83 found
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  1.  51
    Should the “Slow Code” Be Resuscitated?John D. Lantos & William L. Meadow - 2011 - American Journal of Bioethics 11 (11):8-12.
    Most bioethicists and professional medical societies condemn the practice of ?slow codes.? The American College of Physicians ethics manual states, ?Because it is deceptive, physicians or nurses should not perform half-hearted resuscitation efforts (?slow codes?).? A leading textbook calls slow codes ?dishonest, crass dissimulation, and unethical.? A medical sociologist describes them as ?deplorable, dishonest and inconsistent with established ethical principles.? Nevertheless, we believe that slow codes may be appropriate and ethically defensible in situations in which cardiopulmonary resuscitation (CPR) is likely (...)
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  2.  27
    Sequencing Newborns: A Call for Nuanced Use of Genomic Technologies.Josephine Johnston, John D. Lantos, Aaron Goldenberg, Flavia Chen, Erik Parens & Barbara A. Koenig - 2018 - Hastings Center Report 48 (S2):2-6.
    Many scientists and doctors hope that affordable genome sequencing will lead to more personalized medical care and improve public health in ways that will benefit children, families, and society more broadly. One hope in particular is that all newborns could be sequenced at birth, thereby setting the stage for a lifetime of medical care and self‐directed preventive actions tailored to each child's genome. Indeed, commentators often suggest that universal genome sequencing is inevitable. Such optimism can come with the presumption that (...)
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  3.  69
    Are newborns morally different from older children?Annie Janvier, Karen Lynn Bauer & John D. Lantos - 2007 - Theoretical Medicine and Bioethics 28 (5):413-425.
    Policies and position statements regarding decision-making for extremely premature babies exist in many countries and are often directive, focusing on parental choice and expected outcomes. These recommendations often state survival and handicap as reasons for optional intervention. The fact that such outcome statistics would not justify such approaches in other populations suggests that some other powerful factors are at work. The value of neonatal intensive care has been scrutinized far more than intensive care for older patients and suggests that neonatal (...)
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  4.  60
    The doctor-patient relationship in the post-managed care era.G. Caleb Alexander & John D. Lantos - 2006 - American Journal of Bioethics 6 (1):29 – 32.
    The growth of managed care was accompanied by concern about the impact that changes in health care organization would have on the doctor-patient relationship. We now are in a “post-managed care era,” where some of these changes in health care delivery have come to pass while others have not. A re-examination of the DPR in this setting suggests some surprising results. Rather than posing a new and unprecedented threat, managed care was simply the most recent of numerous strains on the (...)
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  5.  6
    SUPPORT and the Ethics of Study Implementation: Lessons for Comparative Effectiveness Research from the Trial of Oxygen Therapy for Premature Babies.John D. Lantos & Chris Feudtner - 2015 - Hastings Center Report 45 (1):30-40.
    The Surfactant, Positive Pressure, and Oxygenation Randomized Trial (SUPPORT) has been the focal point of many different criticisms regarding the ethics of the study ever since publication of the trial's findings in 2010 and 2012. In this article, we focus on a concern that the technical design and implementation details of the study were ethically flawed. While the federal Office Human Research Protections focused on the consent form, rather than on the study design and implementation, OHRP's critiques of the consent (...)
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  6.  22
    What We Do When We Resuscitate Extremely Preterm Infants.Jeremy R. Garrett, Brian S. Carter & John D. Lantos - 2017 - American Journal of Bioethics 17 (8):1-3.
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  7.  26
    Fragile lives with fragile rights: Justice for babies born at the limit of viability.Manya J. Hendriks & John D. Lantos - 2018 - Bioethics 32 (3):205-214.
    There is an inconsistency in the ways that doctors make clinical decisions regarding the treatment of babies born extremely prematurely. Many experts now recommend that clinical decisions about the treatment of such babies be individualized and consider many different factors. Nevertheless, many policies and practices throughout Europe and North America still appear to base decisions on gestational age alone or on gestational age as the primary factor that determines whether doctors recommend or even offer life-sustaining neonatal intensive care treatment. These (...)
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  8.  8
    Death and the neonate.Bryanna Moore & John D. Lantos - 2021 - Journal of Medical Ethics 47 (4):227-228.
