Translating ethical theories into clinical practice presents a perennial challenge to educators. While many suggestions have been put forth to bridge the theory-practice gap, none have sufficiently remedied the problem. We believe the ascendance of hospital medicine, as a dominant new force in medical education and patient care, presents a unique opportunity that could redefine the way clinical ethics is taught. The field of hospital medicine in the United States is comprised of more than 50,000 hospitalists—specialists in inpatient medicine—representing the (...) fastest growing subspecialty in the history of medicine, and its members have emerged as a dominant new force around which medical education and patient care pivot. This evolution in medical education presents a unique opportunity for the clinical ethics community. Through their proximity to patients and trainees, hospitalists have the potential to teach medical ethics in real time on the wards, but most hospitalists have not received formal training in clinical ethics. We believe it is time to strengthen the ties between hospital medicine and medical ethics, and in this article we outline how clinical ethicists might collaborate with hospitalists to identify routine issues that do not rise to the level of an “ethics consult,” but nonetheless require an intellectual grounding in normative reasoning. We use a clinical vignette to explore how this approach might enhance and broaden the scope of medical education that occurs in the inpatient setting: A patient with an intra-abdominal abscess is admitted to the academic hospitalist teaching service for drainage of the fluid, hemodynamic support, and antimicrobial therapy. During the initial encounter with the hospitalist and his team of medical students and residents, the patient reports night sweats and asks if this symptom could be due to the abscess. How should the hospitalist approach this question? (shrink)

ArgumentThe eighteenth-century natural histories ofParaquaria, a Jesuit province in South America ranging from the tropical forest to Río de la Plata (the River Plate), constitute a rich and consistent tradition of nature writing. The way the material is organized, the frequent use of lists of aboriginal names, and the focus on naming, all attest to the missionaries' preoccupation with language, understandable given that they were engaged in writing dictionaries and thesauri of the native tongues. During the nineteenth and twentieth centuries, (...) this body of work went through a series of appropriations, reflecting the various intellectual programs that contributed to the making of the national tradition in Argentina. While these natural histories are still often interpreted in terms of Argentina's national history, science, and literature, I will argue that they should be considered a product of a mixed culture oriented toward the practical and religious goals that are characteristic of most of Jesuit missionary culture, the result of the missionaries' attempt at organizing their experience of the wilderness and their encounter with the aboriginal peoples. (shrink)

ABSTRACT This paper is intended as a contribution to the study of science and religion in late modern Catholic societies. I explore the treatment of natural philosophy vis-à-vis religious authority, the teaching of Biblical geology, and the use of natural theology in texts from Río de la Plata in the transition from late colonial to early independent times. After reviewing the assimilation of modern science into scholastic teaching and the articulation of reason and religious authority, the article considers the handling (...) of the early history of the Earth in the theses of scholastic teachers and in the geological memoirs of the naturalist priest from Montevideo Dámaso Larrañaga. The core of the paper is devoted to the treatment of natural theology in Larrañaga’s Diary of Natural History and in the speeches and documents of enlightened crown bureaucrats. The conclusion is reached that the harmonious character of the relationships between science and religion in this period and location harboured tensions which could be accounted for in terms of the inherent inconsistencies in the programme of Catholic Enlightenment. (shrink)

E! De arte venandi cum avibus deFederico II ha sido ensalzado por pane de medievalistase historiadores de la ciencia como uno delos logros más importantes de la ciencia medieval,sobre la base de su supuesto carâcter "empírico"y "observacional" y su critica a Aiistóteles.En esta comunicación se intenta una reconsideracióndel significado de la obra, ubicândoladentro dei panorama de la literatura sobre losanimales en e! siglo XIII. Luego de proporcionaralgunos datos básicos sobre el tratado, se adoptaun criterio historiogrâfico, pasando revista criticaa las opiniones (...) de los distintos autores que haninvestigado el tema. Posteriormente se discute laconcepción dei De arte venandi como un libro"cientifico" asumiendo que la scientia en elsiglo XIII es radicalmente distinta de la cienciasurgida a partir del siglo XVII, que e! tratadode Federico es la exposición de un ars, en e!sentido que los médicos otorgaban a esta nocióny que la obra pertenece mâs bien ai género detratados sobre cetrería, uno de los modos en losque se articulaba el discurso sobre los animalesen el siglo XIII. (shrink)

