IntroductionCardiology is characterized by its state-of-the-art biomedical technology and the predominance of Evidence-Based Medicine. This predominance makes it difficult for healthcare professionals to deal with the ethical dilemmas that emerge in this subspecialty. This paper is a first endeavor to empirically investigate the axiological foundations of the healthcare professionals in a cardiology hospital. Our pilot study selected, as the target population, cardiology personnel not only because of their difficult ethical deliberations but also because of the stringent conditions in which they (...) have to make them. Therefore, there is an urgent need to reconsider clinical ethics and Value-Based Medicine. This study proposes a qualitative analysis of the values and the virtues of healthcare professionals in a cardiology hospital in order to establish how the former impact upon the medical and ethical decisions made by the latter.ResultsWe point out the need for strengthening the roles of healthcare personnel as educators and guidance counselors in order to meet the ends of medicine, as well as the need for an ethical discernment that is compatible with our results, namely, that the ethical values developed by healthcare professionals stem from their life history as well as their professional education.ConclusionWe establish the kind of actions, communication skills and empathy that are required to build a stronger patient-healthcare professional relationship, which at the same time improves prognosis, treatment efficiency and therapeutic adhesion. (shrink)

Since the passage of Title VII of the Civil Rights Act of 1964 and more recent Federal legislation, managers, regulators, and attorneys have been busy in sorting out the legal meaning of fairness in employment. While ethical managers must follow the law in their hiring practices, they cannot be satisfied with legal compliance. In this article, we first briefly summarize what the law requires in terms of fair hiring practices. We subsequently rely on multiple perspectives to explore the ethical meaning (...) of fairness in hiring. Ethical fairness underlies the law and regulations in this area, but goes beyond them as well. We conclude by demonstrating that ethical hiring practices enable managers to make better hiring decisions. (shrink)

This book offers 32 texts and case studies from across a wide range of business sectors around a managerial framework for Sustainable Business. The case studies are developed for and tested in executive education programmes at leading business schools. The book is based on the premise that the key for managing the sustainable business is finding the right balance over time between managing competitiveness and profitability AND managing the context of the business with its political, social and ecological risks and (...) opportunities. In that way, a sustainable business is highly responsive to the demands and challenges from both markets and societies and managers embrace the complexity, ambivalence and uncertainty that goes along with this approach. The book presents a framework that facilitates the adoption of best business practice. This framework leads executives through a systematic approach of strategic analysis and business planning in risk management, issues management, stakeholder management, sustainable business development and strategic differentiation, business model innovation and developing dynamic capabilities. The approach helps broaden the understanding of what sustainable performance means, by protecting business value against sustainability risks and creating business value from sustainability opportunities. (shrink)

Introduction -- As real as it gets : Derrida -- The experiential divide : Merleau-Ponty and Derrida -- Connective tissue -- The originary disconnect -- Deconstruction and the computer -- Reality show: baudrillard -- The problem with reality -- The genealogy of value -- Hyperreality -- Disappearance and death -- The baudrillard twins -- Reality shows : Virilio -- Speed, light ,and the attack on reality -- The tyranny of real time -- The ultimate interface -- War and faith -- (...) The fate of the real : Lyotard -- Withdrawal of the real : the two waves -- Complexification and the inhuman -- Virtual intelligence -- TDers, BUers, AI, and AL -- The remainder -- Getting real(er) -- The problem of technology -- The question of alienation -- Between alienation and reconciliation -- In praise of materialism. (shrink)

Open and shut -- Thinking about technology -- The problem with technology -- Evil and the empire of good -- Hall of mirrors -- Our faith -- Thinking past technology -- Living among things -- Less is more.

