When the COVID-19 surge hit New York City hospitals, the Division of Medical Ethics at Weill Cornell Medical College, and our affiliated ethics consultation services, faced waves of ethical issues sweeping forward with intensity and urgency. In this article, we describe our experience over an eight-week period (16 March through 10 May 2020), and describe three types of services: clinical ethics consultation (CEC); service practice communications/interventions (SPCI); and organizational ethics advisement (OEA). We tell this narrative through the prism of time, (...) describing the evolution of ethical issues and trends as the pandemic unfolded. We delineate three phases: anticipation and preparation, crisis management, and reflection and adjustment. The first phase focused predominantly on ways to address impending resource shortages and to plan for remote ethics consultation, and CECs focused on code status discussions with surrogates. The second phase was characterized by the dramatic convergence of a rapid increase in the number of critically ill patients, a growing scarcity of resources, and the reassignment/ redeployment of staff outside their specialty areas. The third phase was characterized by the recognition that while the worst of the crisis was waning, its medium- and long-term consequences continued to pose immense challenges. We note that there were times during the crisis that serving in the role of clinical ethics consultant created a sense of dis-ease as novel as the coronavirus itself. In retrospect we learned that our activities far exceeded the familiar terrain of clinical ethics consultation and extended into other spheres of organizational life in novel ways that were unanticipated before this pandemic. To that end, we defined and categorized a middle level of ethics consultation, which we have termed service practice communication intervention (SPCI). This is an underappreciated dimension of the work that ethics consult services are capable of in times of crisis. We believe that the pandemic has revealed the many enduring ways that ethics consultation services can more robustly contribute to the ethical life of their institutions moving forward. (shrink)

In her recent paper ‘The Epistemology of Propaganda’ Rachel McKinnon discusses what she refers to as ‘TERF propaganda’. We take issue with three points in her paper. The first is her rejection of the claim that ‘TERF’ is a misogynistic slur. The second is the examples she presents as commitments of so-called ‘TERFs’, in order to establish that radical (and gender critical) feminists rely on a flawed ideology. The third is her claim that standpoint epistemology can be used to establish (...) that such feminists are wrong to worry about a threat of male violence in relation to trans women. In Section 1 we argue that ‘TERF’ is not a merely descriptive term; that to the extent that McKinnon offers considerations in support of the claim that ‘TERF’ is not a slur, these considerations fail; and that ‘TERF’ is a slur according to several prominent accounts in the contemporary literature. In Section 2, we argue that McKinnon misrepresents the position of gender critical feminists, and in doing so fails to establish the claim that the ideology behind these positions is flawed. In Section 3 we argue that McKinnon’s criticism of Stanley fails, and one implication of this is that those she characterizes as ‘positively privileged’ cannot rely on the standpoint-relative knowledge of those she characterizes as ‘negatively privileged’. We also emphasize in this section McKinnon’s failure to understand and account for multiple axes of oppression, of which the cis/trans axis is only one. (shrink)

While strike action has been common since the industrial revolution, it often invokes a passionate and polarising response, from the strikers themselves, from employers, governments and the general public. Support or lack thereof from health workers and the general public is an important consideration in the justification of strike action. This systematic review sought to examine the impact of strike action on patient and clinician attitudes, specifically to explore (1) patient and health worker support for strike action and (2) the (...) predictors for supporting strike action and the reasons given for engaging in strike action. A systematic scoping review was employed to identify all relevant literature, followed by a textual narrative synthesis. A total of 34 studies met inclusion criteria. Support for strike action was largely context‐dependent. A range of factors impact support for strike action; broader cultural and structural factors, such as unionisation and general acceptance of strike action; systemic factors, such as the nature of the healthcare system, including infrastructure and work conditions; the strike itself and a range of individual factors, the most notable of which was being a student or in an early career stage. There were also some surprising results, for example, during doctors strike, nurses were provided with the opportunity to expand their role, which led to greater professional autonomy and job satisfaction. (shrink)