    Dominic Wilkinson suggests that one of Schubert’s songs has relevance for neonatologists today. In the song, Schubert suggests that death sometimes comes as a friend. Wilkinson ponders whether the song has a message for doctors and parents, who sometimes struggle to figure out whether death is an enemy or a friend to a dying baby. Wilkinson reflects on the case of baby ‘Hal’, who was born with serious cardiomyopathy. Hal’s parents and doctors disagree about whether to withdraw life-support. Through his (...)
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  9.  31
    Sequencing Newborns: A Call for Nuanced Use of Genomic Technologies.Josephine Johnston, John D. Lantos, Aaron Goldenberg, Flavia Chen, Erik Parens, Barbara A. Koenig, Members of the Nsight Ethics & Policy Advisory Board - forthcoming - Zygon.
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  10.  42
    Rethinking Professional Ethics in the Cost-Sharing Era.G. Caleb Alexander, Mark A. Hall & John D. Lantos - 2006 - American Journal of Bioethics 6 (4):W17-W22.
    Changes in healthcare financing increasingly rely upon patient cost-sharing to control escalating healthcare expenditures. These changes raise new challenges for physicians that are different from those that arose either under managed care or traditional indemnity insurance. Historically, there have been two distinct bases for arguing that physicians should not consider costs in their clinical decisions—an “aspirational ethic” that exhorts physicians to treat all patients the same regardless of their ability to pay, and an “agency ethic” that calls on physicians to (...)
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  11.  10
    Do we still need doctors?John D. Lantos - 1997 - New York: Routledge.
    Written with poignancy and compassion, Do We Still Need Doctors? is a personal account from the front lines of the moral and political battles that are reshaping America's health care system. Using compelling firsthand experiences, clinical vignettes, and moral arguments, John D. Lantos, a pediatrician, asks whether, as we proceed with the redesign of our health care system, doctors will -- or should -- continue to fulfill the roles and responsibilities that they have in the past. Interspersing moving personal stories (...)
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  12.  12
    Our suffering and the suffering of our time.John D. Lantos - 2020 - Theoretical Medicine and Bioethics 41 (4):197-201.
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  13.  55
    Vaccine Mandates Are Justifiable Because We Are All in This Together.John D. Lantos & Mary Anne Jackson - 2013 - American Journal of Bioethics 13 (9):1-2.
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  14.  6
    Muddled Measures of Risks and Misremembered Reasons.John D. Lantos & Chris Feudtner - 2015 - Hastings Center Report 45 (3):4-5.
    A commentary on “Were There ‘Additional Foreseeable Risks’ in the SUPPORT Study?,” by Henry J. Silverman and Didier Dreyfuss; “SUPPORT: Risks, Harms, and Equipoise,” by Robert M. Nelson; “The Controversy over SUPPORT Continues and the Hyperbole Increases,” by Alan R. Fleischman; and “SUPPORT and Comparative Effectiveness Trials: What's at Stake?,” by Lois Shepherd, all in the January‐February 2015 issue.
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  15.  11
    Our Next Pandemic Ethics Challenge? Allocating “Normal” Health Care Services.Jeremy R. Garrett, Leslie Ann McNolty, Ian D. Wolfe & John D. Lantos - 2020 - Hastings Center Report 50 (3):79-80.
    The pandemic creates unprecedented challenges to society and to health care systems around the world. Like all crises, these provide a unique opportunity to rethink the fundamental limiting assumptions and institutional inertia of our established systems. These inertial assumptions have obscured deeply rooted problems in health care and deflected attempts to address them. As hospitals begin to welcome all patients back, they should resist the temptation to go back to business as usual. Instead, they should retain the more deliberative, explicit, (...)
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  16.  2
    Should We Aspire to Be Rational About Letting Babies Die?John D. Lantos - 2022 - American Journal of Bioethics 22 (11):51-53.
    It is astoundingly difficult—and may not be desirable—to be rational about decisions to let our babies die. Parents in these situations are caught in a maelstrom of overpowering and often contradic...
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  17.  11
    The Dilemmas of Artificial Wombs: Conventional Ethics and Science Fiction.John D. Lantos & Annie Janvier - 2023 - American Journal of Bioethics 23 (5):82-85.
    Five years ago, remarkable animal experiments on artificial womb technology (AWT) at Children’s Hospital of Philadelphia (CHOP) got us thinking about the ethical for premature babies. We recognized...
