The white coat ceremony is a common practice at many American and European medical schools. Current justification for the ceremony is mainly based on the good will felt by participants and an assumed connection between the ceremony and encouraging humanistic values in medicine. Recent critiques of the ceremony faults its use of oaths, premature alignment of students and faculty, and the selective appropriation of meaning to the white coat itself. This paper responds to recent critiques by addressing their misconceptions and (...) arguing that the white coat ceremony is a contemporary medical ritual with a key role for students and faculty in developing a professional identity.Since its inception in 1993, the white coat ceremony has become a national and international phenomenon. It is now practised at the beginning of the year at more than 100 American medical schools and is supported by foundation grants dedicated to endorsing and encouraging professional development and humanism in medicine.1 While some literature addresses the symbolism and history of the white coat itself, few sources consider the meaning of the ceremony.2–4 A common appeal is to the emotion and good will felt at the event.1,5 Although feelings are important, a deeper justification is called for.Criticism of the WCC is more explicit, charging that the ceremony: uses the Hippocratic Oath inappropriately or, at best, prematurely; fosters improper student faculty relationships, and; interprets the meaning of the white coat selectively.6,7 Critics suggest either that students not be asked to swear an oath together because it might conflict with personally held beliefs, or that students not be allowed to take the oath until they have demonstrated competence as physicians.6 Some also say that the WCC aligns students with faculty and against patients.6 The third …. (shrink)

Background: In Switzerland, non-medical right-to-die organisations such as Exit Deutsche Schweiz and Dignitas offer suicide assistance to members suffering from incurable diseases. Objectives: First, to determine whether differences exist between the members who received assistance in suicide from Exit Deutsche Schweiz and Dignitas. Second, to investigate whether the practices of Exit Deutsche Schweiz have changed since the 1990s. Methods: This study analysed all cases of assisted suicide facilitated by Exit Deutsche Schweiz (E) and Dignitas (D) between 2001 and 2004 and (...) investigated by the University of Zurich’s Institute of Legal Medicine (E: n = 147; D: n = 274, total: 421). Furthermore, data from the Exit Deutsche Schweiz study which investigated all cases of assisted suicide during the period 1990–2000 (n = 149) were compared with the data of the present study. Results: More women than men were assisted in both organisations (D: 64%; E: 65%). Dignitas provided more assistance to non-residents (D: 91%; E: 3%; p = 0.000), younger persons (mean age in years (SD): D: 64.5 (14.1); E: 76.6 (13.3); p = 0.001), and people suffering from fatal diseases such as multiple sclerosis and amyotrophic lateral sclerosis (D: 79%; E: 67%; p = 0.013). Lethal medications were more often taken orally in cases assisted by Dignitas (D: 91%; E: 76%; p = 0.000). The number of women and the proportion of older people suffering from non-fatal diseases among suicides assisted by Exit Deutsche Schweiz has increased since the 1990s (women: 52% to 65%, p = 0.031; mean age in years (SD): 69.3 (17.0) to 76.9 (13.3), p = 0.000), non-fatal diseases: 22% to 34%, p = 0.026). Conclusions: Weariness of life rather than a fatal or hopeless medical condition may be a more common reason for older members of Exit Deutsche Schweiz to commit suicide. The strong over-representation of women in both Exit Deutsche Schweiz and Dignitas suicides is an important phenomenon so far largely overlooked and in need of further study. (shrink)

The threat of bioterrorism, the emergence of the SARS epidemic, and a recent focus on professionalism among physicians, present a timely opportunity for a review of, and renewed commitment to, physician obligations to care for patients during epidemics. The professional obligation to care for contagious patients is part of a larger "duty to treat," which historically became accepted when 1) a risk of nosocomial infection was perceived, 2) an organized professional body existed to promote the duty, and 3) the public (...) came to rely on the duty. Physicians' responses to epidemics from the Hippocratic era to the present suggests an evolving acceptance of the professional duty to treat contagious patients, reaching a long-held peak between 1847 and the1950's. There has been some professional retrenchment against this duty to treat in the last 40 years but, we argue, conditions favoring acceptance of the duty are met today. A renewed embrace of physicians' duty to treat patients during epidemics, despite conditions of personal risk, might strengthen medicine's relationship with society, improve society's capacity to prepare for threats such as bioterrorism and new epidemics, and contribute to the development of a more robust and meaningful medical professionalism. (shrink)

