The working relationship between a private practice physician, whose medical practice was acquired by a health system, and the health system that sponsored the medical practices was studied using a dyadic perspective and drawing from agency theory to identify those characteristics that are present in an effective working relationship. In-depth interviews with currently employed physicians and those whose contracts were terminated within the last 3 years were used to identify why some working relationships failed and others succeeded. Hospital administrators and (...) practice managers that provided the support services to the acquired medical practices were also interviewed for their assessment of the working relationship.As a result of the research, a model for developing an effective working relationship is presented to be considered as a framework for developing future working relationships. Based upon the data, this study posits that the physicians and the hospitals can have a more effective working relationship if specific characteristics are evident before, during, and after the contract is signed. Understanding the factors that contribute to an effective working relationship can help in designing contracts with physicians and better utilize resources at the physician private practice level, as well as at the hospital level. (shrink)

The medical biography of Ludwig van Beethoven remains enigmatic. Some of his health problems, such as his early and eventually profound deafness, are well documented and extensively discussed, although not necessarily well explained . Other medical problems, and his ultimate cause of death, remain unclear. Perhaps unsurprisingly for such an important musical figure, there has been no dearth of speculation about the illnesses that may have befallen Beethoven. Medical historians and physicians have suggested a myriad of illnesses, including but hardly (...) limited to .. (shrink)

Mary Poppins is a magical film and a story of redemption that might be placed alongside the Parable of the Prodigal Son or A Christmas Carol. Mary may be the star of the film, but George Banks is its subject. If the world ever seemed wonderful and filled with surprises for George Banks as a child, it has since been supplanted by a world that is mechanical, predictable, and subject to the demands of business and of propriety. From Jack the (...) Giant Killer people learn that when pride has grown to gigantic proportions it ought to be killed; Cinderella teaches that the humble are exalted; Beauty and the Beast demonstrates the principle that loving the unlovable may result in the transformation from the beastly to the beautiful; and Mary Poppins reminds them that “There is no greater joy than that seen through the eyes of a child,” as Walt Disney observes in Saving Mr. Banks. (shrink)

Political corruption imposes substantial costs on shareholders in the U.S. Yet, we understand little about the basic factors that exacerbate or mitigate the value consequences of political corruption. Using federal corruption convictions data, we find that firm-level economic rents and monitoring mechanisms moderate the negative relation between corruption and firm value. The value consequences of political corruption are exacerbated for firms operating in low-rent product markets and mitigated for firms subject to external monitoring by state governments or monitoring induced by (...) disclosure transparency. Our results should inform managers and policymakers of the tradeoffs imposed on firms operating in politically corrupt districts. (shrink)

In many research studies, tumor biopsies are an unavoidable requirement for achieving key scientific aims. Yet some commentators view mandatory research biopsies as coercive and suggest they should be optional, or at least optional until further data are obtained regarding their scientific usefulness. Further complicating the ethical picture is the fact that some research biopsies offer a potential for clinical benefit to trial participants. We interviewed and surveyed a convenience sample of participants in phase I clinical trials at a single (...) institution. Our primary aim was to describe phase I participants’ understanding of whether a research biopsy offered them the prospect of medical benefit. We also endeavored to describe participants’ views about biopsies—specifically, the benefits of biopsies, if any, and whether biopsies were acceptable, risky, or discouraged trial participation. Finally, we collected data on demographics and attitudes to see if any strong correlations with misunderstanding, acceptability, or riskiness existed. Overall, the respondents tended to view research biopsies as acceptable, though they did not succeed in identifying the lack of benefit of a research biopsy. These findings call for renewed efforts in consent conversations and documents to carefully describe the benefits, or lack thereof, of research biopsies. (shrink)

The coronavirus disease 2019 (COVID-19) pandemic has motivated medical ethicists and several task forces to revisit or issue new guidelines on allocating scarce medical resources. Such guidelines are relevant for the allocation of scarce therapeutics and vaccines and for allocation of ICU beds, ventilators, and other life-sustaining treatments or potentially scarce interventions. Principles underlying these guidelines, like saving the most lives, mitigating disparities, reciprocity to those who assume additional risk (eg, essential workers and clinical trial participants), and equal access may (...) compete with one another. We propose the use of a “categorized priority system” (also known as a “reserve system”) as an improvement over existing allocation methods, particularly because it may be able to achieve disparity mitigation better than other methods. (shrink)