The historiographic tradition of the history of science that originated with Auguste Comte bears all the marks of narratives with roots in the Enlightenment, such as a view of religion as an underdeveloped stage in the ascending road in humanity's quest for a more mature understanding. This article explores the development of the peripheral branch of a tradition that developed in Argentina by the mid‐twentieth century with authors such as the Italians Aldo Mieli, José Babini, and the Hungarian Desiderius Papp. (...) It is argued that, contrary to the historiographic program of the conflict thesis developed in English‐speaking countries, those scholars who cultivated the kind of “positivist” history of science that thrived in continental Europe were inclined to see science as a social and epistemological replacement of a fossilized religious outlook. In the final section, I suggest a way to relate the more or less strong versions of the conflict thesis to different patterns of secularization. (shrink)

Infin de siècleArgentina a secularist ideology of science was part of the positivist world view espoused by liberals and socialists. Between the years 1910 and 1935, a period in which the Catholic Church experienced a significant cultural expansion, the activities of the Catholic naturalist Ángel Gallardo and the astronomer and priest Fortunato Devoto challenged the so far prevailing idea of science as opposed to religion. This paper explores the connections between the scientific, religious and political aspects of those figures in (...) order to get some insights into the complexity of the relationships between science and secularization in societies with a Catholic majority. (shrink)

While COVID-19 has generated a massive burden of illness worldwide, healthcare workers (HCWs) have been disproportionately exposed to SARS-CoV-2 coronavirus infection. During the so-called ‘first wave’, infection rates among this population group have ranged between 10% and 20%, raising as high as one in every four COVID-19 patients in Spain at the peak of the crisis. Now that many countries are already dealing with new waves of COVID-19 cases, a potential competition between HCW and non-HCW patients for scarce resources can (...) still be a likely clinical scenario. In this paper, we address the question of whether HCW who become ill with COVID-19 should be prioritised in diagnostic, treatment or resource allocation protocols. We will evaluate some of the proposed arguments both in favour and against the prioritisation of HCW and also consider which clinical circumstances might warrant prioritising HCW and why could it be ethically appropriate to do so. We conclude that prioritising HCW’s access to protective equipment, diagnostic tests or even prophylactic or therapeutic drug regimes and vaccines might be ethically defensible. However, prioritising HCWs to receive intensive care unit (ICU) beds or ventilators is a much more nuanced decision, in which arguments such as instrumental value or reciprocity might not be enough, and economic and systemic values will need to be considered. (shrink)

BackgroundClinical Ethics Support (CES) services are offered to support healthcare professionals in dealing with ethically difficult situations. Evaluation of CES is important to understand if it is indeed a supportive service in order to inform and improve future implementation of CES. Yet, methods to measure outcomes of CES are scarce. In 2014, the European Moral Case Deliberation Outcomes Instrument (Euro-MCD) was developed to measure outcomes of Moral Case Deliberation (MCD). To further validate the instrument, we tested it in field studies (...) and revised it. This paper presents the Euro-MCD 2.0 and describes the revision process.MethodsThe revision process comprised an iterative dialogue among the authors as Euro-MCD-project team, including empirical findings from six Euro-MCD field-studies and input from European experts in CES and theory. Empirical findings contained perceptions and experiences of MCD outcomes among healthcare professionals who participated in MCDs in various settings in Norway, Sweden and the Netherlands. Theoretical viewpoints on CES, literature on goals of CES and MCD and ethics theory guided the interpretation of the empirical findings and final selection of MCD outcomes.ResultsThe Euro-MCD 2.0 Instrument includes three domains: Moral Competence, Moral Teamwork and Moral Action. Moral Competence consists of items about moral sensitivity, analytical skills and virtuous attitude. Moral Teamwork includes open dialogue and supportive relationships and Moral Action refers to moral decision-making and responsible care. During the revision process, we made decisions about adding and reformulating items as well as decreasing the number from 26 to 15 items. We also altered the sentence structure of items to assess the current status of outcomes (e.g. ‘now’) instead of an assumed improvement over time (e.g. ‘better’) and we omitted the question about perceived importance.ConclusionsThe Euro-MCD 2.0 is shorter, less complex and more strongly substantiated by an integration of empirical findings, theoretical reflections and dialogues with participants and experts. Use of the Euro-MCD 2.0 will facilitate evaluation of MCD and can thereby monitor and foster implementation and quality of MCD. The Euro-MCD 2.0 will strengthen future research on evaluation of outcomes of MCD. (shrink)

