Clinical ethics is a relatively new discipline within medicine, generated not so much by the Can we . . . ? questions of fact and prognosis that physicians ...

It seems intuitive to the believer that God intended through instruction in the Law to define morality, intended to lead humankind to “the right and the good.” Further, God's love for humankind, exemplified by the incarnation, atonement and teachings of Jesus, and empowered by the Holy Spirit, should lead to a better world. Indeed, the Christian worldview is a coherent and valid way to look at bioethical issues in public policy and at the bedside. Yet, as this paper explores, in (...) a pluralistic society such as the United States, it is neither possible nor desirable for Christians to try to force their views on others. Still, it is obligatory for Christians to stand up and articulate their views in the public square. We should try to persuade others using either prudential or moral arguments. While we must be willing to live with “the will of the people,” at the same time, we must not be intimidated into accepting the position that our voice is not valid because it has a religious basis. (shrink)

This paper predicts the probability of a profound world climate change that will affect the governance of the world's societies. Carbon dioxide levels in the earth's atmosphere may be doubled in sixty years, warming the earth's climate and altering drastically the patterns of food production, agriculture, forestry and consequently relations between societies.

Despite the growing interest in Aristotelian approaches to contemporary philosophy of science, few metaphysicians have engaged directly with the question of how a neo-Aristotelian metaphysics of nature might change the landscape for theological discussion concerning theology and naturalism, the place of human beings within nature, or the problem of divine causality. The chapters in this volume are collected into three thematic sections: Naturalism and Nature, Mind and Nature, and God and Nature. By pushing the current boundaries of neo-Aristotelian metaphysics to (...) recover the traditional notion of substantial forms in physics, reframe the principle of proportionality in biology, and restore the hierarchy of being familiar to ancient philosophy, this book advances a metaphysically unified framework that accommodates both scientific and theological knowledge, enriching the interaction between science, philosophy and theology. Neo-Aristotelian Metaphysics and the Theology of Nature will be of interest to scholars and advanced students working in metaphysics, philosophy of science, natural theology, philosophical theology, and analytic theology. (shrink)

In response to the many changes currently going on in health care, this book offers the combined insight and wisdom of a stellar group of scholars and professionals with extensive experience in the health care field. The book opens with a look at people's actual experience of health care today, from four different perspectives. It then addresses foundational questions, including the nature of medicine, nursing, and justice. Surveyed next are the changing economics of health care as well as the impact (...) of these changes on such areas as mental health care, long-term care, health care for minorities, and legal malpractice. The closing section of the book assesses from a Christian perspective available constructive alternatives, including creative funding strategies with special attention to the needs of poor persons, physician unions, and the use of "alternative medicine" therapies. (shrink)

Surveys and routine clinical procedures applied in research protocols are typically considered only minimally risky to participants. The apparent benign nature of "minimal risk" tasks increases the chance that investigators and Institutional Review Boards (IRBs) will overlook the probability that clinical tools will identify signs, symptoms, or definitive test results that are clinically-relevant to subjects' welfare. "Minimal risk" procedures may also pose a particular hazard to participants in clinical research by increasing the therapeutic misconception because the tasks mimic clinical care (...) and are often conducted in clinical settings. Investigators should anticipate which measures could yield clinically-important findings and should describe explicit plans for data monitoring, disclosure, and follow-up. Protocols that include reliable and valid clinical measures should prompt a more detailed risk assessment by the IRB, even when the tasks meet the regulatory criteria for minimal physical, psychological, or emotional risk. (shrink)

