Infant A was born at term with an antenatal diagnosis of gastroschisis. His parents were well informed about the condition and understood that he would require surgery. However, at delivery, his bowel was found to be severely compromised. Infant A returned from theatre with only four centimeters of small bowel. This is physiologically devastating and easily qualifies as ultrashort bowel syndrome. Whilst the prognosis from ultrashort bowel syndrome is greatly improving, the condition continues to carry a significant risk of mortality (...) and morbidity, in part attributable to treatment itself. The cornerstone of management of USBS is provision of intravenous parenteral nutrition. This is not a physiologically normal route of nutrition; it is a medical treatment. Infant A’s parents questioned whether continuation of active treatment was appropriate. If a treatment is not in the patient’s best interests, then it can be argued it is not justified to administer it. Decisions about quality of life are intensely personal. Where there is a significant burden of treatment, even when there is a potential for increased survival, whether the course of treatment is in the child’s best interests must be taken with huge emphasis on the parental perspective and their family values. For well-informed, realistic parents who are welcoming of the full picture of information and implications of their decision, I argue that parents are best placed to make the decision for their child. Long-term PN for USBS may well be a medically encouraged treatment. However, it should not be medically mandated. (shrink)

ABSTRACT:Psychedelic substances have great promise for the treatment of many conditions, and they are the subject of intensive research. As with other medical treatments, both research and clinical use of psychedelics depend on our ability to ensure informed consent by patients and research participants. However, some have argued that informed consent for psychedelic use may be impossible, because psychedelic experiences can be transformative in the sense articulated by L. A. Paul (2014). For Paul, transformative experiences involve either the acquisition of (...) knowledge that cannot be obtained in any other way or changes in the self. Either of these characteristics may appear to undermine informed consent. This article argues, however, that there is limited evidence that psychedelic experiences are transformative in Paul's sense, and that they may not differ in their transformative features from other common medical experiences for which informed consent is clearly possible. Further, even if psychedelic experiences can be transformative, informed consent is still possible. Because psychedelic experiences are importantly different in several respects from other medical experiences, this article closes with recommendations for how these differences should be reflected in informed consent processes. (shrink)

In this article, we defend two claims about the precautionary principle. The first is that there is no ‘core’ precautionary principle that unifies all its different versions. It is more plausible to think of the different versions as being related to each other by way of family resemblances. So although precautionary principle x may have much in common with precautionary principle y, and y with z, there is no set of necessary and sufficient conditions that unify all versions of the (...) principle. Our second claim is that it is sometimes appropriate to think of the precautionary principle as a midlevel principle in the sense proposed by Beauchamp and Childress in their Principles of Biomedical Ethics, i.e. as a non-rigid moral principle. We argue that if the precautionary principle is conceived as a non-rigid principle that needs to be balanced against other principles before a moral verdict can be reached, then this enables us to address some standard objections to the principle. (shrink)

This historical study aims to explain how the transition from student nurse service to fully qualified “graduate nurse” service in the United States in the 20th century affected assumptions about fundamental patient care in hospital wards and provide historical context for current apprenticeship programs. Through analysis of documents from 1920 when student nurse service, a nurse apprentice model, was the norm to 1960 when the nurse apprentice model was waning in favor of registered nurse service, this study found that the (...) replacement of student nurses with registered nurses led to weakened standardization of fundamental bedside care and the introduction of large numbers of unlicensed nursing assistants. While student nurses could perform all the functions of fully qualified graduate nurses, nursing assistants could not, resulting in a separation of fundamental nursing care from the professional nurse role and changes in assumptions and attitudes toward fundamental care. These changes had a negative effect on fundamental nursing care. New apprenticeship programs provide opportunities for improvement. (shrink)

Can humans be friends with animals? If so, what would the moral implications of such friendship be? In a previous issue of this journal, we argued that humans can indeed be friends with animals and that such friendships are morally valuable. The present article is a comment on Mark Rowlands’s reply to our original article. We argue that our original argument is not undermined by Rowlands’s attack.