Many philosophers are impressed by the progress achieved by physical sciences. This has had an especially deep effect on their ontological views: it has made many of them physicalists. Physicalists believe that everything is physical: more precisely, that all entities, properties, relations, and facts are those which are studied by physics or other physical sciences. They may not all agree with the spirit of Rutherford's quoted remark that 'there is physics; and there is stamp-collecting',' but they all grant physical science (...) a unique ontological authority: the authority to tell us what there is. Physicalism is now almost orthodox in much philosophy, notably in much recent philosophy of mind. But although often invoked, it is rarely explicitly defined. It should be. The claim that everything is physical is not as clear as it seems. In this paper, we examine a number of proposed definitions of physicalism and reasons for being a physicalist. We will argue both that physicalism lacks a clear and credible definition, and that in no non-vacuous interpretation is it true. We are concerned here only with physicalism as a doctrine about the empirical world. In particular, it should not be confused with nominalism, the doctrine that there are no universals.2 Nominalism and physicalism are quite independent doctrines. Believers in universals may as consistently assert as deny that the only properties and relations are those studied by physical science. And nominalists may with equal consistency assert or deny that physical science could provide enough predicates to describe the world. That is the question which concerns physicalists, not whether physical predicates name real universals. (We will for brevity write as if they do, but we do not need that assumption.). (shrink)

Dispositions are essential to our understanding of the world. Dispositions: A Debate is an extended dialogue between three distinguished philosophers - D.M. Armstrong, C.B. Martin and U.T. Place - on the many problems associated with dispositions, which reveals their own distinctive accounts of the nature of dispositions. These are then linked to other issues such as the nature of mind, matter, universals, existence, laws of nature and causation.

This book provides an in-depth analysis of consumerism that draws from a wide range of theoretical, clinical and methodological approaches. Contributors demonstrate that consumerism and the culture that surrounds it exert profound and often undesirable effects on both people's individual lives and on society as a whole. Far from being distant influences, advertising, consumption, materialism and the capitalistic economic system affect personal, social and ecological well-being on many levels. Contributors also provide a variety of potential interventions for counteracting the negative (...) influence of consumerism. (shrink)

The discipline of affective neuroscience is concerned with the underlying neural substrates of emotion and mood. This review presents an historical overview of the pioneering work in affective neuroscience of James and Lange, Cannon and Bard, and Hess, Papez, and MacLean before summarizing the current state of research on the brain regions identified by these seminal researchers. We also discuss the more recent strides made in the field of affective neuroscience. A final section considers different hypothetical organizations of affective neuroanatomy (...) and highlights future directions for the discipline. (shrink)

We consider the relation between the uniform interpolation property and the elimination of non-standard quantifiers (the bisimulation quantifiers) in the context of the ?-calculus. In particular, we isolate classes of frames where the correspondence between these two properties is nicely smooth.

Abstract“Clinical ethics consultants” have been practicing in the United States for about 50 years. Most of the earliest consultants—the “pioneers”—were “outsiders” when they first appeared at patients' bedsides and in the clinic. However, if they were outsiders initially, they acclimated to the clinical setting and became “insiders” very quickly. Moreover, there was some tension between traditional academics and those doing applied ethics about whether there was sufficient “critical distance” for appropriate reflection about the complex medical ethics dilemmas of the day (...) if one were involved in the decision making. Again, the pioneers deflected concerns by identifying and instituting safeguards to assure professional objectivity in clinical ethics consultation services. One might suggest that in moving inside and establishing normative practices, the pioneer clinical ethics consultants anticipated adoption of their routines and professionalization of the field. (shrink)

