Mrs. Duong had coronary artery disease, ischemic cardiomyopathy, and mildly altered mental status when her case was presented before an advanced heart therapy medical review board. She was accepted for left ventricular assist device placement pending additional insight into her cognitive state. Before the LVAD could be implanted, however, Mrs. Duong went into cardiogenic shock, and her heart failure team placed an intra‐aortic balloon pump in her subclavian artery. Within two weeks, Mrs. Duong became IABP dependent and deconditioned. The attending (...) deemed her as lacking capacity to make complex medical decisions, and the medical review board officially declined her for LVAD placement. The heart failure and CICU teams feel that Mrs. Duong is not being helped by the care they are giving her. They recommend terminal weaning of the IABP and initiation of comfort care. Her family disagrees, pointing to activities like continued eating and interacting with family. At an impasse after yet another family meeting, the attending for the heart failure team asks the clinical ethics consultant, “Do we have to replace the balloon pump when it fails?”. (shrink)

In this brief commentary, I suggest Selinger and Whyte are essentially correct in their criticism of the Nudge approach advocated by Thaler and Sunstein. I use some examples from road behavior and traffic planning to amplify the criticism that the simple behavioral economics approach fails to take account of the embedding of humans and technology in the wider social and cultural context.

This book examines the link between population growth and environmental impact and explores the implications of this connection for the ethics of procreation. In light of climate change, species extinctions, and other looming environmental crises, Trevor Hedberg argues that we have a collective moral duty to halt population growth to prevent environmental harms from escalating. This book assesses a variety of policies that could help us meet this moral duty, confronts the conflict between protecting the welfare of future people (...) and upholding procreative freedom, evaluates the ethical dimensions of individual procreative decisions, and sketches the implications of population growth for issues like abortion and immigration. It is not a book of tidy solutions: Hedberg highlights some scenarios where nothing we can do will enable us to avoid treating some people unjustly. In such scenarios, the overall objective is to determine which of our available options will minimize the injustice that occurs. This book will be of great interest to those studying environmental ethics, environmental policy, climate change, sustainability, and population policy. (shrink)

We live in anagewhere"progressive" intellectualspresuppose that true democracy demands the affirmation of "global values" and the drive toward a world government, a"universal and homogenous state." Intellectuals, journalists, and educators bemoan the effects of "globalization" even as they uncritically endorse cosmopolitanism and dismissnational attachments as parochial and outdated. They confuse thoughtful patriotism - and commitment to the self-governing nation - with the narrowest form of nationalism. In a wonderfullylucid and learned essay, Trevor Shelley recovers a humane liberal tradition, from Montesquieu (...) to Manent, that takes the political seriously and does full justice to the legitimate claims of both universality and particularity. Whether discussing Tocqueville's critique of the pantheistic reveries of democratic man or Pierre Manent's erudite defense of the nation, the political form that provides the indispensable framework for democratic self-government, Shelley thoughtfully illumines the place and limits of globalization in a democratic age. --Daniel J. Mahoney, Augustine Chair in Distinguished Scholarship, Assumption College. (shrink)

This article reads Carlyle as a reader of Goethe to recover why he proclaimed Goethe as the `benignant spiritual revolutionist' of modernity and `first of the moderns'. As Goethe's first major English translator, Thomas Carlyle was also arguably the first to grasp the nature and purpose of Goethe's project to interpret modernity as a revolutionary epoch involving changes in consciousness, culture and material development. For Carlyle, Goethe's Faust presents modern consciousness and culture from the side of elegy - as the (...) search by an old man for eternal youth and an infinite world without constraints involving tragic loss. Wilhelm Meisters Lehrjahre, by contrast, presents the same processes from the side of romantic quest, that is, from the perspective of a youth growing into adulthood, as looking into the future with infinite hope. Finally in Wilhelm Meisters Wanderjahre, Carlyle discerns that the radical form of this novel as a discontinuous narrative that embodies movement, change and incompletion enables Goethe to represent the social conditions of moderns as a spiritual challenge and historic achievement. Carlyle's critical perspicacity is evident not least in his choice of Goethe's works to translate as much as his own essays on Goethe's place in modern European letters. In his close reading of Goethe, Carlyle captures the symbolic form of modernity as incorporating three levels of revolutionary transformation of individual consciousness, of culture and of modernity as mythic condition consisting of tragic development, creative destruction and perpetual movement and change. Moderns then are challenged to become authors of their own texts and lives. Carlyle contrasts Goethe's achievement against other primary candidates for the title of modern spiritual revolutionist in ironically Goethean terms: Napoleon (Prometheus), Byron (Faust and Young Werther) and Voltaire (Mephistopheles). Thereafter, the older Carlyle puts aside his critical readings of Goethe to become his own Goethean authority on the modern condition, most notably in his most famous books, Sartor Resartus, The French Revolution, Chartism, On Heroes, and Past and Present. By reading Carlyle as a reader of Goethe we can begin to discern that Carlyle was not only an historian, biographer and political commentator of his own place and times but a critical theorist seeking to interpret the modern epoch, with and beyond Goethe. (shrink)

Examines the work of transcendental filmmakers such as Bela Tarr and Terence Malick using a metaphysical framework.