Obese people consume significantly greater amounts of health resources. This study set out to determine if health resource utilization by obese people decreases after losing weight in a comprehensive medically supervized weight management programme. Four hundred and fifty-six patients enrolled in a single-centred, multifaceted weight loss programme in a universal health care system were studied. Patient information was anonymously linked with administrative databases to measure health resource utilization for 1 year before and after the programme. Mean body mass index (BMI) (...) decreased by more than 15%. The mean annual physician visits (pre = 9.6, post = 9.4) did not change significantly after the programme. However, patients saw a significantly fewer number of different physicians per year following the programme (pre = 4.5, post = 3.9; P < 0.001). Mean annual number of emergency visits (pre = 0.2; post = 0.2) and hospital admissions (pre = 0.05; post = 0.08) did not change. Neither baseline BMI, nor its change during the programme, influenced changes in health resource utilization. Our study suggests that weight loss in a supervized weight management programme does not necessarily decrease short-term health resource utilization. Further study is required to determine if patients who maintain their weight loss experience a decrease in health utilization. (shrink)

Responding to volatile criticisms frequently leveled at Leo Strauss and those he influenced, the prominent contributors to this volume demonstrate the profound influence that Strauss and his students have exerted on American liberal democracy and contemporary political thought. By stressing the enduring vitality of classic books and by articulating the theoretical and practical flaws of relativism and historicism, the contributors argue that Strauss and the Straussians have identified fundamental crises of modernity and liberal democracy.

This book explores the relationship between a scientifically updated Aristotelian philosophy of nature and a scientifically engaged theology of nature that cuts across interdisciplinary boundaries. It features original contributions by some of the best scholars engaging with Aristotelianism in contemporary metaphysics, philosophy of science, and philosophical theology. Despite the growing interest in Aristotelian approaches to contemporary philosophy of science, few metaphysicians have engaged directly with the question of how a neo-Aristotelian metaphysics of nature might change the landscape for theological discussion (...) concerning theology and naturalism, the place of human beings within nature, or the problem of divine causality. The chapters in this volume are collected into three thematic sections: Naturalism and Nature, Mind and Nature, and God and Nature. By pushing the current boundaries of neo-Aristotelian metaphysics to recover the traditional notion of substantial forms in physics, reframe the principle of proportionality in biology, and restore the hierarchy of being familiar to ancient philosophy, this book advances a metaphysically unified framework that accommodates both scientific and theological knowledge, enriching the interaction between science, philosophy and theology. Neo-Aristotelian Metaphysics and the Theology of Nature will be of interest to scholars and advanced students working in metaphysics, philosophy of science, natural theology, philosophical theology, and analytic theology. (shrink)

Trust is both ethically important and essential for business but difficult to measure. This paper contributes toward clarifying the nature of trust in a way that is both conceptually helpful for ethical inquiries concerning business and pertinent to the measurement of trust as an element in organizations. Several papers hypothesize that increasing the role of trust in a corporation reduces the need for external monitoring and contracts. Assessing this important hypothesis requires a way to gauge whether a firm has a (...) trusting corporate culture. We develop an objective measure of trust in a firm’s corporate culture by counting the number of times 21 trust-related words appear in an important kind of document: the Management Discussion and Analysis section of the annual report. We report two significant findings: that, contrary to what one might think, firms with a trusting culture frequently use audit and control-type words and that trust is positively linked with subsequent share price volatility. We propose explanations of these findings with the hope of facilitating the objective measurement of trust and enhancement of a trusting atmosphere in corporate culture. (shrink)

: One of the greatest poets of the Victorian period, Robert Browningis taught universally from school through university levels. Given suchmagnitude, the multifaceted poet deserves research attention from variousperspectives. A fascinating aspect of his poetry is that, in spite of his refusal tobe labelled as a Christian, he displays strong faith in God and the afterlife. Hispoetry is steeped in religious connotations that derive heavily from the Bible.There are striking similarities between many concepts preached by Islam andChristianity. It will (...) be interesting to view his poetry from the perspectiveof the former. Islam emphasises its own unique concepts and values to helpits adherents achieve their vision of success. Browning, though acceptingthe central ideas of Christianity, deviates from it conceptually. Given thisbackground, this article attempts to evaluate his notion of faith and its practicefrom Islamic perspectives and discover where the poet’s ideas converge withthose of Islam and where they differ. (shrink)

This is a superb anthology that questions the value and even the existence of honor in the contemporary world. Although readers have had the benefit of excellent works on this concept from mainly a...