First—before you define the dilemma, parse out principles, or vocalize about virtues—consider what caused this case.The COVID-19 pandemic has challenged us all, but particularly caregivers and the...

Cross jurisdictional collaboration efforts and emergency vaccine plans that are consistent with Tribal sovereignty are essential to public health emergency preparedness. The widespread adoption of clearly written federal, state, and local vaccine plans that address fundamental assumptions in vaccine distribution to Tribal nations is imperative for future pandemic response.

In an age of growing academic specialisation, one, moreover, in which experts and expertise are habitually derided in a ‘post-truth’ era, the notion of the ‘public intellectual’ has come to be wide...

Ecologists are challenged by the need to bridge and synthesize different approaches and theories to obtain a coherent understanding of ecosystems in a changing world. Both food web theory and regime shift theory shine light on mechanisms that confer stability to ecosystems, but from different angles. Empirical food web models are developed to analyze how equilibria in real multi-trophic ecosystems are shaped by species interactions, and often include linear functional response terms for simple estimation of interaction strengths from observations. Models (...) of regime shifts focus on qualitative changes of equilibrium points in a slowly changing environment, and typically include non-linear functional response terms. Currently, it is unclear how the stability of an empirical food web model, expressed as the rate of system recovery after a small perturbation, relates to the vulnerability of the ecosystem to collapse. Here, we conduct structural sensitivity analyses of classical consumer-resource models in equilibrium along an environmental gradient. Specifically, we change non-proportional interaction terms into proportional ones, while maintaining the equilibrium biomass densities and material flux rates, to analyze how alternative model formulations shape the stability properties of the equilibria. The results reveal no consistent relationship between the stability of the original models and the proportionalized versions, even though they describe the same biomass values and material flows. We use these findings to critically discuss whether stability analysis of observed equilibria by empirical food web models can provide insight into regime shift dynamics, and highlight the challenge of bridging alternative modelling approaches in ecology and beyond. (shrink)

Property rights are important institutions that influence economic performance and reflect the historical, cultural, and political realities of particular societies. Drawing on a variety of concepts from legal and economic studies, a framework for explaining the origin and evolution of property rights is developed and applied to the specific case of changing ground water rights in Nebraska. The Nebraska case is an interesting example of reliance on local control in regulating water use. Despite the importance of local initiatives in ground (...) water management, this case also illustrates the need for external support from the judicial and legislative systems. The evolution of ground water property rights in Nebraska, as in other parts of the United States, has been conditioned by historical circumstances and changing values and attitudes as well as by economic and political forces. (shrink)

In den historiographischen Debatten über die verschiedenen Ideologien der ersten Hälfte des 20. Jahrhunderts wird der Begriff „katholischer Faschismus“ gelegentlich verwendet, um eine spezifische Version des Faschismus in den 1920ern, 1930ern und 1940ern Jahren zu bezeichnen. Im vorliegenden Aufsatz wird dieses Konzept in historischer und historiographischer Perspektive analysiert. Dabei geht es v. a. um den religiösen Hintergrund, die verschiedenen begrifflichen Unterscheidungen, die wichtigsten Ereignisse und die ideologischen Zusammenhänge. Der protestantische Faschismus sowie das Konfliktfeld zwischen Katholizismus und faschistischer Ideologie werden auch (...) thematisiert.In the historiographical debates about the different streams of ideology in the first half of the 20th century, the term “Catholic fascism” has been used on occasion to refer to a specific version of fascism and Catholicism in the 1920s, 1930s and 1940s. The following article analyzes this concept in historical and historiographical perspective, drawing attention to the religious background, the various conceptual distinctions, key events and ideological interrelationships. Protestant fascism is also addressed along with the ideological conflict between Catholicism and fascist ideology. Before turning to these themes, however, the critical role of papal theological and cultural analysis will be addressed. (shrink)