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  18.  29
    Considering Whether the Dismissal of Vaccine-Refusing Families Is Fair to Other Clinicians.Michael J. Deem, Mark Christopher Navin & John D. Lantos - 2018 - JAMA Pediatrics 172 (6):515-516.
    A recent American Academy of Pediatrics (AAP) clinical report states that it is an acceptable option for pediatric care clinicians to dismiss families who refuse vaccines. This is a clear shift in guidance from the AAP, which previously advised clinicians to “endeavor not to discharge” patients solely because of parental vaccine refusal. While this new policy might be interpreted as encouraging or recommending dismissal of vaccine-refusing families, it instead expresses tolerance for diverse professional approaches. This is unlike the earlier guidance, (...)
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  19.  8
    Healthcare organizations and high profile disagreements.Bryanna Moore & John D. Lantos - 2019 - Bioethics 34 (3):281-287.
    In this paper, we examine healthcare organizations’ responses to high profile cases of doctor–parent disagreement. We argue that, once a conflict crosses a certain threshold of public interest, the stakes of the disagreement change in important ways. They are no longer only the stakes of the child’s interests or who has decision‐making authority, but also the stakes of public trust in healthcare practitioners and organizations and the wide scale spread of medical misinformation. These higher stakes call for robust organization‐level responses. (...)
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  20.  44
    Genomic Contraindications for Heart Transplantation.Danton S. Char, Gabriel Lázaro-Muñoz, Aliessa Barnes, David Magnus, Michael J. Deem & John D. Lantos - 2017 - Pediatrics 139 (4).
  21.  15
    Costs and End-of-Life Care in the NICU: Lessons for the MICU?John D. Lantos & William L. Meadow - 2011 - Journal of Law, Medicine and Ethics 39 (2):194-200.
    Neonatal intensive care units (NICUs) and medical intensive care units (MICUs) are both very expensive. The cost-effectiveness of NICUs has been extensively evaluated, as has the long-term outcomes of subpopulations of NICU patients. NICU treatment is among the most cost-effective of high-tech interventions. And most patients do well. There are fewer evaluations of cost-effectiveness in the MICU and almost no long-term outcome studies. Policymakers who scrutinize expensive high-tech interventions would do well to study the examples found in the NICU.
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  22.  10
    Best Interest, Harm, God’s Will, Parental Discretion, or Utility.John D. Lantos - 2018 - American Journal of Bioethics 18 (8):7-8.
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  23.  14
    Informed Consent for Comparative Effectiveness Research Should Not Consider the Risks of the Standard Therapies That Are Being Studied as Risks of the Research.John D. Lantos - 2017 - Journal of Law, Medicine and Ethics 45 (3):365-374.
    There is a debate at the highest levels of government about how to classify the risks of research studies that evaluate therapies that are in widespread use. Should the risks of those therapies be considered as risks of research that is designed to evaluate those therapies? Or not? The Common Rule states, “In evaluating risks and benefits, the IRB should consider only those risks and benefits that may result from the research.” ). By contrast, the Office of Human Research Protections, (...)
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  24.  5
    What We talk about When We Talk about Ethics.John D. Lantos - 2014 - Hastings Center Report 44 (s1):40-44.
    I was recently invited to talk about ethics with the staff of a level‐three neonatal intensive care unit. They presented a case featuring a full‐term baby born by emergency caesarean‐section after a cord prolapse that caused prolonged anoxia. Her initial pH was 6.7. She was intubated and resuscitated in the delivery room. Her Apgar score remained at 1 for ten minutes. Further evaluation over the next two days revealed severe brain damage. Her prognosis was dismal.The doctors recommended a do‐not‐resuscitate order. (...)
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  25.  27
    Does pediatrics need its own bioethics?John D. Lantos - 2010 - Perspectives in Biology and Medicine 53 (4):613-624.
  26.  12
    Treatment Decisions for Babies with Trisomy 13 and 18.Isabella Pallotto & John D. Lantos - 2017 - HEC Forum 29 (3):213-222.
    Many babies with trisomy 13 and 18 die in the first year of life. Survivors all have severe cognitive impairment. There has been a debate among both professionals and parents about whether it is appropriate to provide life-sustaining interventions to babies with these serious conditions. On one side of the debate are those who argue that there is no point in providing invasive, painful, and expensive procedures when the only outcomes are either early death or survival with severe cognitive impairment. (...)