In last June's themed issue on environmental bioethics, presciently planned in early 2019, we published in addition our very first paper on Covid-19 – a critique of the British Medical Association'...

Bioethics is not a field for the faint-hearted. Life and death decisions are both at stake and everything in between. Increasingly, before-life decisions are being taken as well and this issue comm...

In line with a recent rise in anti-LGBTQ discourse within conservative Russian politics, Aleksandr Dugin has increasingly critiqued “postmodern” theories that allegedly underpin social diversity (sexual, gender, racial, etc.) within the West: queer theory, post-structuralism, and other theoretical accounts of identity and alterity. In Dugin’s argument for a political philosophy of Eurasianism, the Western endorsement of multiculturalism and pluralism is indicative of individualism and “Atlanticist” liberalism, therefore at odds with the traditional, nationalist collectivism of Eurasia. In this light, queer theory (...) is a Western imposition whose philosophical premises directly contradict native, Russian traditions. Dugin’s attack on queer theory, however, mark a departure from the philosopher’s earlier career within the National Bolshevik movement. Throughout the nineties, Dugin was relatively sympathetic with the nascent LGBT movement in Russia: specifically within the political and philosophical circles of National Bolshevism, in which such figures as Eduard Limonov and Slava Mogutin coalesced with fascists and communists around a broad critique of Western capitalism and openly embraced homoeroticism and countercultural, queer dissidence. Dugin’s links to the LGBT movement are even relatively mainstream: his first wife, Evgeniia Debrianskaia, was a prominent gay activist, and both Debrianskaia and Dugin for a time viewed the Eurasianism’s goals as aligned with that of LGBT activism in Russia. This article examines the development of Dugin’s political philosophy in the context of his reading of queer theory. It first discusses the link in historical terms, in the connections between Dugin’s early post-Soviet career and post-Soviet Russian gay activism. The article then focuses on Dugin’s philosophy of “multipolarity,” as a form of resistance to universalist, American hegemony, in order to illustrate how Dugin’s Eurasianist account of political “anti-normativity” both aligns and contradicts with his reading of queer theory. The article concludes with comments on the globalization of queer theory, cultural imperialism, and its relationship to Dugin’s geopolitics. (shrink)

In Metaphor and Film, Trevor Whittock demonstrates that feature films are permeated by metaphors that were consciously introduced by directors. An examination of cinematic metaphor forces us to reconsider the nature of metaphor itself, and the ways by which such visual imagery can be recognised and understood, as well as interpreted. Metaphor and Film identifies the principal forms of cinematic metaphor, and also provides an analysis of the mental operations that one must bring to it. Recent developments in cognitive (...) psychology, especially those relating to the nature and formation of categories, are called upon to explain these processes. Metaphor and Film ranges widely over film theory as it does over philosophical, literary, linguistic, and psychological accounts of metaphor. Particularly useful to those studying film, literature, and aesthetics, this study is also a provocative contribution to an important debate in which film theorists and philosophers are currently engaged. (shrink)

The use of upper limb vibration during exercise and rehabilitation continues to gain popularity as a modality to improve function and performance. Currently, a lack of knowledge of the pathways being altered during ULV limits its effective implementation. Therefore, the aim of this study was to investigate whether indirect ULV modulates transmission along spinal and corticospinal pathways that control the human forearm. All measures were assessed under CONTROL and ULV conditions while participants maintained a small contraction of the right flexor (...) carpi radialis muscle. To assess spinal pathways, Hoffmann reflexes elicited by stimulation of the median nerve were recorded from FCR with motor response amplitudes matched between conditions. An H-reflex conditioning paradigm was also used to assess changes in presynaptic inhibition by stimulating the superficial radial nerve 37 ms prior to median nerve stimulation. Cutaneous reflexes in FCR elicited by stimulation of the SR nerve at the wrist were also recorded. To assess corticospinal pathways, motor evoked potentials elicited by transcranial magnetic stimulation of the contralateral motor cortex were recorded from the right FCR and biceps brachii. ULV significantly reduced H-reflex amplitude by 15.7% for both conditioned and unconditioned reflexes. Therefore, ULV inhibits cutaneous and H-reflex transmission without influencing corticospinal excitability of the forearm flexors suggesting increased presynaptic inhibition of afferent transmission as a likely mechanism. A general increase in inhibition of spinal pathways with ULV may have important implications for improving rehabilitation for individuals with spasticity. (shrink)

Happiness : an introduction to the good life -- Decisions : giving our life to the glory of God -- Gifts : ethics in an ancient Hebrew worldview -- Paradigms : learning how to be good -- Practices : working towards a goal -- Imagination : living into the new possibility with Christ -- Rules : formal ethics in Christianity -- Righteousness : filling our hunger.