The US neutrino community gathered at the Workshop on the Intermediate Neutrino Program at Brookhaven National Laboratory February 4-6, 2015 to explore opportunities in neutrino physics over the next five to ten years. Scientists from particle, astroparticle and nuclear physics participated in the workshop. The workshop examined promising opportunities for neutrino physics in the intermediate term, including possible new small to mid-scale experiments, US contributions to large experiments, upgrades to existing experiments, R&D plans and theory. The workshop was organized into (...) two sets of parallel working group sessions, divided by physics topics and technology. Physics working groups covered topics on Sterile Neutrinos, Neutrino Mixing, Neutrino Interactions, Neutrino Properties and Astrophysical Neutrinos. Technology sessions were organized into Theory, Short-Baseline Accelerator Neutrinos, Reactor Neutrinos, Detector R&D and Source, Cyclotron and Meson Decay at Rest sessions.This report summarizes discussion and conclusions from the workshop. (shrink)

There is an increasing interest in how managers describe and respond to what they regard as moral versus nonmoral problems in organizations. In this study, forty managers described a moral problem and a nonmoral problem that they had encountered in their organization, each of which had been resolved. Analyses indicated that: (1) the two types of problems could be significantly differentiated using four of Jones' (1991) components of moral intensity; (2) the labels managers used to describe problems varied systematically between (...) the two types of problems and according to the problem's moral intensity; and (3) problem management processes varied according to the problem's type and moral intensity. (shrink)

Tool use research has suffered from a lack of consistent theoretical frameworks. There is a plethora of tool use definitions and the most widespread ones are so inclusive that the behaviors that fall under them arguably do not have much in common. The situation is aggravated by the prevalence of anecdotes, which have played an undue role in the literature. In order to provide a more rigorous foundation for research and to advance our understanding of the interrelation between tool use (...) and cognition, we suggest the adoption of Fragaszy and Mangalam's (2018) tooling framework, which is characterized by the creation of a body-plus-object system that manages a mechanical interface between tool and surface. Tooling is limited to a narrower suite of behaviors than tool use, which might facilitate its neurocognitive investigation. Indeed, evidence in the literature indicates that tooling has distinct neurocognitive underpinnings not shared by other activities typically classified as tool use, at least in primates. In order to understand the extent of tooling incidences in previous research, we systematically surveyed the comprehensive tool use catalog by Shumaker et al. (2011). We identified 201 tool use submodes, of which only 81 could be classified as tooling, and the majority of the tool use examples across species were poorly supported by evidence. Furthermore, tooling appears to be phylogenetically less widespread than tool use, with the greatest variability found in the primate order. However, in order to confirm these findings and to understand the evolution and neurocognitive mechanisms of tooling, more systematic research will be required in the future, particularly with currently underrepresented taxa. (shrink)

The problem addressed in this paper is “the main epistemic problem concerning science”, viz. “the explication of how we compare and evaluate theories [...] in the light of the available evidence” (van Fraassen, BC, 1983, Theory comparison and relevant Evidence. In J. Earman (Ed.), Testing scientific theories (pp. 27–42). Minneapolis: University of Minnesota Press). Sections 1– 3 contain the general plausibility-informativeness theory of theory assessment. In a nutshell, the message is (1) that there are two values a theory should exhibit: (...) truth and informativeness—measured respectively by a truth indicator and a strength indicator; (2) that these two values are conflicting in the sense that the former is a decreasing and the latter an increasing function of the logical strength of the theory to be assessed; and (3) that in assessing a given theory by the available data one should weigh between these two conflicting aspects in such a way that any surplus in informativeness succeeds, if the shortfall in plausibility is small enough. Particular accounts of this general theory arise by inserting particular strength indicators and truth indicators. In Section 4 the theory is spelt out for the Bayesian paradigm of subjective probabilities. It is then compared to incremental Bayesian confirmation theory. Section 4 closes by asking whether it is likely to be lovely. Section 5 discusses a few problems of confirmation theory in the light of the present approach. In particular, it is briefly indicated how the present account gives rise to a new analysis of Hempel’s conditions of adequacy for any relation of confirmation (Hempel, CG, 1945, Studies in the logic of comfirmation. Mind, 54, 1–26, 97–121.), differing from the one Carnap gave in § 87 of his Logical foundations of probability (1962, Chicago: University of Chicago Press). Section 6 adresses the question of justification any theory of theory assessment has to face: why should one stick to theories given high assessment values rather than to any other theories? The answer given by the Bayesian version of the account presented in section 4 is that one should accept theories given high assessment values, because, in the medium run, theory assessment almost surely takes one to the most informative among all true theories when presented separating data. The concluding section 7 continues the comparison between the present account and incremental Bayesian confirmation theory. (shrink)