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  27.  14
    The Linares Affair.John D. Lantos, Steven H. Miles & Christine K. Cassel - 1989 - Journal of Law, Medicine and Ethics 17 (4):308-315.
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  28. Ethics committees and resource allocation.John D. Lantos - 1994 - Bioethics Forum 10:27-29.
  29.  17
    The Linares Affair.John D. Lantos, Steven H. Miles & Christine K. Cassel - 1989 - Journal of Law, Medicine and Ethics 17 (4):308-315.
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  30.  41
    Innovation in Human Research Protection: The AbioCor Artificial Heart Trial.E. Haavi Morreim, George E. Webb, Harvey L. Gordon, Baruch Brody, David Casarett, Ken Rosenfeld, James Sabin, John D. Lantos, Barry Morenz, Robert Krouse & Stan Goodman - 2006 - American Journal of Bioethics 6 (5):W6-W16.
    Human clinical research has become a huge economic enterprise (Morin et al. 2002; Noah 2002). Because the human subject at the center can be so easily marginalized, many commentators recommend spec...
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  31. Thirteen Ways of Looking at Henrietta Lacks.John D. Lantos - 2016 - Perspectives in Biology and Medicine 59 (2):228-233.
    What are we to make of Henrietta Lacks? After dying at a young age more than half a century ago, she has now become immortal twice—once biologically, and once culturally.She was first immortalized when cells from her cervical biopsy were cultured and became the first immortal cell line. The idea that this made Lacks herself immortal illustrates the dangerous temptations of genetic reductionism and literary license. Such literary license is illustrated by the title of Rebecca Skloot’s remarkable 2011 bestselling book (...)
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  32.  17
    Do Patients Want to Participate in Decisions About Their Own Medical Care?John D. Lantos - 2015 - American Journal of Bioethics 15 (10):1-2.
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  33.  5
    Costs and End-of-Life Care in the NICU: Lessons for the MICU?John D. Lantos & William L. Meadow - 2011 - Journal of Law, Medicine and Ethics 39 (2):194-200.
    Providing care for a baby born at 24 weeks of gestation in a neonatal intensive care unit is one of the most expensive medical treatments in the United States today. The cost can easily run over $300,000 for one baby. Furthermore, many extremely premature babies who survive are left with chronic diseases or disabilities that require further medical expenses and other specialized services throughout childhood or throughout life. When all these expenditures are totaled up, it can seem that neonatal intensive (...)
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  34.  36
    Reconsidering action: Day-to-day ethics in the work of medicine. [REVIEW]John D. Lantos - 1999 - HEC Forum 11 (1):52-57.
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  35.  1
    Primum Non Nocere Today: A Symposium on Pediatric Bioethics : Proceedings of the International Symposium on Pediatric Bioethics, Pavia, 26-28 May 1994.G. R. Burgio & John D. Lantos - 1994 - Elsevier Science.
    Aggressive therapies and the manipulation of life are now commonly applied to children, often including neonates and children who cannot express their consent. This text discusses a range of bioethical dilemmas concerning children and medicine.
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  36. Clinical Ethics in Pediatrics: An International Perspective.André Kidszun, Pablo Lezama-Del Valle, Jagdish Chinnappa, Priya Pais, Arpana Iyengar, Erwin J. Khoo, Janicke Syltern, Fajar Raza, Sarosh Saleem & John D. Lantos - 2019 - Journal of Clinical Ethics 30 (1):35-45.
    In this article, we first review the development of clinical ethics in pediatrics in the United States. We report that, over the last 40 years, most children’s hospitals have ethics committees but that those committees are rarely consulted. We speculate that the reasons for the paucity of ethics consults might be because ethical dilemmas are aired in other venues. The role of the ethics consultant, then, might be to shape the institutional climate and create safe spaces for the discussion of (...)
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  37. Withholding Information to Protect a Loved One.Todd J. Kilbaugh, Daniel Groll, Nabina Liebow, Wynne Morrison & John D. Lantos - 2016 - Pediatrics 6 (136).
    Parents respond to the death of a child in very different ways. Some parents may be violent or angry, some sad and tearful, some quiet and withdrawn, and some frankly delusional. We present a case in which a father’s reaction to his daughter’s death is a desire to protect his wife from the stressful information. The wife is in the second trimester of a high-risk pregnancy and so is particularly fragile. We asked pediatricians and bioethicists to discuss the ways in (...)