In diesem Aufsatz werden die Veröffentlichungen des Jesuiten Erich Przywara und der sehr einflussreichen jesuitischen Zeitschrift Stimmen der Zeit aus den frühen 193oern Jahren und besonders aus dem Jahr 1933 analysiert. In diesem Zusammenhang antworte ich auch meinen Kritikern. Außerdem werden die Hintergründe und Quellen der spezifischen Form des Antisemitismus dargestellt, die in den Stimmen der Zeit vertreten wurde. Deutsche Jesuiten propagierten 1933 durchaus radikale Positionen in der Zeitschrift. In dem katholischen Blatt liest man u. a., dass die Juden dem (...) deutschen Volk mehr Schaden als Nutzen brächten. Es wurde damals auch die nordische Rasse als für Herrschaft besonders geeignet bezeichnet. Im letzten Teil dieses Aufsatzes werden Przywaras spätere Briefe an Carl Schmitt, den gläubigen antisemitischen deutschen Katholiken, analysiert. Sie zeigen, dass Przywara von dessen antidemokratischer politischer Theorie der 1930er Jahre zutiefst beeindruckt war und die Ideen des Kronjuristen des Dritten Reiches sogar noch in der Zeit nach dem Zweiten Weltkrieg verbreiten wollte. (shrink)

Romano Guardini was one of the most important intellectuals of German Catholicism in the twentieth century. He influenced nearly an entire generation of German Catholic theologians and was the leading figure of the German Catholic youth movement as it grew exponentially in the 1920s. Yet there are many open questions about his early intellectual development and his academic contribution to religious, cultural, social and political questions in the Weimar Republic and in National Socialist Germany. This article draws upon Guardini’s publications, (...) the secondary literature on Guardini and on some archival material, seeking to outline his early development and his engagement with the ideological context following World War I and in National Socialist Germany. Here Guardini’s criticisms of the modern age are presented. Besides this many other issues are addressed, such as his criticism of the women’s movement, his understanding of the youth movement, reception of Carl Schmitt, views of race, interpretation of the controversial Volk-concept, contribution to a Jewish journal in 1933, and his basic positions on the issues of obedience, order and authority. While Guardini was viewed critically by some National Socialists in the Third Reich, the administrative correspondences on him in the 1940s actually show that there was an internal debate about him among the National Socialist officials. This involved different figures, including a diplomat who came to Guardini’s defense. The internal disagreements were made more complicated because Guardini’s brothers were apparently members of the Fascist Party in Italy at this time. (shrink)

The monthly magazine Hochland was probably the most influential Catholic cultural periodical in Germany in the Weimar Period. According to Georg Cardinal von Kopp’s assessment in 1911, it was “unfortunately the most read periodical in all of the educated circles of Germany, Austria and German Switzerland”. Moving beyond the simple rejection of modern culture in Germany, the journal tried to follow a new program of mediatory engagement, although it did continue to hold to traditional positions in many regards. In this (...) article the reception of modern, Enlightenment-affirmative philosophy of religion in the journal is introduced with reference to reviews and essays from the later 1910s to the early 1930s. The journal’s treatment of a few critical subject areas is given close interpretive analysis, including the journal’s treatment of Gertrud Simmel’s Über das Religiöse, individually conceptualized forms of personalist moral theory, and the general shift to phenomenological discourses and the individual in the philosophy of religion. The fundamental rejections of these ideas and these schools of thought in reviews and essays, which are also found in the journal at this time (as in most all German language Catholic cultural journals of the period), are not addressed in this article. The article thus sheds light on an often-forgotten and relatively small minority phenomenon in German Catholic intellectual circles of the Weimar Period, namely the positive embrace of Enlightenment-oriented modern thought. By promoting these ideas at this time, this group made themselves highly vulnerable to disciplinary measures by the Catholic Church. (The journal was put on the Index in 1911.). (shrink)

This groundbreaking handbook of character strengths and virtues is the first progress report from a prestigious group of researchers who have undertaken the systematic classification and measurement of widely valued positive traits. Character Strengths and Virtues classifies twenty-four specific strengths under six broad virtues that consistently emerge across history and culture. This book demands the attention of anyone interested in psychology and what it can teach about the good life.