In this article, I extend the feminist use of Friedrich Nietzsche’s account of memory and forgetting to consider the contemporary externalization of memory foregrounded by transgender experience. Nietzsche’s On the Genealogy of Morals argues that memory is “burnt in” to the forgetful body as a necessary part of subject-formation and the requirements of a social order. Feminist philosophers have employed Nietzsche’s account to illuminate how gender, as memory, becomes embodied. While the account of the “burnt in” repetitions of gender allows (...) us to theorize processes of embodied identity on an individual level, analyzing gender today requires also accounting for how gender is externalized. I take up this question through the specific examples of identity documents and sex-segregated bathrooms. Returning to Nietzsche’s call to practice a resistant forgetting, I conclude by exploring the distinct strategies required to disrupt externalized memory. These strategies include contesting the use of past gender assignments in data collection and rewriting architectural reminders of gender. (shrink)

The figure of Thomas More and his work Utopia have followed chaotic but often separate fates all along history. More wrote his Utopia in 1515, when he was under forty years of age and, more important, before the first expressions of the Lutheran movement in England. Ten years after the first edition of Utopia, Europe had become a different world, often a much more hostile one, a place in which Thomas More assured he would not have repeated the same adventure. (...) In 1532, when busy writing his great polemical work against William Tyndale, More went as far as thinking that Utopia, like Erasmus’s Praise of Folly, might have become subversive and the books needed to be destroyed. He added that he would “helpe to burne... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Wonder, Imagination, and the Matter of Theatre in The TempestMary MooreAriel occurs. Recounting his performance of "the tempest" in Act I, scene 1 of The Tempest, he presents himself as being and action, fracturing grammar, spatial and temporal logic in ways that amaze and confound:I boarded the King's ship; now on the beak, Now in the waist, the deck, in every cabin, I flamed amazement. Sometime I'd divide, And (...) burn in many places; on the topmast, The yards, and bowsprit would I flame distinctly, Then meet and join...(1.2.195–201) 1"I flamed" means that Ariel emits or is flames, which in the normal order of things would consume him. His very narration, however, proves his survival, evoking wonder through the utterance itself. Forceful and compacted syntax, a recognized source of wonder in Classical and Renaissance accounts of style (Biester, pp. 14; 35–40), magnifies this effect. 2 Shakespeare's transitive use of the usually intransitive verb flame reflects a not uncommon practice, as E. A. Abbott shows; 3 but this syntactic device also reflects The Tempest's own logic. Ariel crosses boundaries between [End Page 496] deed and being, verb and noun, subject and object, matter and spirit: he both is and does flames. What could be more jarring to syntax and semantics than a singular subject whose utterance claims that he can flame, divide, meet and join? Just as "a" fire consists of many flames yet functions grammatically as a singular substance in English, just as the Christian Trinity is both singular and multiple, Ariel burns in many places at once. Meanwhile, this extraordinary language seems belied by the actor's very embodiment. Ariel cannot have done what he claims; yet the prior scene has represented the very storm in which Ariel flamed. In that sense, the actor's embodiment represents what we imagine to be matter's intractability, while Ariel's claims, coupled with the storm we have just witnessed, reveal matter's fluidity and permeability to imagination. Fluidity and intractability co-exist, another source of wonder. Sound mimics these paradoxes: the assonance and consonance in flame and amazement create a near rhyme that echoes the near identity of fire and human amazement. If, as Gurr and Ichikawa observe, a Renaissance audience expected to hear more than see a play, this echo calls attention to Ariel's marvelous powers. 4 Lest the noises and pleasures of the Renaissance theatre, which recent scholarship deems to be considerable, distract audience members from this bit of language, similar moments reinforce Ariel's play in and with language and matter throughout the play. Marvelous poetic language is of a piece with a "fever" that is of "the mind," with music that "creeps," actors who vanish, new found goddesses who speak the discoverers' own language.Amazement provides our cue: it and its cognates name the appropriate response to Ariel, his language, and to The Tempest itself. Attention to Ariel's poetic language reveals that it, like the plot, conforms to the marvels of the play and to the period's well documented love for marvels in several ways. Wonder, an aesthetic "'object of desire'" in itself, and a response to the inexplicable in classical and early modern views, may be evoked by the unexpected in style (and through other strategies that the era's handbooks taught). 5 The clause "I flamed amazement" epitomizes the unexpected in syntax as well as differing from one of the few sources found for The Tempest, William Strachey's 1610 letter, which describes just such a storm. 6 While St. Elmo's fire itself may elicit wonder, Shakespeare's syntax and diction reinforce that marvel. And no wonder: rhetoric and theatre alike depend upon audience attention, and wonders naturally evoke it. Jarring language also harmonizes with The Tempest's structural marvels—loose ends, disrupted actions, unforeseen futures—issues several critics explore. 7 [End Page 497]The wonders of The Tempest, however, also involve imagination—in early modern psychology, the human faculty that permits perception of the world and invention of images. 8 Wonder responds to how the perceived differs from the expected, how the imagined supplants the usual, how an... (shrink)

