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)

Is there ever any reason for a doctor to lie to a patient? In this paper, we critically review the literature on lying to patients and challenge the common notion that while lying is unacceptable, a related entity--'benevolent deception' is defensible. Further, we outline a rare circumstance when treating psychotic patients where lying to the patient is justified. This circumstance is illustrated by a clinical vignette.

Multiple studies have been performed to identify the most common ethical dilemmas encountered by ethics consultation services. However, limited data exists comparing the content of ethics consultations requested by specific hospital specialties. It remains unclear whether the scope of ethical dilemmas prompting an ethics consultation differ between specialties and if there are types of ethics consultations that are more or less frequently called based on the specialty initiating the ethics consult. This study retrospectively assessed the incidence and content of ethics (...) consultations called by surgical vs. non-surgical specialties between January 1, 2013 to December 31, 2018 using our RedCap Database and information collected through the EMR via our Clinical and Translational Science Center. 548 total ethics consultations were analyzed. Our results demonstrate that more surgical consults originated from the ICU, as opposed to lower acuity units, and surgical patients were more likely to have a DNR in place. Surgical specialties were more likely to call about issues relating to withholding/withdrawing life-sustaining treatment, while non-surgical specialties were more likely to call about issues related to discharge planning. There appear to be morally relevant differences between consults classified as the “same” that are not entirely captured by the usual ethics consultations classification system. In conclusion, this study highlights the unique ethical issues experienced by surgical vs. non-surgical specialties. Ultimately, our data can help ethics consultation services determine how best to educate various hospital specialties to approach ethical issues commonly experienced within their field. (shrink)

Living donation provides important access to organ transplantation, which is the optimal therapy for patients with end-stage liver or kidney failure. Paired exchanges have facilitated thousands of kidney transplants and enable transplantation when the donor and recipient are incompatible. However, frequently willing and otherwise healthy donors have contraindications to the donation of the organ that their recipient needs. Trans-organ paired exchanges would enable a donor associated with a kidney recipient to donate a lobe of liver and a donor associated with (...) a liver recipient to donate a kidney. This article explores some of the ethical concerns that trans-organ exchange might encounter including unbalanced donor risks, the validity of informed consent, and effects on deceased organ donation. (shrink)

Varro's De lingua Latina is a treasure trove of information. Of the originally twenty-five books, six have come down to us more or less complete. Among these, Books 5–7 give us many hundreds of etymologies, and Books 8–10 discuss the question whether Latin morphology is regular or not. What Varro rarely comments on is sociolinguistic variation. The sociolinguistic comments in Varro's work can almost be counted on one hand. For instance, in 5.162 Varro remarks that cenaculum, from cena ‘dinner’, means (...) ‘attic’ in Roman Latin, but that the original meaning was, as one might expect, ‘dining-room’, a meaning preserved in the non-Roman dialects of Latium, Falerii and Corduba in Spain; the meaning also lives on in religious uses in Lanuvium. In 7.96, Varro tells us that some words are pronounced with -ae- by some, but with -ē- by others. We know that non-Roman varieties of Latin monophthongized -ae- earlier than the Roman dialect did. Varro mentions pairs like scaena / scēna ‘stage’, a loan from Greek σκηνή, which shows that -ae- is hypercorrect here. Interestingly, only in one such pair is the variant with -ē- ascribed to country people, in the name Maesius / Mēsius, and this is indeed the only pair where the diphthong -ae- is original rather than the result of hypercorrection. (shrink)

In this contribution I wish to tackle two corruptions in Book 7 of Varro's De lingua Latina that have hitherto gone unnoticed or been corrected inadequately.

This 1999 volume takes a critical look at the current divide over immigration policies. It hopes to shed light on the debate by bringing together papers that investigate the link between trade and factor mobility, particularly labour migration, from theoretical and empirical perspectives. It examines the substitutability between trade and migration, the impact of regional integration on the location of economic activity, the role of public goods provisions, and the political economy of migration. Several papers quantify the link between trade, (...) trade policies, migration and income distribution in sending and receiving nations using econometric methods and general equilibrium simulations. Case studies of past and present migration episodes are also presented: the impact of NAFTA on migratory pressure and wage gaps; the trade-migration links between Eastern and Western Europe; and the historical experience with migration flows in the nineteenth century. (shrink)