The Covid‐19 pandemic has brought about renewed conversation about equality and equity in the distribution of medical resources. Much of the recent conversation has focused on creating and implementing policies in times of crisis when resources are exhausted. Depending on how the pandemic develops, some communities may implement crisis measures, but many health care facilities are currently experiencing shortages of staff and materials even if the facilities have not implemented crisis standards. There is a need for shared conversation about equality (...) and equity in these times of contingency between conventional and crisis medicine. To respond well to these challenges, I recommend that institutions rely on policy, professional education, and ethics consultation. As is the case with crisis policies, creating contingency policies requires that health care professionals decide on how, specifically, to achieve equity. A policy is only as effective as its implementation; therefore, institutions should invest in context‐specific education on contingency policies. Finally, ethics consultation should be available for questions that contingency policies cannot address. (shrink)

Every clinical ethics consultant, no matter their own spirituality, will meet patients, families, and healthcare professionals whose spiritualities anchor their moral worldviews. How might ethicists respond to those who rely on spirituality when making medical decisions? And further, should ethicists incorporate their own spiritual commitments into their clinical analyses and recommendations? These questions prompt reflection on foundational issues in the philosophy of medicine, political and moral theory, and methods of proper clinical ethics consultation. Rather than attempting to offer definitive answers (...) to these questions, this essay prompts readers to consider their own answers to these questions. Specifically, it offers a taxonomic analysis of six (6) distinct responses: assessment, delegation, examination, translation, incorporation, and assertion. Furthermore, this essay describes the role of the ethicist’s own spiritual commitments during the responses. Each section also names several strengths and weaknesses that ethicists ought to consider when evaluating the purpose and scope of each response. This paper prompts readers to consider circumstances under which they might promote, critique, or incorporate spiritual worldviews—their own and those of their patients—when offering clinical analyses and recommendations. (shrink)

Understanding People provides an overview and critique of current psychological assumptions about people and what differentiates them, and replaces them with a set of ideas taken from social constructionism. It begins with an examination of contemporary theories, then explores the critique of the social constructionists, before laying out the basis of an understanding of human action and behavior, drawing on phenomenology and personal construct theory. Using everyday experience to illustrate the issues in personality theory (Is behavior situation-specific? Why do we (...) have a sense of self? Is there an unconscious?), this book will breathe life into an area of psychology that is so often arid, and, in the eyes of students, divorced from their world. (shrink)

Patients with schizophrenia have an impairment in the inhibition of reflexive saccades, as a consequence of a functional impairment of the prefrontal cortex, which has not yet been encapsulated in terms of a formal model. A number of novel and testable hypotheses can be generated from the framework proposed by Findlay & Walker that will stimulate further research. Their framework therefore marks an important step in the development of a comprehensive functional model of saccadic eye movements. Further advances will be (...) assisted by (1) a recognition of important distinctions in the executive control of volitional saccades and (2) addressing the capacity for cross-model integration of spatial information in the generation of the spatial properties of saccadic eye movements. (shrink)

Recent official publications have emphasised the need for differentiation to take place in classrooms in order to ensure that the needs of all pupils, including the more able, are met effectively. These publications list methods of differentiation which are ‘recommended’ for classroom use. This article researches the views of teachers about the value of these recommended methods of differentiation for able pupils in primary and secondary classrooms. It concludes that the teachers are more subtle in their use of the methods (...) than the official publications allow for and it suggests that no single method can be applied without understanding the context in which it is used. (shrink)

Unethical behavior coordinated and concealed by teams continues to represent a troubling and all-too-frequent occurrence in organizations. Unfortunately, those who are most knowledgeable about this behavior and thereby best suited to report it to authorities—the complicit members themselves—are susceptible to unique pressures that often discourage them from blowing the whistle. Team members rely on their teammates for relational and other beneficial resources, making it more difficult to potentially break those ties by snitching. However, we argue that the pressure to stay (...) silent is alleviated for members who are ostracized by their team members. Drawing on social exchange theory, we theorize that ostracism decreases positive affect and increases negative affect, decreasing individuals’ communion striving motivation and, in turn, increasing the propensity to blow the whistle. In Study 1, we examined the link between ostracism and whistleblowing utilizing a field sample of diverse employees surveyed over time. In Study 2, we built upon Study 1 and conducted a lab study to examine affect and communion striving motivation as serial mediators. Results were generally supportive of our arguments, although we did not find support for the mediating effect of negative affect. (shrink)

This article examines the approaches that historians, beginning in the mid 20th century and into the early 21st century, used to write about the Winnipeg General Strike of 1919. It focuses on five major works: The Winnipeg General Strike by D.C. Masters; Confrontation at Winnipeg by David J. Bercuson; The Workers' Revolt in Canada, 1917-1925 edited by Craig Heron; and When the State Trembled: How A.J. Andrews and the Citizens' Committee Broke the Winnipeg General Strike by Tom Mitchell and Reinhold (...) Kramer. It identifies where the monographs depart from one another in interpretation; as well as where they remain the same. Given the layers of complexity, the interpretation of the event becomes especially salient in the 21st century as its 100th anniversary steadfastly approaches and the question of how should it be publicly presented in 2019 requires an answer soon. (shrink)