Most donated organs in the United States come from brain dead donors, while a small percentage come from patients who die in “controlled,” or expected, circumstances, typically after the family or surrogate makes a decision to withdraw life support. The number of organs available for transplant could be substantially if donations were permitted in “uncontrolled” circumstances–that is, from people who die unexpectedly, often outside the hospital. According to projections from the Institute of Medicine, establishing programs permitting “uncontrolled donation after circulatory (...) determination of death,” or uDCDD, throughout the United States has the potential to provide 22,000 more donation opportunities annually. In contrast, U.S. controlled donation after circulatory determination of death, or cDCDD, cases have increased progressively over the past decade from 87 to 848 donors, but currently account for only 10.6 percent of all deceased donors. Following the IOM recommendations, several projects exploring the feasibility of uDCDD were funded by the federal government, including a grant from the Health Resources and Services Administration that supported a pilot project in New York City in which the authors of this article participated.A key feature of our protocol, and indeed of many uDCDD protocols, is the initiation of preservation methods such as chest compressions and extracorporeal membrane oxygenation shortly after death in order to perfuse and preserve the donor's organs. Critics of uDCDD argue that the means of determining death deviates from generally ascribed principles. They assert that reinstituting circulation in order to preserve organs has the effect of “undoing” the prior determination of death. The result is that cDCDD is widely accepted and practiced routinely even though it only marginally increases the number of organs available for transplantation, and uDCDD is widely considered unacceptable despite being ethically embraced and proven to significantly increase organ donation opportunities in other countries. This article explores the evolution of this counterintuitive state of affairs and calls for a policy that, in line with the IOM report, allows for both cDCDD and uDCDD protocols. (shrink)

A One Health approach holds great promise for attenuating the risk and burdens of emerging infectious diseases (EIDs) in both human and animal populations. Because the course and costs of EID outbreaks are difficult to predict, One Health policies must deal with scientific uncertainty, whilst addressing the political, economic and ethical dimensions of communication and intervention strategies. Drawing on the outcomes of parallel Delphi surveys conducted with policymakers in Singapore and Australia, we explore the normative dimensions of two different precautionary (...) approaches to EID decision-making—which we call regimes of risk management and organizing uncertainty, respectively. The imperative to act cautiously can be seen as either an epistemic rule or as a decision rule, which has implications for how EID uncertainty is managed. The normative features of each regime, and their implications for One Health approaches to infectious disease risks and outbreaks, are described. As One Health attempts to move upstream to prevent rather than react to emergence of EIDs in humans, we show how the approaches to uncertainty, taken by experts and decision-makers, and their choices about the content and quality of evidence, have implications for who pays the price of precaution, and, thereby, social and global justice. (shrink)

In the Monumentum Ancyranum Augustus makes some interesting and, if we can unravel them, undoubtedly important statements, from which certain deductions seem possible as to the number of his legionary soldiers, the rate of mortality among them, their length of service and the provisions made for them after their dicharge. Quite early in the Monument we get the following general assertion: ‘About five hundred thousand Roman citizens were bound to me by the military oath. Of these, after the due expiry (...) of their service, I settled in colonies or sent back to their own municipia somewhat more than three hundred thousand. And to all of them I gave land purchased by myself, or in lieu of land sums of money out of my own resources.’ From the place of this statement in that part of the record relating to his earlier career we might be tempted to infer that the five hundred thousand legionaries were those who formed his armies at the time of Antony's collapse, and that the discharge of three hundred thousand of them, whether planted in colonies or sent back to their domiciles, took place at one and the same time. With regard to the second point, we shall see presently that the vague and indiscriminate statement made here is cleared up by a later passage , from which it appears that the assignation of land belongs to two distinct schemes of colonizations, separated by sixteen years, and that the restoration of discharged soldiers to their municipalities, to whom alone the words ‘pecuniam pro agris dedi’ are applicable, belongs to a still later date. (shrink)

In the April number of the Classical Quarterly, Mr. H. J. Cunningham calls in question my interpretation of a passage in the speech of Claudius on the claims of the Gallic chieftains, which I will follow his good example by quoting in full. It forms the first legible sentence of Column II.

In the Mon. Ancyr. II. 2–11 Augustus makes four statements: He carried out a lectio senatus on three occasions. He held a census in his sixth consulship with Agrippa as his colleague, and completed the lustrum after an interval of forty-two years, the number of citizens registered being four millions and sixty-three thousand. He completed a second lustrum in 8 B.C. invested with the consular imperium and without a colleague, the number of citizens having increased by one hundred and seventy (...) thousand. He completed a third lustrum in 14 A.D. again invested with the consular imperium, but with Tiberius as his colleague, the number of citizens having again increased by seven hundred and four thousand. (shrink)

On those of Professor Elmore's hypotheses which appeared in his original article, I need make very few additional remarks. He restates them with undiminished confidence in this Review in January, 1918, but, except on one or two side issues, he makes no attempt to answer the careful and reasoned criticism to which I subjected them. The further developments of his theories, to which he calls my special attention, call for some examination, which however shall be brief.