This case is about a study of burn patients that included a request to the IRB for a waiver of consent for perianal specimen collection–a request which ultimately was not approved by a reviewing IR...

In lieu of an abstract, here is a brief excerpt of the content:Wonder, Imagination, and the Matter of Theatre in The TempestMary MooreAriel occurs. Recounting his performance of "the tempest" in Act I, scene 1 of The Tempest, he presents himself as being and action, fracturing grammar, spatial and temporal logic in ways that amaze and confound:I boarded the King's ship; now on the beak, Now in the waist, the deck, in every cabin, I flamed amazement. Sometime I'd divide, And (...) burn in many places; on the topmast, The yards, and bowsprit would I flame distinctly, Then meet and join...(1.2.195–201) 1"I flamed" means that Ariel emits or is flames, which in the normal order of things would consume him. His very narration, however, proves his survival, evoking wonder through the utterance itself. Forceful and compacted syntax, a recognized source of wonder in Classical and Renaissance accounts of style (Biester, pp. 14; 35–40), magnifies this effect. 2 Shakespeare's transitive use of the usually intransitive verb flame reflects a not uncommon practice, as E. A. Abbott shows; 3 but this syntactic device also reflects The Tempest's own logic. Ariel crosses boundaries between [End Page 496] deed and being, verb and noun, subject and object, matter and spirit: he both is and does flames. What could be more jarring to syntax and semantics than a singular subject whose utterance claims that he can flame, divide, meet and join? Just as "a" fire consists of many flames yet functions grammatically as a singular substance in English, just as the Christian Trinity is both singular and multiple, Ariel burns in many places at once. Meanwhile, this extraordinary language seems belied by the actor's very embodiment. Ariel cannot have done what he claims; yet the prior scene has represented the very storm in which Ariel flamed. In that sense, the actor's embodiment represents what we imagine to be matter's intractability, while Ariel's claims, coupled with the storm we have just witnessed, reveal matter's fluidity and permeability to imagination. Fluidity and intractability co-exist, another source of wonder. Sound mimics these paradoxes: the assonance and consonance in flame and amazement create a near rhyme that echoes the near identity of fire and human amazement. If, as Gurr and Ichikawa observe, a Renaissance audience expected to hear more than see a play, this echo calls attention to Ariel's marvelous powers. 4 Lest the noises and pleasures of the Renaissance theatre, which recent scholarship deems to be considerable, distract audience members from this bit of language, similar moments reinforce Ariel's play in and with language and matter throughout the play. Marvelous poetic language is of a piece with a "fever" that is of "the mind," with music that "creeps," actors who vanish, new found goddesses who speak the discoverers' own language.Amazement provides our cue: it and its cognates name the appropriate response to Ariel, his language, and to The Tempest itself. Attention to Ariel's poetic language reveals that it, like the plot, conforms to the marvels of the play and to the period's well documented love for marvels in several ways. Wonder, an aesthetic "'object of desire'" in itself, and a response to the inexplicable in classical and early modern views, may be evoked by the unexpected in style (and through other strategies that the era's handbooks taught). 5 The clause "I flamed amazement" epitomizes the unexpected in syntax as well as differing from one of the few sources found for The Tempest, William Strachey's 1610 letter, which describes just such a storm. 6 While St. Elmo's fire itself may elicit wonder, Shakespeare's syntax and diction reinforce that marvel. And no wonder: rhetoric and theatre alike depend upon audience attention, and wonders naturally evoke it. Jarring language also harmonizes with The Tempest's structural marvels—loose ends, disrupted actions, unforeseen futures—issues several critics explore. 7 [End Page 497]The wonders of The Tempest, however, also involve imagination—in early modern psychology, the human faculty that permits perception of the world and invention of images. 8 Wonder responds to how the perceived differs from the expected, how the imagined supplants the usual, how an... (shrink)

