Patient outcome after serious brain injury is highly variable. Following a period of coma, some patients recover while others progress into a vegetative state (unresponsive wakefulness syndrome) or minimally conscious state. In both cases, assessment is difficult and misdiagnosis may be as high as 43%. Recent advances in neuroimaging suggest a solution. Both functional magnetic resonance imaging and electroencephalography have been used to detect residual cognitive function in vegetative and minimally conscious patients. Neuroimaging may improve diagnosis and prognostication. These techniques (...) are beginning to be applied to comatose patients soon after injury. Evidence of preserved cognitive function may predict recovery, and this information would help families and health providers. Complex ethical issues arise due to the vulnerability of patients and families, difficulties interpreting negative results, restriction of communication to “yes” or “no” answers, and cost. We seek to investigate ethical issues in the use of neuroimaging in behaviorally nonresponsive patients who have suffered serious brain injury. The objectives of this research are to: (1) create an approach to capacity assessment using neuroimaging; (2) develop an ethics of welfare framework to guide considerations of quality of life; (3) explore the impact of neuroimaging on families; and, (4) analyze the ethics of the use of neuroimaging in comatose patients. (shrink)

At the heart of process-relational theology in the tradition of Alfred North Whitehead (1861-1947) and Charles Hartshorne (1897-2000) is the rejection of coercive omnipotence and the embrace of divine persuasion as the patient and uncontrolling means by which God works with a truly self-creative world. According to Whitehead, Plato's conviction that God is a persuasive agency and not a coercive agency constitutes "one of the greatest intellectual discoveries in the history of religion." According to Hartshorne, omnipotence is a "theological (...) mistake." What is behind these claims? Why do process-relational philosophers and theologians reject divine omnipotence? How have they justified a commitment to divine persuasion, and what kind of theoretical and practical implications are involved? Featuring contributions from key process-relational thinkers, this book situates a shift "from force to persuasion" across multiple thresholds of discourse, from philosophy and theology to spirituality and politics to pluralism, axiology, and apocalypse. It aims to reawaken attention to the operations of divine persuasion as ever-loving and inherently noncoercive, but always at risk in an open and relational universe. (shrink)

BackgroundSevere brain injury is a leading cause of death and disability. Diagnosis and prognostication are difficult, and errors occur often. Novel neuroimaging methods can improve diagnostic and prognostic accuracy, especially in patients with prolonged disorders of consciousness (PDoC). Yet it is currently unknown how family caregivers understand this information, raising ethical concerns that disclosure of neuroimaging results could result in therapeutic misconception or false hope.MethodsTo examine these ethical concerns, we conducted semi-structured interviews with caregivers of patients with PDoC who were (...) enrolled in a concurrent neuroimaging research program designed to detect covert consciousness following severe brain injury. Caregivers held surrogate decision-making status for a patient. Interviews were conducted at two time points for each caregiver. The first interview occurred before the disclosure of neuroimaging results. The second occurred after disclosure. Descriptive analysis was applied to the data of four interview topics: (1) expectations for neuroimaging; (2) reactions to evidence of preserved cognition; (3) reactions to null results; and (4) understanding of the results and study.ResultsTwelve caregivers participated in the study; two caregivers shared surrogate decision-making status for one patient with PDoC. Twenty-one interviews were completed; one caregiver declined to participate in the post-disclosure interview. Three patients with PDoC associated with the study displayed evidence of covert consciousness. Overall, caregivers understood the neuroimaging research and results. Caregivers who received results of covert consciousness were generally pleased. However, there was some variation in expectations and reactions to these data and null results.ConclusionThis study, for the first time, reveals caregiver expectations for and reactions to neuroimaging evidence of covert consciousness in patients with PDoC. Caregivers understood the neuroimaging research and results, casting doubt on speculative ethical concerns regarding therapeutic misconception and false hope. However, disclosure of neuroimaging result could be improved. Pre-disclosure consultations might assist professionals in shaping caregiver expectations. Standardization of disclosure might also improve comprehension of the results. (shrink)

After severe brain injury, one of the key challenges for medical doctors is to determine the patient’s prognosis. Who will do well? Who will not do well? Physicians need to know this, and families need to do this too, to address choices regarding the continuation of life supporting therapies. However, current prognostication methods are insufficient to provide a reliable prognosis. -/- Functional Magnetic Resonance Imaging (MRI) holds considerable promise for improving the accuracy of prognosis in acute brain injury patients. Nonetheless, (...) research on functional MRI in the intensive care unit context is ethically challenging. These studies raise several ethical issues that have not been addressed so far. In this article, Prof. Charles Weijer and his co-workers provide a framework for researchers and ethics committees to design and review these studies in an ethically sound way. (shrink)

This book taps the best American thinkers to answer the essential American question: How do we sustain our experiment in government of, by, and for the people? Authored by an extraordinary and politically diverse roster of public officials, scholars, and educators, these chapters describe our nation's civic education problem, assess its causes, offer an agenda for reform, and explain the high stakes at risk if we fail.