A significant amount of scientific evidence shows that childhood vaccination constitutes one of the most successful and cost-effective public health interventions of the last century. It has saved millions of lives. Nonetheless, many parents are reluctant or outright hostile to having their children vaccinated. Similarly, in spite of the fact that vaccines against SARS-CoV-2, the virus that causes COVID-19, are highly effective in protecting people against death and serious illness, about a third of adults in the United States are still (...) unvaccinated as of July 2022. What leads people to be skeptical of vaccines or to refuse them altogether?The dominant narrative answering this... (shrink)

Education for Total Liberation is a collection of essays from leaders in the field of critical animal pedagogy (CAP). CAP emerges from activist educators teaching critical animal studies and is rooted in critical theory as well as the animal advocacy movement. Critical animal studies (CAS) argues for an interdisciplinary approach to understanding our relationships with nonhuman animals. CAS challenges two specific fields of theory: (1) animal studies, rooted in vivisection and testing on animals in the hard sciences and (2) human-animal (...) studies, which reinforces a socially constructed binary between humans and animals and adopts abstract theoretical approaches. In contrast, CAS takes a progressive and committed approach to scholarship and sees the exploitation of nonhuman animals as interrelated with oppression of humans based on class, gender, race, ability, sexuality, age, and citizenship. CAS promotes the liberation of all animals and challenges all systems of domination. Education for Total Liberation is appropriate for undergraduate and graduate level readers (and beyond) who wish to learn from examples of radical pedagogical projects shaped by CAS and critical pedagogy. Contributing to this collection are Anne C. Bell, Anita de Melo, Carolyn Drew, Amber E. George, Karin Gunnarsson Dinker, Sinem Ketenci, John Lupinacci, Anthony J. Nocella II, Sean Parson, Helena Pedersen, Ian Purdy, Constance L. Russell, J.L. Schatz, Meneka Repka, William E. Shanahan III, and Richard J, White. (shrink)

The aim of this paper is to show that critics of biological explanations of human nature may be granting too much to those who propose such explanations when they argue that the truth of genetic determinism implies an end to critical evaluation and reform of our social institutions. This is the case because when we argue that biological determinism exempts us from social critique we are erroneously presupposing that our social values, practices, and institutions have nothing to do with what (...) makes biological explanations troublesome. My argument is that what constitutes a problem for those who are concerned with social justice is not the fact that particular behaviours may be genetically determined, but the fact that our value system and social institutions create the conditions that make such behaviours problematic. Thus, I will argue that even if genetic determinism were correct, the requirement of assessing and transforming our social practices and institutions would be far from superfluous. Biology is rarely destiny for human beings and the institutions they create. (shrink)

Deze korte studie biedt niet de zoveelste inleiding in het denken van Spinoza, maar doet verslag van de persoonlijke, vijfentwintig jaar durende zoektocht om de vaak moeilijke thema's van Spinoza onder de knie te krijgen. Om via Spinoza's filosofie meer te begrijpen van de wereld en van het eigen leven. Om de vreugde te ervaren die dit verbeterde inzicht, in oorzaken en gevolgen, en ook in de eigen beperktheid, ons biedt. Elk hoofdstuk gaat over een onderwerp dat de auteur bijzonder (...) aanspreekt. Bestaat er een levenswil, Spinoza's conatus, die mensen voort doet leven ook onder de meest bittere omstandigheden? Is kennis en inzicht gradueel van aard? Wat is het verschil tussen adequate en inadequate kennis van de oorzaken van ons handelen? Hoe ontwikkelt een machtsstaat zich tot een rechtsstaat? (shrink)

Artikelen en lezingen uit de periode 1970-1982.