Consequentialism, one of the major theories of normative ethics, maintains that the moral rightness of an act is determined solely by the act's consequences and its alternatives. The traditional form of consequentialism is one-dimensional, in that the rightness of an act is a function of a single moral aspect, such as the sum total of wellbeing it produces. In this book Martin Peterson introduces a new type of consequentialist theory: multidimensional consequentialism. According to this theory, an act's moral rightness (...) depends on several separate dimensions, including individual wellbeing, equality and risk. Peterson's novel approach shows that moral views about equality and risk that were previously thought to be mutually incompatible can be rendered compatible, and his precise theoretical discussion helps the reader to understand better the distinction between consequentialist and non-consequentialist theories. His book will interest a wide range of readers in ethics. (shrink)

Puritans had big stories to tell, and they cast themselves big parts to play in those stories. The fervent English Protestants who believed that the Elizabethan Church urgently needed further reformation, and the self-selecting band among them who went on to colonize New England, were sure that they could re-create the churches of the apostolic age, and eliminate centuries’ worth of Romish accretions. By instituting scriptural forms of worship, these purified churches might have a beneficial influence on the state as (...) well, and bring about the rule of the godly. If a purified English church and state could inaugurate reformation across all of Christendom, spread the gospel to infidels around the globe, and usher in the millennium, then all the better. In 1641, an anonymous tract called A Glimpse of Sions Glory announced that the new puritan-controlled Parliament would bring on “Babylon's destruction... The work of the day [is] to give God no rest till he sets up Jerusalem in the praise of the whole world.” The leading minister of colonial Boston at the time, John Cotton, predicted that as soon as 1655, as Michael Winship summarizes Cotton: the states and Christian princes of Europe, under irresistible supernatural influence, would have instituted congregationalism [Massachusetts’ form of church polity] and overthrown Antichrist and Muslim Turkey. The example of their churches’ pure Christianity would have brought about the conversion of Jews and pagans across the globe. Thereafter, the churches of Christ would enjoy the millennium's thousand years of peace before the climactic battle with Gog and Magog at the end of time. Those are big stories. (shrink)

In this analytically oriented work, Peterson articulates and defends five moral principles for addressing ethical issues related to new and existing technologies: the cost-benefit principle, the precautionary principle, the sustainability principle, the autonomy principle, and the fairness principle.

In Plato's Apology, Socrates says he spent his life examining and questioning people on how best to live, while avowing that he himself knows nothing important. Elsewhere, however, for example in Plato's Republic, Plato's Socrates presents radical and grandiose theses. In this book Sandra Peterson offers a hypothesis which explains the puzzle of Socrates' two contrasting manners. She argues that the apparently confident doctrinal Socrates is in fact conducting the first step of an examination: by eliciting his interlocutors' reactions, (...) his apparently doctrinal lectures reveal what his interlocutors believe is the best way to live. She tests her hypothesis by close reading of passages in the Theaetetus, Republic and Phaedo. Her provocative conclusion, that there is a single Socrates whose conception and practice of philosophy remain the same throughout the dialogues, will be of interest to a wide range of readers in ancient philosophy and classics. (shrink)

