Describes 100 real-life ethical dilemmas faced by school administrators.

As out-of-hospital emergencies become more commonplace, so does the call for a “doctor in the house”. New York City paediatrician Mitchell Rubin has responded to numerous such crises over the past 25 years. He explores reactions on all sides of this peculiar physician–victim relationship, his growing concerns and fears, and possible reasons why many doctors hesitate to act. His thoughts and experiences instigate the discussion about the need for a universal system of Good Samaritan physician respondersWhile flying to Italy (...) last spring, the pilot’s voice came over the loudspeaker: “Is there a doctor on board”? How many times have I heard this request in the last 25 years? A passenger had fainted. As I began caring for her, the pilot asked me, “Should we take the plane down?”. Surprised to be given this responsibility, I took my best guess and answered “no”. After a stressful landing, while I gave oxygen to the prostrate woman, we were met by an ambulance on the tarmac. The woman was appreciative and gracious, the pilot scarcely offered thanks, and I began my vacation exhausted.Having been trained as a paediatrician, I have responded to nearly two dozen “Good Samaritan” scenarios, where a person was injured or became critically sick in a public setting. Perhaps I have had more than my fair share, but I wonder if this is an important and mounting phenomenon. With America growing older and more and more people with serious, chronic illnesses remaining active in the community, we should not be surprised to see increasing numbers of out-of-hospital emergencies. And, as this becomes more commonplace, I become less and less certain of the role I—and other physicians like me—should have.When I was young, cocky and fearless, the call to meet an emergency was exciting. Shortly after training, an …. (shrink)

> Wealthy nations must do much more, much faster. The United Nations General Assembly in September 2021 will bring countries together at a critical time for marshalling collective action to tackle the global environmental crisis. They will meet again at the biodiversity summit in Kunming, China, and the climate conference 26) in Glasgow, UK. Ahead of these pivotal meetings, we—the editors of health journals worldwide—call for urgent action to keep average global temperature increases below 1.5°C, halt the destruction of nature (...) and protect health. Health is already being harmed by global temperature increases and the destruction of the natural world, a state of affairs health professionals have been bringing attention to for decades.1 The science is unequivocal; a global increase of 1.5°C above the preindustrial average and the continued loss of biodiversity risk catastrophic harm to health that will be impossible to reverse.2 3 Despite the world’s necessary preoccupation with COVID-19, we cannot wait for the pandemic to pass to rapidly reduce emissions. Reflecting the severity of the moment, this editorial appears in health journals across the world. We are united in recognising that only fundamental and equitable changes to societies will reverse our current trajectory. The risks to health of increases above 1.5°C are now well established.2 Indeed, no temperature rise is ‘safe’. In the past 20 years, heat-related mortality among people aged over 65 has increased by more than 50%.4 Higher temperatures have brought increased dehydration and renal function loss, dermatological malignancies, tropical infections, adverse mental health outcomes, pregnancy complications, allergies, and cardiovascular and pulmonary morbidity and mortality.5 6 Harms disproportionately affect the most vulnerable, including children, older populations, ethnic minorities, poorer communities and those with underlying health problems.2 4 Global heating is also contributing to the decline in …. (shrink)

Critical care society guidelines recommend that ethics committees mediate intractable conflict over potentially inappropriate treatment, including Do Not Resuscitate status. There are, however, limited data on cases and circumstances in which ethics consultants recommend not offering cardiopulmonary resuscitation despite patient or surrogate requests and whether physicians follow these recommendations. This was a retrospective cohort of all adult patients at a large academic medical center for whom an ethics consult was requested for disagreement over DNR status. Patient demographic predictors of ethics (...) consult outcomes were analyzed. In 42 of the 116 cases, the patient or surrogate agreed to the clinician recommended DNR order following ethics consultation. In 72 of 74 of the remaining cases, ethics consultants recommended not offering CPR. Physicians went on to write a DNR order without patient/surrogate consent in 57 of those cases. There were no significant differences in age, race/ethnicity, country of origin, or functional status between patients where a DNR order was and was not placed without consent. Physicians were more likely to place a DNR order for patients believed to be imminently dying. The median time from DNR order to death was 4 days with a 90-day mortality of 88.2%. In this single-center cohort study, there was no evidence that patient demographic factors affected ethics consultants’ recommendation to withhold CPR despite patient/surrogate requests. Physicians were most likely to place a DNR order without consent for imminently dying patients. (shrink)