Concept and theory formation in the social sciences, by A. Schutz.--Is it a science? by S. Morgenbesser.--Knowledge and interest, by J. Habermas.--Sociological explanation, by T. Burns.--Methodological individualism reconsidered, by S. Lukes.--The problem of rationality in the social world, by A. Schutz.--Concepts and society, by E. Gellner.--Symbols in Ndembu ritual, by V. Turner.--Telstar and the Aborigines or La pensée sauvage, by E. Leach.--Groote Eylandt totemism and Le totémisme aujourd'hui, by P. Worsley.--Bibliography (p. 225-228).

«Claros del bosque» es uno de los libros esenciales de la trayectoria filosófica de María Zambrano en el que vemos, por primera vez, en marcha su «razón poética». Nadie mejor que la propia autora para presentarnos el significado de esta obra: “«Claros del bosque» dentro de mi pensamiento vertido en lo impreso, salvo alguna excepción, aparece como algo inédito salido de ese escribir irreprimible que brota por sí mismo y que ha ido a parar a cuadernos y hojas que nadie (...) conoce, ni yo misma, reacia que soy a releerme. Tenía que suceder por fuerza. Mas creo que el carácter de ofrenda de «Claros del bosque» a la persona a quien va dedicado en su tránsito tiene que ver en ello, acentuando así el carácter de ofrenda que todo lo que he publicado tiene desde siempre. Nada es de extrañar que la razón discursiva apenas aparezca. Con anterioridad esbocé una ‘Crítica de la razón discursiva’ que no podría prometerme que salga de ese estado. Creo, pues, que como libro es el que más responde a esa ‘idea’ hace tiempo formulada de que ‘pensar es ante todo –como raíz, como acto–– descifrar lo que se siente’, entendiendo por sentir el ‘sentir originario’, expresión usada por mí desde hace años. Y también que ‘el hombre es el ser que padece su propia trascendencia’ en un incesante proceso de unificación entre pasividad y conocimiento, entre ser y vida. Vida verdadera, sorprendida tan sólo en algunos claros que se abren en la espesura inicial entre cielo y tierra. Y en el remoto horizonte donde cielo y tierra, ser y vida, vida y muerte se anegan”. (shrink)

Respected Catholic ethicists have recently defended the use of salpingostomy and methotrexate in the management of ectopic pregnancies.This article examines the arguments for the revised assessments to determine whether there are sound reasons to believe that these two methods do not constitute the direct and immediate killing of innocent human beings. National Catholic Bioethics Quarterly 11.1 (Spring 2011): 65–82.

Although a conventional environmentalism focuses on the health of ecological systems, Pope Francis’s 2015 environmental encyclical Laudato Sí invokes St. Francis of Assisi to emphasize God’s love for the individual organism, no matter how small. Decrying the tendency to regard other creatures as mere objects to be controlled and used, Pope Francis urges our enactment of a ‘universal communion’ governed by love. I suggest, however, that Laudato Sí’s animal ethic, as focused on ordering human and animal need, is inadequate to (...) its overarching vision of cross-species communion. This vision requires the sort of cross-species relational bridge implicit in Maurice Merleau-Ponty’s view of agency as an irreducibly ‘animate’ expression of choice and afforded further definition in Kenneth J. Shapiro’s conception of a ‘kinesthetic empathy.’ As the phenomenological epistemology underlying both discourses makes possible a rough correspondence, I put these in conversation to demonstrate that a Merleau-Pontyan and reciprocal agency is a constitutive aspect of the fullest sort of cross-species relation, such that recognition of this agency can both deepen our understanding of ‘universal communion’ and foster engagement in its practice. (shrink)