A 47-year-old woman with a history of anxiety disorder is admitted to the hospital for shortness of breath. On the third day of hospitalization, she asks her physician for a copy of all documents pertaining to her care. What expectation should she have for full disclosure? Are there limits on her access to her medical records and do her physician's concerns about professional privilege matter?The virtues of transparency in medicine have been well described. As proponents of transparency, we favor patient (...) access to their medical records, but we are increasingly troubled by the ease and extent of disclosure in current practice as technology advances and... (shrink)

Undocumented and undomiciled, Gustavo Jiménez had been in the United States for several years. He knew his leg wasn’t right when it began to swell and redden. After the cellulitis spread to his bloodstream, he was found unconscious on the street and admitted to the intensive care unit. He improved quickly and was soon able to tell a social worker his name and that he had family in Quito. Then his health took a turn for the worse, and he developed (...) multisystem organ failure. His doctors believed his prognosis grave and further care futile. They wanted to invoke a provision under their state’s law that allows, at the discretion of at least two physicians, for the withdrawal of life‐sustaining therapy for isolated and decisionally incapacitated patients, but the social worker had ethical concerns about the doctors’ desire to make such a momentous decision without family input. She asked for a “time‐out to locate his family,” but one of the doctors asserted, “His family isn’t here, and you’ll never find them. Besides we need the bed. The ER is full of patients we can help.” What is owed a patient and family in such a situation? (shrink)

As in other countries, the public in Argentina became aware of the existence of something called “the theory of relativity” only after November 1919. Although the news of Arthur Eddington's eclipse expedition, which provided the first confirmation of Einstein's theory, was poorly reported in the newspapers, by the end of 1920 Einstein had become a household name for the educated middle class of Buenos Aires, the capital city of the country. This was in great measure the result of the activity (...) of a few enthusiastic lecturers. Significantly, none of them belonged to the prestigious Institute of Physics of the University of La Plata, which during the decade of the 1910s was considered the most important center of physical research in Latin America. Between July and August 1920 the Spanish physicist Blas Cabrera – perhaps the greatest popularizer of Einstein's theory in Spain – visited Argentina and talked about relativity. In September Georges Duclout, a French engineer who had graduated from the Zurich Polytechnic and by then was professor of applied mechanics at the School of Exact, Physical and Natural Sciences of the University of Buenos Aires, also gave a series of conferences on the subject. That same month José Ubach, a Jesuit astronomer trained at the Ebro Observatory in Spain, and established in Buenos Aires, lectured on relativity at the Colegio del Salvador. (shrink)

Atualmente, biotecnologias são empregadas na forma de protocolos a fim de sincronizar o crescimento folicular e a ovulação, bem como permitir que vacas atuem como receptoras de embriões visando melhorar o potencial genético do rebanho. O objetivo desse estudo foi avaliar o efeito da utilização de implantes intravaginais de progesterona de 1º, 2º e 3º uso no protocolo de transferência de embriões em tempo fixo (TETF) sobre a taxa de prenhez em receptoras girolandas. O experimento ocorreu em uma fazenda localizada (...) no município de São Sebastião do Maranhão (MG). Foram utilizadas 74 vacas submetidas aos seguintes protocolos: No dia 0 (D0) administrou-se 2 ml de 17β-Estradiol e progesterona e foi colocado o implante intravaginal de progesterona. Estes implantes foram colocados de forma aleatória, sendo de 1° uso (grupo 1; n=15), 2° (grupo 2; n=24) ou 3° (grupo 3; n=35).No D8, os implantes foram retirados e administrou-se 2 ml PGF2α; 1,5 ml de eCG e 1 ml de 17β-Estradiol e progesterona. A inovulação dos embriões in vitroo correu no D (16) para todas as vacas que apresentaram um corpo lúteo. As variáveis qualitativas (prenhe ou não prenhe) foram comparadas em tabelas de contingência e analisadas pelo teste de qui-quadrado a 5% de probabilidade. Neste estudo não houve diferença estatística entre os grupos protocolados em relação ao aproveitamento como receptoras: 1º uso (53,3%), 2º (79,2%) e 3º (68,65). Ademais, observou-se uma taxa de prenhez entre os grupos de 37,5% para o 1º uso, 42,1% para o 2º e 33,3% para o 3º (P>0,05). Dentre as vantagens ao reaproveitamento dos implantes multiusos destaca-se a redução dos custos dos protocolos hormonais, já que a progesterona é o hormônio mais oneroso, desta forma, a maximização do uso reduz o valor final do protocolo sem prejuízos a taxa de prenhez. (shrink)