In this paper, we examine the case of psychedelic medicine for Alzheimer’s disease and related dementias (AD/ADRD). These “mind-altering” drugs are not currently offered as treatments to persons with AD/ADRD, though there is growing interest in their use to treat underlying causes and associated psychiatric symptoms. We present a research agenda for examining the ethics of psychedelic medicine and research involving persons living with AD/ADRD, and offer preliminary analyses of six ethical issues: the impact of psychedelics on autonomy and consent; (...) the impact of “ego dissolution” on persons experiencing a pathology of self; how psychedelics might impact caregiving; the potential exploitation of patient desperation; institutional review boards’ orientation to psychedelic research; and methods to mitigate inequity. These ethical issues are magnified for AD/ADRD but bear broader relevance to psychedelic medicine and research in other clinical populations. (shrink)

This up-to-date introduction to decision theory offers comprehensive and accessible discussions of decision-making under ignorance and risk, the foundations of utility theory, the debate over subjective and objective probability, Bayesianism, causal decision theory, game theory, and social choice theory. No mathematical skills are assumed, and all concepts and results are explained in non-technical and intuitive as well as more formal ways. There are over 100 exercises with solutions, and a glossary of key terms and concepts. An emphasis on foundational aspects (...) of normative decision theory (rather than descriptive decision theory) makes the book particularly useful for philosophy students, but it will appeal to readers in a range of disciplines including economics, psychology, political science and computer science. • Has over 100 end of chapter review questions and exercises with solutions • Includes a chapter on how to draw a decision matrix • Explains the link between individual decision making, game theory and social choice theory Contents Preface; 1. Introduction; 2. The decision matrix; 3. Decisions under ignorance; 4. Decisions under risk; 5. Utility; 6. The mathematics of probability; 7. The philosophy of probability; 8. Why should we accept the preference axioms; 9. Causal vs. evidential decision theory; 10. Bayesian vs. non-Bayesian decision theory; 11. Game theory I: basic concepts and zero sum games; 12. Game theory II: nonzero sum and co-operative games; 13. Social choice theory; 14. Overview of descriptive decision theory; Appendix A. Glossary; Appendix B. Proof of the von Neumann-Morgenstern theorem; Further reading; Index. (shrink)

The results of a survey of business professionals verified a relationship between perceptions of corporate citizenship and organizational commitment. More important, the results demonstrated that the relationship between corporate citizenship and organizational commitment was stronger among employees who believe highly in the importance of the social responsibility of businesses. The results also indicated that the ethical measure of corporate citizenship was a stronger predictor of organization commitment than the economic, legal, and discretionary measures. Last, the results revealed that the discretionary (...) measure was more strongly associated with organizational commitment among female employees. (shrink)

In 1931 the mathematical logician Kurt Godel published a revolutionary paper that challenged certain basic assumptions underpinning mathematics and logic. A colleague of Albert Einstein, his theorem proved that mathematics was partly based on propositions not provable within the mathematical system and had radical implications that have echoed throughout many fields. A gripping combination of science and accessibility, Godel’s Proof by Nagel and Newman is for both mathematicians and the idly curious, offering those with a taste for logic and philosophy (...) the chance to satisfy their intellectual curiosity. (shrink)

This study examined the relationship between unethical employee behavior and the dimensions of the Ethical Climate Questionnaire (ECQ). In order to explore the relationship between the dimensions of the ECQ and unethical behavior, the factor structure of five previously identified empirical models and the hypothesized nine-dimension model for the ECQ was tested with a confirmatory factor analysis. The analysis revealed that the hypothesized nine-dimension model provided as good or even better fit to the data than the five empirically derived models. (...) Therefore, the nine-dimensional model was used to examine the criterion-related validity of the ECQ. The results demonstrated that the nine ethical climate dimensions were correlated with some of the unethical behaviors examined in this study, but not others. However, the results clearly demonstrated that most of the ethical climate dimensions were significantly related to an aggregate measure of unethical behavior. It was suggested that these results might account for the differences in previous studies on the criterion-related validity of the ECQ. The results also replicated a previous report that the association between unethical behavior and ethical climate is stronger in organizations that do not have a code of ethics. Finally, a difference was observed in the ethical climates for organizations with a code of ethics and organizations without a code of ethics. (shrink)