Farmers’ markets, often structured as non-profit or cooperative organizations, play a prominent role in emerging alternative food networks of western Canada. The contribution of these social economy organizations to network development may relate, in part, to the process of regional clustering. In this study we explore the nature and significance of farmers’ market clustering in the western Canadian provinces of British Columbia and Alberta, focusing on the possible connection between clustering and a “scaling up” of alternative food networks. Survey and (...) interview results from four regional clusters indicate that in addition to spatial agglomeration, dynamic processes of interaction and knowledge exchange are occurring and are shaped by vendor mobility as well as collaborative and competitive forces. Horizontal and vertical collaborations are resulting in innovative strategies to address challenges of scale, scope, infrastructure, and organizational capacity that are prevalent in alternative food networks. Government support for market clustering has been modest to date but, we argue, could play a more prominent role in facilitating cluster development as part of a broader collaborative strategy involving public, private, and social economy sectors in the scaling up of alternative food networks. (shrink)

The Politics of Feminist Knowledge Transfer draws together analytical work on gender training and gender expertise. Its chapters critically reflect on the politics of feminist knowledge transfer, understood as an inherently political, dynamic and contested process, the overall aim of which is to transform gendered power relations in pursuit of more equal societies, workplaces, and policies. At its core, the work explores the relationship between gender expertise, gender training, and broader processes of feminist transformation arising from knowledge transfer activities. Examining (...) these in a reflective way, the book brings a primarily practice-based debate into the academic arena. With contributions from authors of diverse backgrounds, including academics, practitioners and representatives of gender training institutions, the editors combine a focus on gender expertise and gender training, with more theory-focused chapters. (shrink)

In this volume, María Cerezo examines Wittgenstein's Tractatus Logico-Philosophicus as a response to some of Frege's and Russel's logical problems. In analyzing the tractarian conditions for the possibility of language, she explains the two main theories of the proposition in Tractatus : the truth-functions theory and the picture theory. Cerezo shows that Wittgenstein initially separates the account of the structure of a proposition from the explanation of its expression. However, contrary to his intention, the combination of these theories creates new (...) difficulties, since the requirements of each theory cannot be fully respected by the others. Cerezo also argues that Wittgenstein's theory of language cannot be fully understood unless attention is paid to his theory of expression and his doctrine of projection by the metaphysical subject. (shrink)

Forty years after Dax Cowart fought to have his voice heard regarding his medical treatment, patient autonomy and rights are at the heart of patient care today. Yet, despite its centrality in patient care, the tension between a severely burned patient’s right to stop treatment and the physician’s role in saving a life has not abated. As this case study explores, barriers remain to hearing and respecting a patient’s treatment decisions. Dismantling these barriers involves dispelling the myths that burn patients (...) must grin and bear intense pain to recover and that a patient’s choice to discontinue treatment equals physician failure. Moreover, in these situations, sustained, direct engagement between physician and patient can reduce the moral distress of all involved and enable physicians to hear and better accept when a patient is calling for the end of the day. (shrink)

Impression management refers to behaviors used by individuals to control the impressions they make on audiences. This study demonstrated that business men and women were more likely to defend their questionable behavior by using excuses and justifications than to openly concede errors of judgment and behavior. Three hundred and sixty two participants received a scenario in which they had allegedly engaged in questionable behavior. The participants then wrote a position paper explaining their actions. Results indicated that people in business attempt (...) to avoid being associated with potentially negative interpretations of their behavior primarily through the use of justifications and excuses. In general, the types of responses were relatively consistent across work experience, educational and occupational levels. However, in some instances the specific explanations used depended on gender and age. (shrink)