Jakob Huber's Kant's Grounded Cosmopolitanism: Original Common Possession and the Right to Visit sets out a rich and novel project of Kant interpretation and defence. Huber does well to wed argumen...

Examines the political significance of ideas about happiness through the work of utilitarian philosophers William Thompson and Jeremy Bentham. Happiness is political. The way we think about happiness affects what we do, how we relate to other people and the world around us, our moral principles, and even our ideas about how society should be organized. Utilitarianism, a political theory based on hedonistic and individualistic ideas of happiness, has been dominated for more than two-hundred years by its founder, Jeremy Bentham. (...) In Happiness, Democracy, and the Cooperative Movement, Mark J. Kaswan examines the work of William Thompson, a friend of Bentham’s who nonetheless offers a very different utilitarian philosophy and political theory based on a different conception of happiness, but whose work has been largely overlooked. Kaswan reveals the importance of our ideas about happiness for our understanding of the basic principles and nature of democracy, its role in society and its character as a social institution. In what is the closest examination of Thompson’s political theory to date, Kaswan moves from philosophy to theory to practice, starting with conceptions of happiness before moving to theories of utility, then to democratic theory, and finally to practice in the first detailed account of how Thompson’s ideas laid the foundations for the cooperative movement, which is now the world’s largest democratic social movement. Mark J. Kaswan is Assistant Professor of Government at the University of Texas at Brownsville and J. Robert Beyster and Michael W. Huber Fellow, Rutgers University School of Management and Labor Relations. (shrink)

The controversy surrounding the use of hydroxychloroquine, an antimalarial drug, for COVID-19 has raised numerous ethical and policy problems. Since the suggestion that HCQ has potential for COVID-19, there have been varying responses from clinicians and healthcare institutions, ranging from adoption of protocols using HCQ for routine care to the conduct of randomised controlled trials to an effective system-wide prohibition on its use for COVID-19. In this article, we argue that the concept of ‘disease public profile’ has become a prominent, (...) if not the sole, determinant in decision-making across various healthcare responses to the pandemic. In the case of COVID-19, the disease’s public profile is based on clinical and non-clinical factors that include contagiousness, clinical presentation and media coverage. In particular, we briefly examine the dangers of a heightened public profile in magnifying the inequality of diseases and undermining three key ethical concepts, namely evidence-based practice, sustainable allocation and meaningful consent. (shrink)

Beyond Agreement addresses the thorny question of how to make interreligious dialogue productive when the religious differences are so large that finding common ground seems unlikely. The book offers a way to think about interreligious dialogue that allows people to stay committed to their own truth as they have come to know it while being open to learning from other religions.

To this end, I propose to follow a somewhat unusual pattern, in that there will be no point-by-point consideration of issues raised by Taylor and Kullman. Instead, I intend to outline Merleau-Ponty's position on language, speech, and meaning as presented in the Phénoménologie de la Perception, and proceed from there to a discussion of the pre-objective.