In "Behavioral Law and Economics: The Assault on Consent, Will, and Dignity," Mark D. White uses the moral philosophy of Immanuel Kant to examine the intersection of economics, psychology, and law known as "behavioral law and economics." Scholars in this relatively new field claim that, because of various cognitive biases and failures, people often make choices that are not in their own interests. The policy implications of this are that public and private organizations, such as the state and employers, (...) can and should design the presentation of options and default choices in order to "steer" people to the decision they would make, were they able to make choices in the absence of their cognitive biases and failures. Such policies are promoted under the name "libertarian paternalism," because choice is not blocked or co-opted, but simply "nudged." White argues that such manipulation of choice is impossible to conduct in people's true interests, and any other goal pursed by policymakers substitutes their own ends, however benevolent they may be, for people's true ends. Normatively, such manipulation should not be conducted because it fails to respect the dignity and autonomy of persons, what some hold to be the central idea in Kant's ethical system, and which serves to protect the individual from coercion, however subtle, from other persons or the state. (shrink)

As clinical ethics consultants move toward professionalization, the process of certifying individual consultants or accrediting programs will be discussed and debated. With certification, some entity must be established or ordained to oversee the standards and procedures. If the process evolves like other professions, it seems plausible that it will eventually include a written examination to evaluate the core knowledge competencies that individual practitioners should possess to meet peer practice standards. The American Society for Bioethics and Humanities has published core knowledge (...) competencies for many years that are accepted by experts as the prevailing standard. Probably any written examination will be based upon the ASBH core knowledge competencies. However, much remains to be done before any examination may be offered. In particular, it seems likely that a recognized examining board must create and validate examination questions and structure the examination so as to establish meaningful, defensible parameters after dealing with such challenging questions as: Should the certifying examination be multiple choice or short-answer essay? How should the test be graded? What should the pass rate be? How may the examination be best administered? To advance the field of health care ethics consultation, thought leaders should start to focus on the written examination possibilities, to date unaddressed carefully in the literature. Examination models—both objective and written—must be explored as a viable strategy about how the field of health care ethics consultations can grow toward professionalization. (shrink)

This chapter investigates into what makes Captain America a great role model by describing some of his basic virtues. By looking at how Captain America embodies virtues such as courage and humility, he serves as a role model not only in terms of the virtues themselves but also in how he puts them into practice. The chapter argues that Captain America's supposed “black‐and‐white” ethics weren't simplistic in the 1940s, they are just as applicable now as they were then. One (...) persistent wrong about which Cap expresses righteous indignation is prejudice towards minorities. Captain America's tremendous willingness to sacrifice can be traced to his oversized sense of responsibility. Perseverance is what philosophers call an executive virtue because it helps people follow through on their judgment made in light of their virtues and principles. The virtues described in this chapter are only the ones most commonly attributed to Captain America in the comics. (shrink)

This book introduces the moral philosophy of Immanuel Kant—in particular, the concepts of autonomy, dignity, and character—to economic theory, explaining the importance of integrating these two streams of intellectual thought. Mainstream economics is rooted in classical utilitarianism, recommending that decision makers choose the options that are expected to generate the largest net benefits. For individuals, the standard economic model fails to incorporate the role of principles in decision-making, and also denies the possibility of true choice, which can be independent of (...) preferences and principles altogether. For policymakers, standard decision-making frameworks recommend tradeoffs that are beneficial in terms of material goods or wealth, but may be morally questionable from a more person-centered perspective. Integrating Kantian ethics affects economics in three important ways. This integration allows for a more complete understanding of human choice, incorporating not just preferences and constraints, but also principles and strength of will or character. It demonstrates the broader impact of welfare economics, which generates policies that affect not only persons' well-being, but also their dignity and autonomy. Finally, it reconciles the traditional, individualist stance in economic models of choice with the social responsibility emphasized by many systems of philosophical ethics and heterodox schools of economics. (shrink)