In 2015, the major critical care societies issued guidelines outlining a procedural approach to resolving intractable conflict between healthcare professionals and surrogates over life-sustaining treatments (LST). We report our experience with a resolving conflict procedure. This was a retrospective, single-centre cohort study of ethics consultations involving intractable conflict over LST. The resolving conflict process was initiated eleven times for ten patients over 2,015 ethics consultations from 2000 to 2020. In all cases, the ethics committee recommended withdrawal of the contested LST. (...) In seven cases, the patient died or was transferred or a legal injunction was obtained before completion of the process. In the four cases in which LST was withdrawn, the time from ethics consultation to withdrawal of LST was 24.8 ± 12.2 days. Healthcare provider and surrogate were often distressed during the process, sometimes resulting in escalation of conflict and legal action. In some cases, however, surrogates appeared relieved that they did not have to make the final decision regarding LST. Challenges regarding implementation included the time needed for process completion and limited usefulness in emergent situations. Although it is feasible to implement a due process approach to conflict over LST, there are factors that limit the procedure’s usefulness. (shrink)

We seem to prefer that medicine and medical care be provided through altruistic motives. Even the pharmaceutical industry justifies its behavior in terms of altruistic purposes. But economists have known since Adam Smith that self-interested behavior can create large and growing social benefits. This is true for medical care as well as for other goods. First, I consider specifically the case of pharmaceutical promotion, both to physicians and to consumers. I argue that such promotion is highly beneficial to patients and (...) leads to health improvements. I consider some criticisms of promotion, and show that they are misguided. I then provide some evolutionary explanations for our erroneous beliefs about medical care. (shrink)

This is the first book to examine individual rights from an economic perspective, collecting together leading articles in this emerging area of interest and showing the vibrant and expanding scholarship that relates them. Areas covered include The implications of constitutional protections of individual rights and freedoms, including freedom of speech and of the press, The right to bear arms, The right against unreasonable searches, The right against self-incrimination, The right to trial by jury, The right against cruel and unusual punishment, (...) including capital punishment. The focus of these papers is both theoretical and empirical, examining how economics can illuminate the entire sequence of crime and punishment, from the decision to commit a crime, to police methods for apprehending and arresting criminals, to the rules used in trials to the scope of punishment for the convicted. (shrink)

It is not from the benevolence of the butcher, the brewer, or the baker that we expect our dinner, but from their regard to their own interest.Adam Smith, Wealth of NationsAs the quote above indicates, economists generally are more comfortable with self interest as a motivating force for social benefit than with altruism. This is because in most instances in a market economy, self interest will lead agents to provide benefits for others. Ultimately this is because the butcher or baker (...) will not get paid unless he does something that others are willing to pay for. This is the source of the famous “invisible hand,” also discussed by Adam Smith.This might sound trivial, except that in discussing aspects of medicine we seem to lose sight of this mechanism and rely on other tools to provide benefits. These tools do not work as well as naked self interest would. Some might say that medicine and medical progress is too important to depend on the market. (shrink)

Dominance hierarchies (sometimes called “pecking orders”) are virtually universal in social species, including humans. In most species and in ancestral and early human societies, these hierarchies allocate scarce resources, including food and often access to females. Humans sometimes use hierarchies for these allocational purposes, but humans use hierarchies for productive purposes as well—as in firms, universities, and governments. Productive hierarchies and dominance hierarchies share many features. As a result, people, including students of human behavior, often confuse types of hierarchies. For (...) example, the Communist Manifesto attributes features to productive hierarchies that are actually characteristic of dominance hierarchies. Government hierarchies are particularly confusing, as they have many features of both types. In modern societies with socially mandated monogamy and voluntary attachment to hierarchies in the form of competitive labor markets, productive hierarchies are generally useful for all members, and it is important not to confuse the two types, either in policy or in scientific analysis. (shrink)