We performed an EEG graph analysis on data from 31 typical readers (22.27 ± 2.53 y/o) and 24 dyslexics (22.99 ± 2.29 y/o), recorded while they were engaged in an audiovisual task and during resting-state. The task simulates reading acquisition as participants learned new letter-sound mappings via feedback. EEG data was filtered for the delta (0.5–4 Hz), theta (4–8 Hz), alpha (8–13 Hz), and beta (13–30 Hz) bands. We computed the Phase Lag Index (PLI) to provide an estimate of the (...) functional connectivity between all pairs of electrodes per band. Then, networks were constructed using a Minimum Spanning Tree (MST), a unique sub-graph connecting all nodes (electrodes) without loops, aimed at minimizing bias in between groups and conditions comparisons. Both groups showed a comparable accuracy increase during task blocks, indicating that they correctly learned the new associations. The EEG results revealed lower task-specific theta connectivity, and lower theta degree correlation over both rest and task recordings, indicating less network integration in dyslexics compared to typical readers. This pattern suggests a role of theta oscillations in dyslexia and may reflect differences in task engagement between the groups, although robust correlations between MST metrics and performance indices were lacking. (shrink)

Any theory of information needs to comply with what we call the implementation, formalization, and representation constraints. These constraints are justified by basic considerations concerning scientific modelling and methodology. In the first part of this paper, we argue that the implementation and formalization constraints cannot be satisfied because the relation between Shannon information and IIT must be clarified. In the second part of the paper, we focus on the representation constraint. We argue that IIT cannot succeed in satisfying this constraint (...) for semantic contents without offering models for concepts, conceptual roles, and context sensitivity. In the final part of the paper, further complications are raised with respect to the distinction between consciousness and attention, which apply more specifically to the representation constraint. We conclude with some recommendations as to how IIT may succeed in solving these problems, highlighting the advantages and enormous potential of IIT as a scientific theory. (shrink)

Both these developments would have surprised Berkeley. He would have found it paradoxical that the vulgar should have rejected his vulgar immaterialism as paradoxical, since he of course believed himself to be on their side in the matter, and characterised his own philosophy as a.

In the present paper we study the framework of additive utility theory, obtaining new results derived from a concurrence of algebraic and topological techniques. Such techniques lean on the concept of a connected topological totally ordered semigroup. We achieve a general result concerning the existence of continuous and additive utility functions on completely preordered sets endowed with a binary operation ``+'', not necessarily being commutative or associative. In the final part of the paper we get some applications to expected utility (...) theory, and a representation theorem for a class of complete preorders on a quite general family of real mixture spaces. (shrink)

Hitherto, the standard edition of Berkeley's works has been A. C. Fraser's of 1901, published by the Oxford University Press. The chief differences between the two editions are these. Professors Luce and Jessop give of each text the latest edition published by Berkeley himself, adding all significant variations in any earlier editions in footnotes, whereas Fraser followed no uniform procedure, and sometimes combined different editions. This difference is obviously an improvement. Further, Professor Luce's edition of Berkeley's pair of notebooks, which (...) he calls Philosophical Commentaries and which Fraser called Commonplace Book of occasional metaphysical thoughts, differs radically from Fraser's; Professor Luce has also given a different, and better, text of the Theory of Vision Vindicated. Finally, Volume II of the new edition amplifies Berkeley's brief correspondence with the American philosopher, Samuel Johnson, since it contains Johnson's letters to Berkeley, in which he questions some points in Berkeley's system, whereas Fraser published Berkeley's replies only. The editors' notes and introductions are brief, and have been written with the primary aim of presenting an accurate text. This policy is welcome, since it remains all too true that, as Professor Jessop remarks, "hitherto Berkeley has been read far too little, and his expositors far too much"; which, in the case of so excellent a writer as Berkeley, is doubly a pity. (shrink)