This paper critically engages ethical issues in the allocation of novel, and potentially costly, health care resources to patients with disorders of consciousness. First, we review potential benefits of novel health care resources for patients and their families and outline preliminary considerations to address concerns about cost. We then address two problems regarding the allocation of health care resources to patients with disorders of consciousness: (1) the problem of uncertain moral status; and (2) the problem of accurately measuring the welfare (...) burdens these resources would relieve. We conclude by suggesting that opportunity-based frameworks might complement standard approaches for justifying resources allocation to patients with disorders of consciousness. (shrink)

This article argues that supported decision making is ideal for people with dynamic cognitive and functional impairments that place them at the margins of autonomy. First, we argue that guardianship and similar surrogate decision-making frameworks may be inappropriate for people with dynamic impairments. Second, we provide a conceptual foundation for supported decision making for individuals with dynamic impairments, which integrates the social model of disability with relational accounts of autonomy. Third, we propose a three-step model that specifies the necessary conditions (...) of supported decision making: identifying domains for support; identifying kinds of supports; and reaching a mutually acceptable and formal agreement. Finally, we identify a series of challenges for supported decision making, provide preliminary responses, and highlight avenues for future bioethics research. (shrink)

What does everyone in the modern world need to know? Renowned psychologist Jordan B. Peterson's answer to this most difficult of questions uniquely combines the hard-won truths of ancient tradition with the stunning revelations of cutting-edge scientific research. Humorous, surprising and informative, Dr. Peterson tells us why skateboarding boys and girls must be left alone, what terrible fate awaits those who criticize too easily, and why you should always pet a cat when you meet one on the street. (...) What does the nervous system of the lowly lobster have to tell us about standing up straight (with our shoulders back) and about success in life? Why did ancient Egyptians worship the capacity to pay careful attention as the highest of gods? What dreadful paths do people tread when they become resentful, arrogant and vengeful? Dr. Peterson journeys broadly, discussing discipline, freedom, adventure and responsibility, distilling the world's wisdom into 12 practical and profound rules for life. [This book] shatters the modern commonplaces of science, faith and human nature, while transforming and ennobling the mind and spirit of its readers. (shrink)

Two interpretations of the precautionary principle are considered. According to the normative interpretation, the precautionary principle should be characterised in terms of what it urges doctors and other decision makers to do. According to the epistemic interpretation, the precautionary principle should be characterised in terms of what it urges us to believe. This paper recommends against the use of the precautionary principle as a decision rule in medical decision making, based on an impossibility theorem presented in Peterson . However, (...) the main point of the paper is an argument to the effect that decision theoretical problems associated with the precautionary principle can be overcome by paying greater attention to its epistemic dimension. Three epistemic principles inherent in a precautionary approach to medical risk analysis are characterised and defended. (shrink)

_Being Human _examines the complex connections among conceptions of human nature, attitudes toward non-human nature, and ethics. Anna Peterson proposes an "ethical anthropology" that examines how ideas of nature and humanity are bound together in ways that shape the very foundations of cultures. Peterson discusses mainstream Western understandings of what it means to be human, as well as alternatives to these perspectives, and suggests that the construction of a compelling, coherent environmental ethics will revise our ideas not only (...) about nature but also about what it means to be human. (shrink)

We argue that some algorithms are value-laden, and that two or more persons who accept different value-judgments may have a rational reason to design such algorithms differently. We exemplify our claim by discussing a set of algorithms used in medical image analysis: In these algorithms it is often necessary to set certain thresholds for whether e.g. a cell should count as diseased or not, and the chosen threshold will partly depend on the software designer’s preference between avoiding false positives and (...) false negatives. This preference ultimately depends on a number of value-judgments. In the last section of the paper we discuss some general principles for dealing with ethical issues in algorithm-design. (shrink)