My argument: P1: If my personhood is caused by Truth then, Truth is a person. P2: My personhood is caused by Truth. C: Therefore, Truth is a person. The argument hinges on the Causal Principle: A cause is, at least, as powerful as its effect. I can get 1 from 10, but I cannot get 10 from 1; therefore, the causal principle is vindicated. Truth is more than a person as you and I are, He is the archetype of personhood (...) by and in which all other personhoods move and have their being. Unlike Descartes who was unable to stop a slide into ever more skepticism, the Archimedean point of Truth - though, I am not directly going into math and logic here I believe them to function likewise as bulwarks against skepticism – does just that. The tsunami of skepticism has been unable to sweep up this hill. We can indeed know with surety, which is absolute certainty, that Truth exists and by extension God, who is Truth, and the rest of what Descartes builds back as sure i.e., the external, sensory world. (shrink)

Epitomised by tedium and existential vacuity, ennui insidiously permeates the psyche of healthcare professionals, often eluding detection. Its etiological roots extend beyond its salient exploration in French literature, harking back to the early Christian treatises on acedia or spiritual desuetude.1 Throughout the centuries, ennui has undergone a substantive evolution, mirroring the vicissitudes in cultural cognition and existential sentiment. Spanning from the discourse in medieval monasticism to cogitations during the Renaissance and Enlightenment epochs, ennui has metamorphosed into a pivotal motif across (...) the literary, philosophical and theological spectra.2 This intricate concept, embodying a profound and variegated historical lineage, has been meticulously dissected and recontextualised by a cadre of preeminent thinkers and literary connoisseurs. In the contemporary medical ethics landscape, ennui emerges from labyrinthine historical antecedents, manifesting as profound existential drift among healthcare professionals. This state, marked by discord between self and purposive existence, leads to disengagement and disillusionment, challenging practitioners’ resilience and ethical decision-making capacities. Ennui ignites introspection but insidiously undermines their engagement and fervour, casting a shadow over professional zeal and mental fortitude. In their reflections, existential philosophers like Søren Kierkegaard and Albert Camus, diverging from Pascal’s theological exegesis, explored quintessential human experience and essence leitmotifs. Their analyses of despair and the absurd show parallels with ethical dilemmas and complexities in medical practice. …. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Full Collection of Personal NarrativesAustin Morris, Lisa P., Jeanne Kerwin, Jean Watson, Eve Makoff, Brent R. Carr, Anonymous One, Michelle Prong, Laura J. Hoeksema, Tracy R. Wilson, Frances Rieth Maynard, Laura A. Katers, and Maggie Taylor• Against Their Wishes: The Gift of a Goodbye• Lisa’s Story• Unbefriended• The Clinical Ethics Consult: Transforming Ambivalence to Action• Side Stepping The Issues: Disappointment With An Ethics Consult For A Medically High Risk (...) Patient• My Father Dies Alone• Whose Voice Matters? The Role of Ethics Consultation in Supporting the 16-Year-Old Healthcare Decision-Maker of a Critically Ill Neonate• The Healing Power of an Ethics Consult• Clinical Ethicists: Can They Help Families in Their Times of Need?• “It’s All Personal”• Fault Lines• Difficult, Difficult, Lemon, DifficultCopyright © 2024 Johns Hopkins University Press... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Side Stepping The Issues: Disappointment With An Ethics Consult For A Medically High Risk PatientBrent R. CarrMonths of severe symptoms were a blur—hour after hour of suffering. Sleep is her only respite. Her 5-word diagnosis, “treatment-refractory depression with anxious distress,” seemed too orderly, like a flattened 2-dimensional strip of ribbon that simply ironed out all the chaos and confused distress roiling within her. Anyone entering the psychiatric unit early (...) in the morning could hear her near-breathless sobbing, calling for nursing help, repeatedly pleading to anyone who would listen that she was dying. By afternoon, her wheelchair would be situated off to one side of the milieu to prevent agitation of other [End Page 13] patients. From there, she would summon them with small gestures or brief, incessant outbursts to save her, that her body was decaying, withering before them. Such is the torment of nihilistic delusions. She flailed her arms, rocking back and forth, lamenting that no one would help. Although she possessed full leg strength, she refused to stand from the wheelchair, fearing collapse. These distressed pleas were sustained well past each dinner, the anguish echoing from her room, and during her evening shower. Sometimes a pillow-muffled sigh and silence would disclose when her torments became engulfed in sleep.Two years prior, she had a similar episode that lasted almost 3-years. It had failed to respond to months of psychotherapy and more than 15 medication trials. That time, she had cried with happiness after the mental illness went into full remission after only a three-week course of electroconvulsive therapy (ECT). She described this as her miracle. But as miraculous as the ECT was for her, it was problematic. She is a high-risk patient with ongoing hypertension and Wolff-Parkinson-White Syndrome, a condition that leads to an inappropriately fast pulse from aberrant electrical pathways in the heart. During the final week of ECT, she experienced a marked blood pressure surge that led to severe cardiac pathology—Takatsubo’s cardiomyopathy. This is also known as “stress cardiomyopathy” or “broken heart syndrome,” befitting the vexed emotional state she had been in. The cardiomyopathy resembled a myocardial infarct, and it took several months for her to fully recover. Unfortunately, this prevented the use of ECT as a relapse prevention treatment. By one-year post-ECT, her systolic left ventricular dysfunction had resolved, and her ejection fraction (the heart’s pumping efficiency) had normalized.Now, once again, she was treatment-resistant, and ECT was the treatment of choice. The risk stratification for ECT encompassed her prior Takatsubo’s cardiomyopathy, which has a small but known chance for recurrence. This made her a high-risk patient. This risk was convoluted even more by her depression-induced psychosis, wherein she believed that she was dying, that meds were poisoning her, and that ECT would kill her from a heart attack. Before the psychiatric team consulted the ECT service, a mental health court had already ruled regarding her lack of capacity for her medical decisions. The court had authorized her husband as her proxy with authority to consent for her medical care, including for ECT. My role in this case was as the ECT proceduralist from the neuromodulation service who had been consulted by the primary team. The husband was an informed individual and signed consent for ECT. These events all coincided with the primary attending’s departure on scheduled leave. There was now a new covering attending.The resident psychiatrist was apprehensive about ECT and deliberated that the patient was at least able to identify potential risks of ECT—even if exacerbated by a nihilistic delusion. The resident speculated that perhaps the patient should at least be able to refuse ECT, given her previous cardiomyopathy. The newly arrived attending deferred a response regarding her concern and stated it had already been decided by the “team.” This amplified doubt. The medical students sensed the resident’s apprehension and felt confused about whether the patient should receive ECT or not. This dynamic quickly spilled over into nursing discussions, where some were now hesitating about the decision. The cohesiveness of the psychiatry treatment team was compromised... (shrink)