Ethics support services like Moral Case Deliberation intend to support healthcare professionals in ethically difficult situations. To assess outcomes of MCD, the Euro-MCD Instrument has been developed. Field studies to test this instrument are needed and have been conducted, examining important outcomes before MCD participation and experienced outcomes. The current study aimed to describe how participants’ perceive the importance of MCD outcomes after MCD; compare these perceptions with those before MCD participation; and test the factor structure of these outcomes. Swedish, (...) Norwegian and Dutch healthcare professionals rated the importance of outcomes in the Euro-MCD Instrument after four and eight MCDs. Ratings were compared with those before MCD participation using paired and independent samples t-tests. The factor structure was tested using exploratory factor analyses. After 4 and 8 MCDs, 443 respectively 247 respondents completed the instrument. More than 69% rated all MCD outcomes as ‘quite’ or ‘very’ important, especially outcomes from Enhanced Collaboration, Improved Moral Reflexivity and Improved Moral Attitude. Significant differences for 16 outcomes regarding ratings before and after MCD participation were not considered meaningful. Factor analyses suggested three categories, which seemingly resemble the domains Improved Moral Reflexivity, Enhanced Collaboration and a combination of Improved Moral Attitude and Enhanced Emotional Support. After participation in MCDs, respondents confirmed the importance of outcomes in the Euro-MCD Instrument. The question on perceived importance and the categorization of outcomes need reconsideration. The revised instrument will be presented elsewhere, based on all field studies and theoretical reflections. (shrink)

In disproof of the materialist principle, that common things exist unperceived, and in defence of the New Principle, Philonous here objects that it is inconceivable that a common thing should do so. Hylas replies that, on the contrary, we can and do think of, e.g., a tree standing alone as opposed to a tree being perceived by an observer. But Philonous counter-objects to this reply that it contains a contradiction, since it asserts that we can think of something which is (...) not thought of. (shrink)

In this paper I identify a tension between the two sets of works by Kuhn regarding the genesis of the “new historiography” of science. In the first, it could be said that the change from the traditional to the new historiography is strictly endogenous. In the second, the change is predominantly exogenous. To address this question, I draw on a text that is considered to be less important among Kuhn’s works, but which, as shall be argued, allows some contact between (...) Kuhn’s two approaches via Koyré. I seek to point out and differentiate the roles of Koyré and Kuhn – from Kuhn’s point of view – in the development of the historiography of science and, as a complement, present some reflections regarding the justification of the new historiography. (shrink)

Thomas Kuhn's philosophy of science, which he developed by focusing on physics, was later applied by other authors to virtually all areas or disciplines of culture. What interests me here, however, is the movement in the opposite direction: the role that one of these disciplines, history of art, played in the conception of Kuhn'stheoryof science.In a 1969 article, his only published text concerning science and art, Kuhn makes a brief and intriguing observation about The Structure of Scientific Revolutions. He says (...) the book was a belated product of his discovery of the parallels between science and art. This is a retrospective assertion about Structure, as well as that of the... (shrink)