     
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  38. Ethical issues in neonatology.John D. Lantos - 2012 - In D. Micah Hester & Toby Schonfeld (eds.), Guidance for Healthcare Ethics Committees. Cambridge University Press.
     
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  39. In Practice: At the Lok Nayak Hospital, Delhi.John D. Lantos - forthcoming - Hastings Center Report.
     
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  40. Introduction : The Fascinating Synergy of Shared Decision Making.John D. Lantos - 2021 - In The ethics of shared decision making. Oxford University Press.
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  41. Shared decision making, truth-telling, and the recalcitrant family.John D. Lantos - 2021 - In The ethics of shared decision making. Oxford University Press.
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  42.  7
    The ethics of shared decision making.John D. Lantos (ed.) - 2021 - New York, NY: Oxford University Press.
    There are some paradoxes in the way doctors and patients make medical decisions today. Today's patients are more empowered than were patients in the past. They have the right to see their medical records. The law requires doctors to obtain their informed consent for treatment. Patients are told about the options for treatment and the risks and benefits of each option. Their values and preferences are elucidated in order to guide the treatments that are provided.
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  43. What we talk about when we talk about ethics.John D. Lantos - 2014 - In Martha Montello (ed.), Narrative ethics: the role of stories in bioethics. John Wiley and Sons.
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  44.  30
    Attitudes of paediatric and obstetric specialists towards prenatal surgery for lethal and non-lethal conditions.Ryan M. Antiel, Farr A. Curlin, John D. Lantos, Christopher A. Collura, Alan W. Flake, Mark P. Johnson, Natalie E. Rintoul, Stephen D. Brown & Chris Feudtner - 2017 - Journal of Medical Ethics:medethics-2017-104377.
    Background While prenatal surgery historically was performed exclusively for lethal conditions, today intrauterine surgery is also performed to decrease postnatal disabilities for non-lethal conditions. We sought to describe physicians' attitudes about prenatal surgery for lethal and non-lethal conditions and to elucidate characteristics associated with these attitudes. Methods Survey of 1200 paediatric surgeons, neonatologists and maternal–fetal medicine specialists. Results Of 1176 eligible physicians, 670 responded. In the setting of a lethal condition for which prenatal surgery would likely result in the child (...)
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  45. Correspondence.James B. Swire, Peter A. Singer, Mark Siegler, John D. Lantos, Jean C. Emond, Peter F. Whitington, J. Richard Thistlethwaite & Christoph E. Broelsch - 1990 - Theoretical Medicine and Bioethics 11 (4).
     
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  46.  16
    Review of Ruth Levy Guyer. Baby at Risk: The Uncertain Legacies of Medical Miracles for Babies, Families, and Society 1. [REVIEW]John D. Lantos - 2007 - American Journal of Bioethics 7 (10):45-46.
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  47.  11
    The Weird Divergence of Ethics and Regulation With Regard to Informed Consent.John D. Lantos - 2013 - American Journal of Bioethics 13 (12):31-33.
  48.  17
    Stories of Biology and MedicineThe Gold Bug VariationsOperation Wandering SoulGalatea 2.2. [REVIEW]John D. Lantos & Richard Powers - 1996 - Hastings Center Report 26 (3):17.
    The Novels of Richard Powers The Gold Bug Variations Operation Wandering Soul Galatea 2.2.
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  49.  10
    Medically Vulnerable Clinicians and Unnecessary Risk During the COVID-19 Pandemic.Annie Janvier & John D. Lantos - 2020 - American Journal of Bioethics 20 (7):13-14.
    Volume 20, Issue 7, July 2020, Page 13-14.
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  50.  12
    When Deeply Held Personal Beliefs Conflict with Collective Societal Norms.John D. Lantos - 2019 - Perspectives in Biology and Medicine 62 (3):503-518.
    In complex societies, there will always be situations in which an individual's deeply held beliefs conflict with the collective norms of the society. When only one individual challenges those norms, the norms generally hold. When challenges come from many individuals, the norms themselves may change. The tolerance for different beliefs will depend upon the political structure of the society and the specific beliefs that are being challenged.The Greek tragedy Antigone is an exploration of the choices that rulers can make regarding (...)
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