Institutional review board delays may hinder the successful completion of federally funded research in the U.S. military. When this happens, time-sensitive, mission-relevant questions go unanswered. Research participants face unnecessary burdens and risks if delays squeeze recruitment timelines, resulting in inadequate sample sizes for definitive analyses. More broadly, military members are exposed to untested or undertested interventions, implemented by well-intentioned leaders who bypass the research process altogether. To illustrate, we offer two case examples. We posit that IRB delays often appear in (...) the service of managing institutional risk, rather than protecting research participants. Regulators may see more risk associated with moving quickly than risk related to delay, choosing to err on the side of bureaucracy. The authors of this article, all of whom are military-funded researchers, government stakeholders, and/or human subject protection experts, offer feasible recommendations to improv... (shrink)

It is argued that a chief obstacle to a naturalistic explanation of the origins of mind is human exceptionalism, as exempli fi ed in the seventeenth century by René Descartes and in the twentieth century by Noam Chomsky. As an antidote to human exceptionalism, we turn to the account of aesthetic judgment in Charles Darwin’s Descent of Man , according to which the mental capacities of humans differ from those of lower animals only in degree, and not in kind. (...) Thoroughgoing naturalistic explanation of these capacities is made easier by shifting away from the substance-metaphysical implications of the search for an account of mind , toward a dispositional account of the origins of mindfulness . (shrink)

This volume is a Festschrift dedicated to Charles Kahn comprised of more than 20 papers presented at the conference "Presocratics and Plato: Festschrift Symposium in Honor of Charles Kahn", 3-7 June 2009. The conference was held at the European Cultural Center of Delphi, Greece, and was organized and sponsored by the HYELE Institute for Comparative Studies and Parmenides Publishing, with endorsement from the International Plato Society, and the Dean of the School of Arts and Sciences, University of Pennsylvania. (...) Contributors: Julia Annas - University of Arizona; Sarah Broadie - University of St. Andrews; Lesley Brown - University of Oxford; Tomás Calvo-Martínez - Universidad Complutense de Madrid; Diskin Clay - Duke University; John M. Dillon - Trinity College, Dublin; Dorothea Frede - Humbolt University, Berlin; Arnold Hermann - HYELE Institute for Comparative Studies; Carl A. Huffman - DePauw University; Enrique Hülsz Piccone - Universidad Nacional Autonoma de Mexico; D.M. Hutchinson - St. Olaf College; Paul Kalligas - National and Kapodistrian University, Athens; Vassilis Karasmanis - National Technical University, Athens; Aryeh Kosman - Haverford College; Anthony A. Long - University of California, Berkeley; Richard McKirahan - Pomona College; Susan Sauvé Meyer - University of Pennsylvania; Alexander P.D. Mourelatos - University of Texas at Austin; Satoshi Ogihara - Tohoku University, Japan; Richard Patterson - Emory University; Christopher J. Rowe - Durham University; David Sedley - University of Cambridge; Richard Sorabji - University of Oxford. (shrink)

This chronological collection of Moore's most compelling and dramatic images, taken as the movement progressed through Alabama, Mississippi, Tennessee, and Georgia, highlights activity from 1958 to 1965. Included are the iconic scenes of black protestors huddled in a doorway to escape the crippling blasts of fire hoses in Birmingham; a white bigot swinging a baseball bat seconds before cracking it on the head of a black woman during the desegregation of the Capitol Cafeteria in Montgomery; a young and stunned Dr. (...) Martin Luther King Jr. pinned to the counter of a police precinct, his arm twisted behind his back; the devastating aftermath of "Bloody Sunday" on the Edmund Pettus Bridge in Selma; and Bull Connor's police dogs tearing mercilessly at the legs of a protestor in downtown Birmingham. Celebrity protestors--comedian Dick Gregory, poet Galway Kinnell, singers Joan Baez, Mary Travers, Pete Seeger, and Harry Bellafonte, actor Pernell Roberts, and writer James Baldwin--are featured alongside the many nameless but committed participants and the recognized major leaders of the movement. (shrink)

In "Frailty Triage: Is Rationing Intensive Medical Treatment on the Grounds of Frailty Ethical?," Wilkinson (2021) argues that the use of frailty scores in ICU triage does not necessarily involve discrimination on the basis of disability. In support of this argument, he claims, “it is not the disability per se that the score is measuring – rather it is the underlying physiological and physical vulnerability." While we appreciate the attention Wilkinson explicitly pays to disability in this piece, we find the (...) distinction between disability and underlying vulnerability untenable both theoretically and practically. In this peer commentary, we begin with a brief overview of research in philosophy of disability concerning the meaning of the concept itself. We argue that this research demonstrates that many forms of disability do not involve underlying vulnerabilities, and, furthermore, that Wilkinson equivocates between "disability" understood as a medical category vs. "disability" understood as a feature of lived experience. We reject Wilkinson’s distinction on these grounds and offer further considerations to avoid disability discrimination in emergency and crisis standards of care contexts. (shrink)