Systematic study of the intersection of ethics consultation services and solid organ transplants and recipients can identify and illustrate ethical issues that arise in the clinical care of these patients, including challenges beyond resource allocation. This was a single-centre, retrospective cohort study of all adult ethics consultations between January 1, 2007, and December 31, 2017, at a large academic medical centre in the north-eastern United States. Of the 880 ethics consultations, sixty (6.8 per cent ) involved solid organ transplant, thirty-nine (...) (65.0 per cent) for candidates and twenty-one (35.0 per cent ) for recipients. Ethics consultations were requested for 4.3 per cent of heart, 4.9 per cent of lung, 0.3 per cent of liver, and 0.3 per cent of kidney transplant recipients over the study period. Nurses were more likely to request ethics consultations for recipients than physicians (80.0 per cent vs 20.0 per cent, p = 0.006). The most common reason for consultation among transplant candidates was discussion about intensity of treatment or goals of care after the patient was not or was no longer a transplant candidate. The most common reason for ethics consultation among transplant recipients was disagreement between transplant providers and patients/families/non-transplant healthcare professionals over the appropriate intensity of treatment for recipients. Very few consultations involved questions about appropriate resource allocation. Ethics consultants involved in these cases most often navigated communication challenges between transplant and non-transplant healthcare professionals and patients and families. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:An Exposition of The Divine Names, The Book of Blessed Dionysius by Thomas AquinasMichael J. Rubin, Elizabeth C. Shaw, and Staff*AQUINAS, Thomas. An Exposition of The Divine Names, The Book of Blessed Dionysius. Translated and edited with an introduction by Michael A. Augros. Merrimack, N.H.: Thomas More College Press, 2021. xxv + 549 pp. Cloth, $65.00The profound influence that Pseudo-Dionysius had on Aquinas’s thought, especially in his (...) metaphysics of participation and his apophatic theology, has been known for some time now, thanks to the excellent work of such scholars as Fran O’Rourke. One would therefore think that Aquinas’s Exposition of the Divine Names (his only commentary on the works of Pseudo-Dionysius) would have been translated a lot sooner. This delay is assuredly due not just to the difficulty of translating this work but also to a certain embarrassment felt by Thomists over Aquinas’s sincere belief that the “Dionysius” who wrote the Divine Names was the Areopagite whose conversion at the teaching of St. Paul is mentioned in the Acts of the Apostles. That the author calling himself “Dionysius” was in fact a theologian writing in the fifth or sixth centuries has been well established by modern scholarship. Hence, Thomists may have felt tempted to discount or at least pass over the influence of this author on Aquinas since it is discomfiting to think that the Church’s greatest theologian accorded such authority to an imposter.Michael Augros tackles these concerns head-on in the excellent introduction to his new translation of the Divine Names commentary. First, Augros points out that in past centuries a pseudonym was usually not an act of forgery but, rather, a way of concealing the author’s identity, which an early Christian theologian might well decide to do either out of humility or out of a desire “to avoid provoking certain prejudices” in those who disagreed with him in contemporary theological disputes. Moreover, it is likely that the work was never intended for the general public (who could easily mistake the pseudonym as genuine) but, rather, was written for those “already initiated in a particular Neoplatonic school of Christian theology,” who would recognize the author as being “one of their own” but without knowing his precise identity. Finally, in taking the particular name of “Dionysius,” the author of the Divine Names was indicating his intention for the work: Just as the biblical Dionysius was a Greek philosopher who converted to Christianity, so the works of Pseudo-Dionysius [End Page 345] are an attempt to reconcile Greek philosophy with the Christian faith.It therefore seems likely, as Augros observes, that Aquinas would still have accorded a great deal of respect to the Divine Names even if he had learned the truth of the author’s identity. The work would not have had the same deuterocanonical authority for him that comes with being written by a direct disciple of St. Paul himself, but “the inherent cogency, coherence, and beauty” of Pseudo-Dionysius’s theology would have been the same. Hence, Pseudo-Dionysius would surely have earned from Aquinas the “docile attitude” appropriate “for a philosopher and theologian of the first order, such as Boethius.”That Aquinas was right to see the author of the Divine Names as a master philosopher and theologian becomes evident when one dives into the text itself, in which Aquinas sees a truly dazzling order, both externally and internally. According to Aquinas, the Divine Names discusses those truths about God of which there are intelligible likenesses in creatures, such as goodness or wisdom, whereas the truths about God of which there are sensible likenesses (for example, “when God is called a lion, or a rock”) are treated by Pseudo-Dionysius in The Symbolic Theology; meanwhile, in the lost or fictional work The Divine Characteristics, Dionysius claims to have treated those truths about God (such as the Trinity) that cannot be known through any likenesses in creatures.Aquinas finds a still more intricate order within the Divine Names itself. Since this work is dedicated to “the divine names by which the processions of God to creatures are manifested,” the plan of the work... (shrink)

We present some techniques in c.c.c. forcing, and apply them to prove consistency results concerning the isomorphism and embeddability relations on the family of ℵ 1 -dense sets of real numbers. In this direction we continue the work of Baumgartner [2] who proved the axiom BA stating that every two ℵ 1 -dense subsets of R are isomorphic, is consistent. We e.g. prove Con). Let K H, be the set of order types of ℵ 1 -dense homogeneous subsets of R (...) with the relation of embeddability. We prove that for every finite model L, : Con iff L is a distributive lattice. We prove that it is consistent that the Magidor-Malitz language is not countably compact. We deal with the consistency of certain topological partition theorems. E.g. We prove that MA is consistent with the axiom OCA which says: “If X is a second countable space of power ℵ 1, and { U 0,\h.;, U n−1 } is a cover of D ▪ X x X -} x,x> ¦ x ϵ X } consisting of symmetric open sets, then X can be partitioned into { X i \brvbar; i ϵ ω } such that for every i ϵ ω there is l such that D ⊇ U l ”. We also prove that MA+OCA [xrArr] 2 ℵ 0 = ℵ 2. (shrink)