David Lewis is widely credited with the first formulation of common knowledge and the first rigorous analysis of convention. However, common knowledge and convention entered mainstream game theory only when they were formulated, later and independently, by other theorists. As a result, some of the most distinctive and valuable features of Lewis' game theory have been overlooked. We re-examine this theory by reconstructing key parts in a more formal way, extending it, and showing how it differs from more recent game (...) theory. In contrast to current theories of common knowledge, Lewis' theory is based on an explicit analysis of the modes of reasoning that are accessible to rational individuals and so can be used to analyse the genesis of common knowledge. Lewis' analysis of convention emphasises the role of inductive reasoning and of salience in the maintenance of conventions over time. Footnotes Earlier versions of this paper were presented at the 13th Amsterdam Colloquium at the University of Amsterdam, at a workshop on social norms at Wissenschaftskolleg zu Berlin, and at seminars at Tilburg University and the University of Bristol. We are grateful for comments from participants at those meetings, from two anonymous referees, and from Michael Bacharach, Nick Bardsley, Cristina Bicchieri, Luc Bovens, Simon Grant, David McCarthy, Shepley Orr, Brian Skyrms, Peter Vanderschraaf, Peter Wakker and Jörgen Weibull. Robert Sugden's work was supported by the Leverhulme Trust. (shrink)