Est-il vrai que la notion chrétienne de création soit une notion complètement nouvelle par rapport à la philosophie grecque ? Telle est la question qu'on se pose dans l'article ci-dessus. Si d'habitude on est incliné à répondre à cette question par l'affirmative, c'est en admettant que, assez généralement, la philosophie grecque connaît l'idée d'une matière préexistante. C'est ainsi que les apologètes grecs du deuxième siècle, tels qu'Aristide et Théophile d'Antioche, se sont opposés à la philosophie grecque et spécialement à la (...) doctrine de Platon telle qu'ils l'ont comprise. L'auteur essaie de démontrer que, en fait, Platon n'a pas admis une matière préexistante dans le sens voulu par ses adversaires. Il n'a ni enseigné que les éléments préexistassent à l'œuvre créatrice du Démiurge , ni introduit sa notion d' espace dans le sens de matière, telle qu'Aristote, suivant sa propre terminologie, a voulu l'expliquer. C'est donc une erreur de dire que Platon ait admis une matière qui soit « coéternelle » et « du même âge », donc du même ordre que Dieu. Pour Platon, et pour Aristote également, le principe non déterminé ne saurait, comme tel, être du même orde que le premier Principe de l'être qui est comme tel un principe déterminant et déterminé. C'e'st une erreur, encore, de dire que, sur ce point comme sur beaucoup d'autres, Aristote était plus près de la vérité, donc du Christianisme, que Platon, le « Démiurge » du dernier n'étant pas une cause totale, tandis que le Premier Moteur d'Aristote était, dans un sens, vraiment une cause totale. Ce qui se voit clairement chez Platon, non seulement dans le Timée, mais aussi dans la République et dans le Philète , c'est qu'il est constamment et profondément préoccupé de fonder l'existence relative dans l'Existence absolue. Il a reconnu le rapport entre le monde visible et le Monde transcendant comme une relation de dépendance totale et essentielle. Or, si, dans son essence, la notion chrétienne de création n'est autre chose qu'une telle relation de dépendance, Platon, qui a fait de cette notion la base de toute sa philosophie, était par là-même près de la foi chrétienne. Aristote, d'autre part, bien qu'il ait dit une fois au moins que de son premier Principe tout l'univers dépend, a minimisé en fait le rapport entre le premier Principe et notre monde. Dans la notion chrétienne de création deux éléments se dissinguent : L'Etre Absolu, dont sort tout ce qui est relatif, se distingue dans son essence de tout ce qui n'est pas Lui. Le mode selon lequel l'être relatif sort de l'Absolu n'est pas celui d'une nécessité de nature, mais d'un acte de volonté. En partant de cette analyse, on peut déterminer exactement les degrés de différence ou d'affinité entre la notion chrétienne de création et les différents systèmes de philosophie grecque. En rapport avec la Stoa, la différence est dans la notion de Dieu : ne reconnaissant pas sa transcendance, on méconnaît l'opposition entre l'Absolu et l'être relatif. Quant à Aristote, il n'explique aucunement comment l'être relatif provient de l'Absolu : son premier Moteur n'est pas la cause de l'être, et les « formes » immanentes des objets naturels restent chez lui sans aucune explication. Sans doute, Platon explique davantage. Il est suivi par les Néoplatoniciens qui font provenir l'être relatif de l'Absolu, tout en connaissant une différence essentielle entre l'un et l'autre, mais n'admettant point d'acte de volonté de la part de l'Absolu. Platon qui, probablement, admettait un acte de volonté, se trouvait par là-même le plus près de la notion chrétienne de création. Il en différait, cependant, sur quelques points importants. Il n'enseigne qu'en partie une création directe : c'est que le Nous transcendant qui est le Démiurge, constitue des éléments le monde visible ; ces éléments, il ne les a pas trouvés comme tels, mais il les a faits de — « quelque chose » qu'on n'a pas le droit de nommre une chose. Il « fait » donc le monde dans son aspect intelligible. Mais il reste un aspect qui échappe à la pensée et qui, comme tel, ne saurait provenir du Principe Suprême qui domine la hiérarchie platonicienne de l'être. Ensuite, le Nous transcendant fait les âmes : l'âme du monde, les astres , les âmes humaines. Il ne fait ni les corps humains ni les êtres vivants d'un ordre inférieur à l'homme. Ceux-là, ils sont tous créés par les « dieux créés » et secondaires qui sont les Astres. Pour Platon, l'Esprit transcendant qui crée le monde n'est pas le Principe suprême. Il se trouve d'après ce qu'il paraît, à un degré plus bas dans la hiérarchie de l'être. Ce seront les penseurs chrétiens, ce sera tout d'abord Saint Athanase qui, en unifiant essentiellement le Père et son Logos, a réuni l'Un et le Nous transcendant qui est le Démiurge de Platon. Au lieu d'opposer au Platonisme la doctrine qu'il n'y a pas de matière préexistante, Dieu ayant « concréé » la matière, nous préférons de dire : Platon a éloigné la notion d'infini et d'indétermination de son principe suprême ; donc, il en a fait un autre principe, jamais du même ordre que l'Un, mais tout de même un principe fondamental. La notion chrétienne de Dieu, d'autre part, renferme et le caractère de l'Un et celui de l'Infini. (shrink)

O artigo procura investigar as correlações entre os temas da liberdade e da alteridade, no conjunto do pensamento de J. Paul-Sartre.