When Does Human Life Begin?"; (3) "The Doctor's Dilemma"; (4) "The Woman's Point of View"; (5) "The Man's Point of View"; (6) "Abortion and the Law." Even the subsections within each chapter are not chronological periods. Within each subsection, Kapparis clearly strives for a chronological arrangement, but he is not always successful, and there are times when the chronological progression will not be clear to the non-specialist. When discussing the role of midwives, for instance, Kapparis begins with Soranus' description of their role, saying, "The few available references to the role of the midwife in the community reveal that Greek midwives were well-respected figures with an important role to play as health advisers, and a daunting list of responsibilities" (85). There is no initial indication that Soranus' remarks are directed to midwives in Rome of the second century C.E. After backtracking to take account of a remark in Plato's Theaetetus, Kapparis concludes, "the tasks of the midwife had not really changed much from the classical period to the time of Soranus (second century AD)" (87). The conclusion from just these two citations is questionable in the extreme, but without further cultural embedding, the statement is virtually meaningless. In ancient Greece, for example, a midwife was expected to have given birth herself, and the role would often have been filled simply by the older female members of a household, whereas Soranus says that personal experience in childbirth is not a prerequisite for a midwife because he sees it as a far more professional position. Even when Kapparis does present the material with strong chronological and cultural markers, it would be very hard for a non-specialist to separate out from each subsection the strands that go together to make a cohesive society.One of the biggest problems in the tenor of Kapparis's discussion derives from his projecting the later, largely Christian, concern over the fate of the fetus into the classical Greek period. Obviously there was a range of opinions on the subject in antiquity, just as there is today; and there were probably many people, especially pregnant women and prospective fathers, who felt a strong emotional attachment to the fetus at all stages. However, one cannot begin to assess the [End Page 613] attitude towards abortion in ancient Athens without acknowledging that the society countenanced the exposure of newborn infants. Kapparis does not deal with this issue at any length until pages 154-62. On page 69 he tries to downplay its significance by saying, "An individual's conscience, strength of religious feeling, and broad perception of human identity would be important factors in the decision over the fate of an unwanted infant." But conscience, religious feeling, and perception of human identity for the vast majority of people are largely shaped by the culture in which they live. Athenians, and other Greeks, lived in a society in which they could, with impunity, expose a newborn simply for being female. While I am sure that in many cases it was a... (shrink)

This paper draws from contemporary psychoanalytic theory as well as nineteenth-century crowd theory to critique Louis Althusser’s account of the ideological interpellation of the subject. I argue that rather than ideology interpellating the individual as a subject, bourgeois ideology interpellates the subject as an individual. By “bourgeois ideology” I mean the loose set of ideas and apparatuses associated with European modernity, an instrumental concept of reason, and the emergence of the capitalist mode of production. The advantage of reversing the Althusserian (...) account is that the subject is not pre-constrained to the individual form, a form that is itself always already as failing and impossible as it is assumed and demanded. In Althusser’s version, the individuality that emerges in history is posited as universal, a given. In mine, the individual form is itself the problem; it’s a coercive and unstable product of the enclosure of the common in never-ceasing efforts to repress, deny, and foreclose collective political subjectivity. The individual is thus a form of capture. Rather than natural or given, the individual form encloses into a singular bounded body collective bodies, ideas, affects, desires, and drives. There is nothing necessary about the link between subjectivity and individuality; it is an effect contingent to the array of processes that converge into bourgeois modernity. (shrink)

This book is designed to make the various hardships encountered by many students more personal in order to give teachers insight into the very real needs of today’s students.

John Playfair left a library of over 1,400 volumes at his death. Analysing these augments our understanding of his mind, particularly with regard to geology. Two questions of special import are why this teacher of mathematics was interested in geology at all, and why, having written his Illustrations of the Huttonian theory of the Earth he never completed the proposed second edition of this famous and influential work.