Kant famously argued in the Groundwork that our fundamental moral obligation is simply to respect the humanity in persons. However, his fuller view, found in the Metaphysic of Morals, is that the humanity in persons not only demands our respect, but also our love. Neither of these demands, of course, requires that we feel anything for others, and Kant is much more specific here about what constitutes respect between persons. But in elaborating this position he also claims that these demands (...) are somehow opposed, as though love were a sort of moral gravity and respect a sort of moral centrifugal force, which together create a cohesive moral/social bond, but alone would allow “nothingness (immorality)... [to] drink up the whole kingdom of (moral) beings” (MdS 6:449). Marcia Baron, in her illuminating paper, argues that this and related remarks are surely an exaggeration. After all, respect sometimes requires that we come closer and love sometimes imposes limits. And not only does Kant ground all duties in respect, but this is the same philosopher who, early on in the Groundwork, claimed that the Christian command to “love our neighbor” must be understood as commanding, not a feeling, but “beneficence from duty” (G 4:399). Since acting from duty is acting out of respect, “practical” love itself requires respect. So why does he think that they are opposing forces? (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:A Nietzschean Bestiary: Becoming Animal Beyond Docile and BrutalRobert N. MatuozziA Nietzschean Bestiary: Becoming Animal Beyond Docile and Brutal, edited by Christa Davis Acampora and Ralph R. Acampora ; xxxii & 371 pp. Lanham, MD: Rowman & Littlefield, 2004. $75.00 cloth, $29.95 paper.What if instead of re-reading Nietzsche's corpus, one imagines what it would be like to view his works on the "Nietzsche Network." Imagine a spectator situated (...) in the middle of a vast amphitheatre preparing to watch these simulacra. Gazing up and around a series of giant, flat-screen video monitors arrayed in layers around the interior wall of an amphitheatre, the spectator views and listens to Nietzsche's multi-media texts as, simultaneously, they seductively flash their provocative narratives in flickering streams of high-resolution sounds, words, and images.The Nietzsche Network is a roaring carnival. It consists of colorful, speculative historical dramatizations and equally enticing philosophical tableaux. Dark ambient musical motifs, laced with interludes of explosive, uncontrollable laughter, are a subliminal presence. Lurid detective stories and somber cultural narratives and slashing polemics implicate cultures and ideologies in festivals of cruelty and soul-murder. Poignant genealogical and aphoristic asides on joy [End Page 443] and work and suffering, weird psychological skits starring well-known ensemble casts are accompanied by hoarse oratory, soaring denunciations, and sober etymological digressions. Intermittently, the spectator is startled by abrupt, sometimes strident proclamations, like confessional bulletins shot from nowhere.Nietzsche's siren-like prose exhibits an extraordinary rhetorical range. This is particularly true of the polychromatic works originally published in the gloaming of his career in the period after 1886. Nietzsche's compelling, fluvial style is accounted for in this volume by the kinetic movements of lizards and the halcyon tones of birds, to his study of the ancient Greek and Roman classics (and to the lost musicality of Greek tragedy in particular), and to his emphatic embrace of a kind of plosive, Dionysian philosophical technics.The content of the Nietzsche Network spans thousands of years of human experience and thought. A prequel features a substantial bestiary of traditional animals and emergent biomorphic forms set in a variety of carefully animated zoological dioramas. Among the modernists, has there been another thinker as strangely original and subversive? Allowing for fundamental differences, only Valéry comes to mind. Like the silent, ruminating cow in his "untimely" essay on history, Nietzsche prevents the past from injecting noise into present and future philosophizing. He will be the exemplary philosopher of the other-than-human as he campaigns to re-inscribe human animality into the zoological text of nature. Through explicit pronouncements and in scattered philosophical sorties involving human animality and his (desperate) utopist vision of human perfectibility, Nietzsche attempted to attain—at least conceptually—what Richard Rorty aptly calls the "historical sublime, a future which has broken all relations with the past."This excellent collection of essays on Nietzsche's bestiary demonstrates the surprising persistence of the animal imaginary in his thought. The various pieces also illuminate the multiple thematic and linguistic transformations Nietzsche develops as he enlists animals in his feral, anti-essentialist dialectic on the obscure continuum between "humans," "animals," and "nature." It turns out that a degraded version of Nietzsche's strangest thought experiment on animalism, the übermensch, is perhaps only a few years away from being produced through emerging boutique bioengineering, a prospect that has some commentators on both the left and the right blinking with apprehension. These essays amply demonstrate that Nietzsche's bestial philosophy of human and animal alterity subverts, among other paradigms, the strange Cartesian notion that animals are mechanical automata while humans are transcendental rationalists. As one commentator in this book broadly puts it, Nietzsche shows that the various schemes concocted to put an illusory distance between humans and animals have ended up being an immensely corrupting "pretense" (p. 224).Precursor bestiaries are indicated in this volume, though the medieval tradition originating in the Physiologus is here mostly displaced by a different [End Page 444] menagerie of cultural affiliations. The fabulist Aesop is present, along with Aristotle and Montaigne, though La Fontaine is not, and Pico Mirandola's famous remarks in his Oration on... (shrink)