Since the Global Financial Crisis, a surge of interest in the use of finance as a tool to address social and economic problems suggests the potential for a generational shift in how the finance industry operates and is perceived. J. C. de Swaan seeks to channel the forces of well-intentioned finance professionals to improve finance from within and help restore its focus on serving society. Drawing from inspiring individuals in the field, de Swaan proposes a framework for pursuing a viable (...) career in finance while benefiting society and upholding humanistic values. In doing so, he challenges traditional concepts of success in the industry. This will also engage readers outside of finance who are concerned about the industry's impact on society. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Happiness of “Those Who Lack the Use of Reason”Miguel J. RomeroHuman beings would have been created uselessly and in vain were they unable to attain happiness, as would be the case with anything that cannot attain its ultimate end.(De Malo, q. 5, a. 1, ad 1)A STUDY OF “those who lack the use of reason” in the thought and spirit of St. Thomas Aquinas has much to (...) offer the patient reader. We better understand what it means to be a rational animal, the image of triune God, when we investigate why, exactly, “mindless persons” (amentes) are not exceptions or even outliers in Aquinas’s account of the creaturely dignity and perfectibility of the human being.Aquinas remarks with some regularity on persons afflicted with the condition amentia, which is variously and inconsistently interpreted (in translation) as “imbeciles,” “fools,” “madmen,” “lunatics,” “the demented,” or “the insane.” The amentes are persons who lack the use of reason in a profound and debilitating way; and, as I will show, the fact that we are sometimes found in this state informs Aquinas’s analysis of human nature and, in particular, Aquinas’s teaching on the good wrought by Christ for the members of his body. Our guiding question is this: Thinking with Aquinas, how do we account for the natural and supernatural happiness of those of us who lack the use of reason?My purpose in this article is to explore what Aquinas has to say about the happiness of persons who are baptized and [End Page 49] confirmed by the Church, and who have what neuro-psychologists would describe as a profound cognitive impairment. The question is particularly striking when we recall that, for Aquinas, the distinguishing aptitude of the human being (proper to our intellectual nature and coordinate with our creaturely perfection) is the operation of an incorruptible intellectual capacity—a capacity, however, that is only reduced from potentiality to act when the corruptible “internal sense organ” is disposed to receive, in terms of health and circumstance, a coordinated sense impression of material species. Thus, a further question emerges: According to Aquinas, what is the perfective effect of grace in this life upon the nature of a person who completely lacks the use of reason due to an organic corruption or disorder of the ‘internal sense organ’?The discussion is divided into five parts. I begin (part I) by locating those who “lack the use of reason” within the theological infrastructure of Aquinas’s moral psychology and I identify the main problematic. With respect to that problematic, the principal conceptual resources provided by Aquinas are then outlined and two challenges are identified (part II).The first challenge is methodological, concerning the speculative import of the sacramental life of the Church. Francisco de Vitoria’s Relectio de eo ad quod tenetur homo veniens ad usum rationis (1534) highlights for us (part III) a constellation of judgments relevant to interpreting Aquinas on these themes, in particular, Aquinas’s formulation of prerational intellectual acts vis-à-vis the participation and membership of “mindless persons” in the sacramental life of the Body of Christ.The second challenge is to show the continuity between Aquinas’s account of the human being and his practical remarks on those who lack the use of reason. Specifically, given the various ways that, and degrees to which, the human being can lack the use of reason, I trace (part IV) Aquinas’s analysis of the power and operation of intellect, focusing on the intellectual acts which can be impaired and, concurrently, the intellectual acts which cannot be impaired in a living human being. Aquinas’s remarks on those latter acts not only reflect the [End Page 50] significance of the doctrine of the image of God in his account of human nature, but, even more, they shed light on the prosthesis of sacramental grace in his understanding of the properly human happiness capacitated and purposed in all whom God has called in Christ—a call to discipleship and devotion that includes those of us who have a profound, lifelong cognitive impairment (Rom 8:28; 9:11; Eph 1:3-14; II Tim 1:8-11).I conclude... (shrink)

Peut-on continuer à considérer les canons d’Elvire comme appartenant à un seul concile ? L’historiographie française la plus répandue jusqu'a ce jour a répondu affirmativement à cette question. Depuis la fin du siècle dernier, on assiste a un débat très anime sur l’authenticité et l’unité des Actes dits d’Elvire. Les différentes thèses se partagent entre deux approches totalement opposées : l’une soutient l’unité des Actes, sans refuser qu’ils aient pu être remanies au cours de leur transmission historique ; l’autre, a (...) la suite de l’article pionnier de M. Meigne (1975), défend le caractère composite des Actes, qui constitueraient une collection de dispositions juridiques hétérogènes. L’article présente l’état actuel de la recherche sur le concile d’Elvire ainsi que les enjeux principaux du débat. (shrink)