IN Plato’s eyes, unity was a prime requisite of civil society: “there is no greater good than whatsoever binds the State together into one”. Plato carried his conception of unity to an extreme; for his organic conception has the defect of postulating members who are means to the life of the rest, and do not share in that life. And yet Plato argues from his organic conception of the state to the conclusion, that as in an organism part must be (...) proportioned to suit part, and all to suit the whole—as no part must grow unduly, lest every part should suffer—so in a State class must be proportioned to class, and all classes be adjusted to the good of the whole. (shrink)

This book explores an undeveloped area in postmodern thought: organizational ethics. Ethical debates and analyses usually focus on a particular act or action, an actor, and/or how a secular society should address any of those particular persons or events. In the Post Modern age, ethical decisions and policies are characterized by moral and cultural pluralism. However, there is a second factor that complicates ethical and policy decisions even further. This book argues that in the postmodern age ethical decisions often need (...) to be understood as part of the decision making of organizations and bureaucracies. Organizational decisions often have direct bearing on the choices made by individuals. Two areas that exemplify postmodern issue are the areas of health care and education. For example the decision making of Admissions Officers in American higher education, are influenced by decisions that have been made by the university about the size of the class and the diversity of the class. Health Care organizations make policy decisions that affect every aspect of a patient’s care from admission to treatment and the types of care that are or are not offered. Both education and health care are the object of the significant investment of resources, both areas are value laden in postmodern, pluralistic societies, and yet we do not have a comprehensive method to understand them or evaluate them. This book is of interest to bioethicists, physicians, nurses, health care policy students, educational policy experts, students and government regulators. (shrink)

In this paper the authors argue that research ethics committees should not be paternalistic by rejecting research that poses risk to people competent to decide for themselves. However it is important they help to ensure valid consent is sought from potential recruits and protect vulnerable people who cannot look after their own best interests. The authors first describe the tragic deaths of Jesse Gelsinger and Ellen Roche. They then discuss the following claims to support their case: competent individuals are epistemologically (...) and ethically in the best position to say which risks are reasonable for them, so RECs should be no more restrictive than the “normal” constraints on people taking risks with themselves; RECs do not judge individual competence ; individual liberty is mostly limited by what serves the public interest, and RECs do not determine public interest; RECs may have a paternalistic role in preventing exploitation of competent people vulnerable to the use of incentives, and in protecting the interests of incompetent people; however, the moral and political authority of RECs has not been established in this respect. (shrink)

Introduction -- Tending the dark fire: the Boehmian notion of drive -- The night-side of nature: the early Schellingian unconscious -- The speculative psychology of dissociation: the later Schellingian unconscious -- Schellingian libido theory.

In examining Ennead VI 4[22], we find Plotinus in conflict with modern, i.e., Cartesian or Kantian, assumptions about the relation of soul and body and the identification of the self with the subject. Curiously, his images and exposition are more in tune with Twentieth Century notions such as wave and field. With these as keys, we are in a position to unlock the subtlety of Plotinus' analysis of the way soul and body are present together, with sensation structured through the (...) body and judgment coming from the soul. The problem of the self concerns not only the unity of the self in terms of body and soul, but also how the self is constituted in relation to other selves, both keeping its individuality and sharing its experiences at the same time. (shrink)

Menander's lost comedyThaiswith its famous protagonist, thehetairalover of Ptolemy I Soter and perhaps Alexander himself, was plainly well known at Rome, and is alluded to several times in Latin poetry of the Augustan and later periods, as Ariana Traill has shown. My purpose here is to argue that the literary characterisation of Thais in Menander's play underlies certain aspects of Lesbia as presented in the poetry of Catullus; that Catullus' poetry uses the plays of Menander has been demonstrated by Richard (...) Thomas, arguing that Catullus 8 shows clear traces of Demea's monologue in theSamia(325–56). (shrink)

The limitation of act by potency, central in the metaphysics of Thom as Aquinas, has its origins in Plotinus. He transforms Aristotle ’s horizontal causality of change into a vertical causality of participation. Potency and infinity are not just un intelligible lack of limit, but productive power. Form determines matter but is limited by recepti on into matter. The experience of unity begins with sensible things, which always have parts, so what is really one is incorporeal, without division and separation. (...) Unity is like the esse of Thomas, since it is the act that makes a thing what it is and has its fullness in God. (shrink)