Little is known about how researchers view ethically salient aspects of human studies. As part of a National Institutes of Mental Health-funded study, the authors performed a confidential written survey to assess the attitudes, views, and experiences of researchers with institutional review board approved protocols at the University of New Mexico. A total of 363 researchers (57% response rate) participated. Investigators overall held favorable views of general ethical aspects of research and ethics-based safeguards, and they identified a positive role of (...) ethics training. Investigators with more experience encountering ethical problems (p < .001), more ethics training (p = .001), and a PhD or MD/PhD (p = .003) held more favorable general ethical perspectives. Women investigators (p < .03), nonphysician investigators (p < .001), those whose training had been helpful in resolving ethical dilemmas (p = .006), and those for whom spirituality is important (p = .008) more strongly endorsed ethical safeguards. Investigators perceive the scientific and ethical aspects of their work as valuable and linked, and they affirm the role of safeguards in human studies. Formal ethics preparation and training initiatives were also viewed positively by investigators. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Post-Genomic RevolutionA Paradigm Shift for Biopsychosocial SystemsClaude Robert Cloninger, MD, PhD (bio)The pstchologist Danielle Dick and psychiatrist Kenneth Kendler (DK) began an ongoing study in 2011 called Spit for Science (S4S) in which they obtained saliva as a peripheral source of DNA along with assessment of detailed self-report information on alcohol and other substance use, selected personality traits, and psychosocial history about the students entering a large (...) university (Dick et al., 2014). They hoped to identify the genes underlying the heritability of alcohol use and related behaviors to inform students about their individual risk, and thereby to promote increased self-awareness and health. The students were highly cooperative volunteers, and many peer-reviewed research papers have been published from these data.Eric Turkheimer, a psychologist who studies how genes and environments shape the development of human behavior (Harden et al., 2007; Loehlin et al., 2009; Turkheimer et al., 2003), reviewed all the resulting publications coming from S4S along with coauthor Sarah Greer (Turkheimer & Greer, 2024). Turkheimer and Greer (TG) were surprised to find the study has failed to identify any genes that have substantial (“nontrivial”) effects on reported levels of consumption or problems related to their use of alcohol or other substances, except for a variant of the gene for aldehyde dehydrogenase (ALDH2), which was already known to cause many people of Asian descent to flush when they drink alcohol. TG state that, “Again and again, the results of S4S investigations demonstrated tiny, and frequently null, contributions of genetics to differences in drinking and related behaviors among college students. GWAS [genome-wide association studies] revealed practically no genome-wide significant SNPs [single nucleotide polymorphisms], and the SNPs identified at less stringent levels of significance were never mentioned more than once” (Turkheimer & Greer, 2024).TG concluded that the design, execution, psychometric measures, and analysis of the data were excellent. However, they also discuss facts that raise doubts about the adequacy of the design and methods. Namely, it is an inconvenient fact, [End Page 429] but widely known, that approaches to GWAS that are frequently used in psychiatric genetics require huge samples (often hundreds of thousands) to detect statistically significant genes because the observed effects have consistently been weak whenever genes are assumed to act independently, as did DK. Consequently, polygenic risk scores are weak and inconsistent predictors of behavioral phenotypes (Zwir et al., 2020c). Nevertheless, TG fault DK and their coauthors for an overemphasis on statistical significance in large samples rather than prominently reporting that the observed effect sizes of genes were only weakly and inconsistently associated with any measured features of substance use.TG report that they were surprised by the weak and inconsistent findings from genetic variants from this GWAS because they knew that twin and family studies (i.e., what they call “genetics at altitude”) have previously found strong and consistent evidence of the heritability of phenotypes like those measured by DK. For example, in my own research with adoptees separated from their biological parents at an early age and reared by adoptive parents, the risk of alcohol abuse in adoptees was strongly predicted by alcohol abuse and related behaviors in their biological, but not adoptive, parents (Bohman et al., 1981; Cloninger et al., 1981; Sigvardsson et al., 1996) and by their childhood personality, particularly novelty seeking, when the children were followed into young adulthood (Cloninger, 1987; Cloninger et al., 1988). However, it is well-known that the methods used by DK for GWAS consistently fail to detect most of the heritable variance for behavioral phenotypes estimated in twin studies, which include much variability from complex patterns of gene–gene interaction (Table 1) (Cloninger & Zwir, 2022). This consistent observation in GWAS studies that assume genes act independently is called the missing or hidden heritability problem.Nevertheless, DK expressed optimism in 2011 that genome-wide measurement of genetic variants would identify genetic markers to predict risk of alcohol-related phenotypes in college students. They do so because they assume that all the information about heritable processes can be extracted from genome-wise scans of SNPS. The heritable phenotypes of interest in S4S included patterns of use of alcohol and other recreational... (shrink)

Calls for the “translation” of research from bench to bedside are increasingly demanding. What is translation, and why does it matter? We sketch the recent history of outcome-oriented translational research in the United States, with a particular focus on the Roadmap Initiative of the National Institutes of Health (Bethesda, MD). Our main example of contemporary translational research is stem cell research, which has superseded genomics as the translational object of choice. We explore the nature of and obstacles to translational research (...) and assess the ethical and biomedical challenges of embracing a translational ethos. (shrink)