What if you were to discover that you were only one half of a whole—that you had a divine double? In the second and third centuries CE, Charles Stang shows, this idea gripped the religious imagination of the Eastern Mediterranean, offering a distinctive understanding of the self that has survived in various forms down to the present.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Politics of Aristotle by AristotleCharles M. YoungAristotle. The Politics of Aristotle. Translated by Peter L. Phillips Simpson. Chapel Hill: University of North Carolina Press, 1997. Pp. xliv + 274. Cloth, $39.95. Paper, $12.95.Peter Simpson’s attractively produced, readable, and generally accurate new translation offers much of assistance to the student of Aristotle’s Politics. In addition to providing [End Page 356] titles to books and chapters, Simpson has broken (...) chapters into sections, which he also titles and briefly summarizes. The summaries allow Simpson to give indications as to the flow of Aristotle’s thought without building them into the translation itself. The sections of the translation also correspond to the sections of Simpson’s still newer A Philosophical Commentary on the Politics of Aristotle (Chapel Hill: University of North Carolina Press, 1998); notes to the translation also sometimes point to the line of argument in the commentary. Simpson also includes a translation of the last book of the Nicomachean Ethics, which many see as an introduction or transition to the Politics, a brief discussion of the translations of certain key terms, a glossary of significant terms, and an analytical outline of the argument of the Politics. The result is a welcome and useful translation and set of tools.Two of Simpson’s decisions in preparing his translation are regrettable. First, Simpson places the discussion of the best polis in books 7 and 8 between the discussion of the nature of the polis and its kinds in book 3 and the discussion of other sorts of polis in books 4–6, thus printing the books in the order 1, 2, 3, 7, 8, 4, 5, 6. There are good reasons for believing that this is how Aristotle intended the Politics to be read. But in deciding the order in which to print the books, these reasons must be weighed against the inconvenience and confusion produced by departing from the normal, manuscript ordering of the books. In my view this is not even a close call. One can easily indicate one’s belief about the correct order of the books, as Simpson does (xvi–xx), and avoid all inconvenience by printing the books in their manuscript order.More to be regretted is Simpson’s decision (made, I imagine, for aesthetic reasons) not to follow the increasingly common and laudable practice of printing Bekker numbers in the margins of translations of Aristotle. These numbers are a great convenience to readers, for they make it easy to locate specific passages in different translations and in the Greek original. Simpson does give the Bekker number of the beginning of each of his sections, and he may think that this is enough to allow readers to locate specific passages easily (he says as much in his Commentary, xiii). But Simpson’s sections are sometimes as big as a Bekker page, and many of them are as many as ten to fifteen lines long; I speak from experience in reporting that it is more difficult and time-consuming to find one’s way around Simpson’s translation than it should be. [End Page 357]Charles M. YoungClaremont Graduate UniversityCopyright © 1999 Johns Hopkins University Press... (shrink)

For nearly a decade we have taught the history and philosophy of science as part of courses aimed at the professional development of physics teachers. The focus of the history of science instruction is on the stages in the development of the concepts and theories of physics. For this instruction, we designed activities to help the teachers organize their understanding of this historical development. The activities include scientific modeling using archaic theories. We conducted surveys to gauge the impact on the (...) teachers of including the conceptual history of physics in the professional development courses. The teachers report greater confidence in their knowledge of the history of physics, that they reflect on this history for their teaching, and that they use of the history of physics for their classroom instruction. In this paper, we provide examples of our activities, the rationale for their design, and discuss the outcomes for the teachers of the instruction. (shrink)

This chapter contains sections titled: Introduction Courage and Self‐control The Object of Cheer Danger as the Object of Cheer Safety as the Object of Cheer Success as the Object of Cheer Horatius at the Bridge Acting for the Sake of the Fine When is Death Fine? Note Bibliography.

This chapter contains sections titled: Introduction Preliminaries Universal vs. Particular Justice The Scope of Particular Justice Justice and the Doctrine of the Mean: The Problem Distributive and Corrective Justice Political Justice Pleonexia Justice and the Doctrine of the Mean: Aristotle's Solution Conclusion Bibliography.

This chapter contains sections titled: Introduction Preliminaries Apology 21b9–23c1: The Origins of the Socratic Elenchus Inconsistency Does Socrates Cheat? Some Stabs at Explanations Concluding Remarks Note.

Abstract:Alasdair Maclntyre (1984) asserts that the ethical systems of the Enlightenment (formalism and utilitarianism) have failed to provide a meaningful definition of “good.” Lacking such a definition, business managers have no internal standards by which they can morally evaluate their roles or acts. Maclntyre goes on to claim that managers have substituted external measures of “winning” or “effectiveness” for any internal concept of good. He supports a return to the Aristotelian notion of virtue or “excellence.” Such a system of virtue (...) ethics depends on an interrelationship of the community, one’s roles in that community, and the virtues one needs to perform that role well. This article develops Maclntyre’s concept of virtue ethics and shows how this paradigm fits well with existing theories about organizational behavior. (shrink)

Battle Hall Davies' brother Nick ran away from home when she was in high school. Now he has found her and she is going to stay with him for the summer before starting college. Battle discovers that neither she nor her brother is the person she thought they were.