We present some techniques in c.c.c. forcing, and apply them to prove consistency results concerning the isomorphism and embeddability relations on the family of ℵ 1 -dense sets of real numbers. In this direction we continue the work of Baumgartner [2] who proved the axiom BA stating that every two ℵ 1 -dense subsets of R are isomorphic, is consistent. We e.g. prove Con). Let K H , be the set of order types of ℵ 1 -dense homogeneous subsets of (...) R with the relation of embeddability. We prove that for every finite model L , : Con iff L is a distributive lattice. We prove that it is consistent that the Magidor-Malitz language is not countably compact. We deal with the consistency of certain topological partition theorems. E.g. We prove that MA is consistent with the axiom OCA which says: “If X is a second countable space of power ℵ 1 , and { U 0 ,\h.;, U n−1 } is a cover of D ▪ X x X -} x,x> ¦ x ϵ X } consisting of symmetric open sets, then X can be partitioned into { X i \brvbar; i ϵ ω } such that for every i ϵ ω there is l such that D ⊇ U l ”. We also prove that MA+OCA [xrArr] 2 ℵ 0 = ℵ 2. (shrink)

Let B be a superatomic Boolean algebra (BA). The rank of B (rk(B)), is defined to be the Cantor Bendixon rank of the Stone space of B. If a ∈ B - {0}, then the rank of a in B (rk(a)), is defined to be the rank of the Boolean algebra $B b \upharpoonright a \overset{\mathrm{def}}{=} \{b \in B: b \leq a\}$ . The rank of 0 B is defined to be -1. An element a ∈ B - {0} is (...) a generalized atom $(a \in \widehat{At}(B))$ , if the last nonzero cardinal in the cardinal sequence of B $\upharpoonright$ a is 1. Let a,b $\in\widehat{At}$ (B). We denote a ∼ b, if rk(a) = rk(b) = rk(a · b). A subset H $\subseteq \widehat{At}$ (B) is a complete set of representatives (CSR) for B, if for every a $\in \widehat{At}$ (B) there is a unique h ∈ H such that h ∼ a. Any CSR for B generates B. We say that B is canonically well-generated (CWG), if it has a CSR H such that the sublattice of B generated by H is well-founded. We say that B is well-generated, if it has a well-founded sublattice L such that L generates B. THEOREM 1. Let B be a Boolean algebra with cardinal sequence $\langle\aleph_0: i . If B is CWG, then every subalgebra of B is CWG. A superatomic Boolean algebra B is essentially low (ESL), if it has a countable ideal I such that rk(B/I) ≤ 1. Theorem 1 follows from Theorem 2.9, which is the main result of this work. For an ESL BA B we define a set F B of partial functions from a certain countably infinite set to ω (Definition 2.8). Theorem 2.9 says that if B is an ESL Boolean algebra, then the following are equivalent. (1) Every subalgebra of B is CWG; and (2) F B is bounded. THEOREM 2. If an ESL Boolean algebra is not CWG, then it has a subalgebra which is not well-generated. (shrink)

ABSTRACTNew methods of calculating indices from the dot-probe task measure temporal dynamics in attention bias or fluctuations in attention bias towards and away from emotional stimuli over time. H...

The problem of God's subordination to laws of logic and mathematics in jewish philosophy and theology.

THEOREM 1. (⋄ ℵ 1 ) If B is an infinite Boolean algebra (BA), then there is B 1 such that $|\operatorname{Aut} (B_1)| \leq B_1| = \aleph_1$ and $\langle B_1, \operatorname{Aut} (B_1)\rangle \equiv \langle B, \operatorname{Aut}(B)\rangle$ . THEOREM 2. (⋄ ℵ 1 ) There is a countably compact logic stronger than first-order logic even on finite models. This partially answers a question of H. Friedman. These theorems appear in §§ 1 and 2. THEOREM 3. (a) (⋄ ℵ 1 ) If (...) B is an atomic ℵ 1 -saturated infinite BA, ψ ε L ω 1ω and $\langle B, \operatorname{Aut} (B)\rangle \models\psi$ then there is B 1 such that $|\operatorname{Aut}(B_1)| \leq |B_1| = \aleph_1$ and $\langle B_1, \operatorname{Aut}(B_1)\rangle\models\psi$ . In particular if B is 1-homogeneous so is B 1 . (b) (a) holds for B = P(ω) even if we assume only CH. (shrink)