Explore the mind and world of the brilliant neurosurgeon-turned-Sorcerer Supreme Doctor Stephen Strange Marvel Comics legends Stan Lee and Steve Ditko first introduced Doctor Stephen Strange to the world in 1963—and his spellbinding adventures have wowed comic book fans ever since. Over fifty years later, the brilliant neurosurgeon-turned-Sorcerer Supreme has finally travelled from the pages of comics to the big screen, introducing a new generation of fans to his mind-bending mysticism and self-sacrificing heroics. In Doctor Strange and Philosophy, Mark D. (...) White takes readers on a tour through some of the most interesting and unusual philosophical questions which surround Stephen Strange and his place in the Marvel Universe. Essays from two-dozen Philosophers Supreme illuminate how essential philosophical concepts, including existentialism, epistemology, metaphysics, and ethics, relate to the world of Doctor Strange. Fans will find answers to all their Strange questions: How does Doctor Strange reconcile his beliefs in science and magic? What does his astral self say about the relationship between mind and body? Why is he always so alone? And what does he mean when he says we’re just “tiny momentary specks within an indifferent universe”—and why was he wrong? You won’t need the Eye of Agamotto to comprehend all that is wise within. Doctor Strange and Philosophy offers comic book fans and philosophers alike the chance to dive deeper into the world of one of Marvel’s most mystical superheroes. (shrink)

Properly speaking, money and law are natural outgrowths of human society, evolving over time via the voluntary cooperation that lies at the heart of the social enterprise. And as gold and the golden rule have for millennia formed the basis, respectively, of society’s money and law, they accordingly constitute the “twin pillars of civilization,” governing the social enterprise such that, in Mises’s words, “the human species has multiplied far beyond the margin of subsistence.” It stands to reason, then, that if (...) money and law are corrupted, the social enterprise will be corrupted as well. And as this is precisely what the state has done, essentially toppling the twin pillars of civilization, it is necessary to understand what the state is, where it came from, and how it has systematically gone about corrupting money and law, and thus the social enterprise as a whole. For only then can money and law be returned to their rightful owners, and only then can the state be put in its proper place. Which is no place so far as the proper functioning of civil society is concerned. (shrink)

This chapter focuses on the “America” part of Captain America's name and explores the more political aspects of his life and character. It looks at patriotism in general and how to characterize Captain America's brand of it; Cap's uneasy relationship with politics and the United States government; and how Cap puts principles above politics, even if it means defying his own government and giving up the shield and the title. The chapter explains that Cap's devotion to his country is based (...) on the principles and ideals upon which it was founded, and he regularly holds his government accountable to those same standards, which he interprets as inclusive and cosmopolitan, applying to the world outside America as well as everybody within it. It dispels any illusions that Captain America is a jingoist flag‐waver, and explains instead that he embodies an inclusive and cosmopolitan patriotism that balances idealism with clear‐eyed pragmatism. (shrink)

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

In this paper we argue that the approach for teaching non-Western, and specifically Chinese philosophy to undergraduate Western students, does not have to be significantly different than that for teaching philosophies from “Western” traditions. Four areas will be explored. Firstly, we look at debates on teaching non-Western philosophy from the perspective of themes or traditions, suggesting that, as an overarching guideline, it is mote discussion. Secondly, in terms of making generalizations, we argue that no more explanation of the “Chineseness” of (...) Chinese philosophy be offered than the “Germanness” of German philosophy, or “Greekness” of Greek philosophy. Thirdly, that lines of philosophical coherences are not limited to regional or cultural bounds. Finally, that foreign language be used in a way that invites understanding and does not close ideas off to students. In sum, we suggest applying well proven methods of teaching “Western” philosophy to Chinese (and other “Non-Western”) philosophies. After all, value of Chinese and other “Non-Western” philosophies comes not from their being “Chinese” or “Non-Western,” but from being philosophical. (shrink)

Killing is a topic that divides superhero fans like no other. Wonder Woman is a curious case, though. Traditionally associated with compassion and love, Diana is also a fierce warrior. While seeing Wonder Woman's choice through the lens of moral philosophy, it would seem that the deck is stacked against Lord in terms of one school of ethics, consequentialism. Consequentialism requires that we make a moral decision by choosing the option with the best (or least bad) outcomes. The simple math (...) dictates that Wonder Woman can guarantee the least loss of life by killing Max Lord. The decision Wonder Woman faced with respect to Max Lord closely resembles the one Superman faced when three renegade Kryptonians, each more powerful than Superman, wiped out the entire population of an Earth in an alternate dimension and threatened to do the same in his. (shrink)