Este artículo analiza las numerosas versiones de un Apocalipsis islámico que predice la aparición de 12 soberanos entre los musulmanes. Mantiene que las primeras versiones de este apocalipsis fueron puestas en circulación durante el período omeya, alrededor del año 100 H, cuando el número de califas se acercaba al duodécimo. La coincidencia entre los dos números simbólicos, 12 y 100, alimentó una atmósfera apocalíptica que favoreció la circulación de las primeras versiones del apocalipsis. Estas versiones hacen uso del modelo bíblico (...) de los doce príncipes de Israel que se han identificado con los doce soberanos musulmanes. El artículo continúa examinando varias versiones de este apocalipsis básico, versiones que reflejan circunstancias políticas posteriores, surgidas durante el final del período omeya y el comienzo del ‛abbāsī En estas versiones revisadas, el modelo bíblico ha sido reemplazado por el coránico y por un modelo árabe. El artículo examina también la función de este apocalipsis en el šī‛īsmo Duodecimano. (shrink)

Modelling data in applied areas particularly in reliability engineering is a prominent research topic. Statistical models play a vital role in modelling reliability data and are useful for further decision-making policies. In this paper, we study a new class of distributions with one additional shape parameter, called a new generalized exponential-X family. Some of its properties are taken into account. The maximum likelihood approach is adopted to obtain the estimates of the model parameters. For assessing the performance of these estimators, (...) a comprehensive Monte Carlo simulation study is carried out. The usefulness of the proposed family is demonstrated by means of a real-life application representing the failure times of electronic components. The fitted results show that the new generalized exponential-X family provides a close fit to data. Finally, considering the failure times data, the Bayesian analysis and performance of Gibbs sampling are discussed. The diagnostics measures such as the Raftery–Lewis, Geweke, and Gelman–Rubin are applied to check the convergence of the algorithm. (shrink)

"Dr. Rubin has brought cognitive psychology into a wholly unprecedented dialogue with studies in oral tradition. The result is a truly new perspective on memory and the processes of oral tradition." --John Miles Foley, University of Missouri.

"Dr. Rubin has brought cognitive psychology into a wholly unprecedented dialogue with studies in oral tradition. The result is a truly new perspective on memory and the processes of oral tradition." --John Miles Foley, University of Missouri.

There is increasing interest in determining what impact having women in management positions may have on corporate social responsibility initiatives. Various authors suggest that gender equality practices should be factored into the broader framework of CSR. This paper examines how the presence of women on corporate boards, in top and middle management and as heads of CSR departments, influences gender equality practices in the field of CSR. Using information collected from companies that have signed up to Women's Empowerment Principles in (...) Spain, we show that the presence of women in the aforesaid posts has a positive impact on CSR activities with gender equality objectives. We thus supplement the justice, business and moral arguments with further arguments in support of the incorporation of women into not only corporate boards but all management positions. Finally, we provide a view of how gender equality can be included in the broader framework of CSR. (shrink)

In recent years, firms have greatly increased the amount of resources allocated to activities classified as Corporate Social Responsibility (CSR). While an increase in CSR expenditure may be consistent with firm value maximization if it is a response to changes in stakeholders' preferences, we argue that a firm's insiders (managers and large blockholders) may seek to overinvest in CSR for their private benefit to the extent that doing so improves their reputations as good global citizens and has a "warm-glow" effect. (...) We test this hypothesis by investigating the relation between firms' CSR ratings and their ownership and capital structures. Employing a unique data set that categorizes the largest 3000 U. S. corporations as either socially responsible (SR) or socially irresponsible (SI), we find that on average, insiders' ownership and leverage are negatively related to the firm's social rating, while institutional ownership is uncorrelated with it. Assuming that higher CSR ratings is associated with higher CSR expenditure level, these results support our hypothesis that insiders induce firms to over-invest in CSR when they bear little of the cost of doing so. (shrink)

A structure has a (finite-string) automatic presentation if the elements of its domain can be named by finite strings in such a way that the coded domain and the coded atomic operations are recognised by synchronous multitape automata. Consequently, every structure with an automatic presentation has a decidable first-order theory. The problems surveyed here include the classification of classes of structures with automatic presentations, the complexity of the isomorphism problem, and the relationship between definability and recognisability.