This article states that, with his narrative, the author of Daniel 6 creates the presence of Elohim outside Jerusalem and Israel, within non-Israelite environments. Applying a body-space frameset to the texts of Daniel 6 helps to read the text as a construction of concepts. With his narrative the author creates the presence of Elohim outside Jerusalem and Israel, within non-Israelite environments. Furthermore, a spatial frameset shows that the story of Daniel 6 can be read as a conclusion to a larger (...) narrative that stretches from Daniel 1–6. In this narrative the author utilises spatial concepts such as the character of Daniel; the lion’s den; Jerusalem and King Darius, to establish the omnipresence of the God of Israel. In constructing this presence of-God reality the author conveys a message of hope and trust in the authority of the God of Israel. In this regard Daniel 6 is not just a story about the character Daniel being persecuted for his faith; rather it is a story about the God of Israel establishing his presence and his ability to act through and within space and time. (shrink)

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)

Undocumented and undomiciled, Gustavo Jiménez had been in the United States for several years. He knew his leg wasn’t right when it began to swell and redden. After the cellulitis spread to his bloodstream, he was found unconscious on the street and admitted to the intensive care unit. He improved quickly and was soon able to tell a social worker his name and that he had family in Quito. Then his health took a turn for the worse, and he developed (...) multisystem organ failure. His doctors believed his prognosis grave and further care futile. They wanted to invoke a provision under their state’s law that allows, at the discretion of at least two physicians, for the withdrawal of life‐sustaining therapy for isolated and decisionally incapacitated patients, but the social worker had ethical concerns about the doctors’ desire to make such a momentous decision without family input. She asked for a “time‐out to locate his family,” but one of the doctors asserted, “His family isn’t here, and you’ll never find them. Besides we need the bed. The ER is full of patients we can help.” What is owed a patient and family in such a situation? (shrink)

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)

Applying cognitive linguistics to the text of Daniel 1 is a useful exegetical aid for a better understanding of the narrative. Studying the author's use of 'spatial markers' such as 'Jerusalem', 'Babylon', 'temple' and some other spatial features, makes it possible to reconstruct the narrative into a 'cognitive spatial frameset'. In this particular exegetical frameset, Daniel 1 can be described as a narrated confrontation between Yahweh and the gods of Babylon. Within this conflict between deities, Daniel, the divine agent becomes (...) a spatial embodiment of Yahweh's power and authority to act inside a hostile, non-Israelite environment and at the same time undermines the authority of the Babylonian gods. (shrink)

Translating ethical theories into clinical practice presents a perennial challenge to educators. While many suggestions have been put forth to bridge the theory-practice gap, none have sufficiently remedied the problem. We believe the ascendance of hospital medicine, as a dominant new force in medical education and patient care, presents a unique opportunity that could redefine the way clinical ethics is taught. The field of hospital medicine in the United States is comprised of more than 50,000 hospitalists—specialists in inpatient medicine—representing the (...) fastest growing subspecialty in the history of medicine, and its members have emerged as a dominant new force around which medical education and patient care pivot. This evolution in medical education presents a unique opportunity for the clinical ethics community. Through their proximity to patients and trainees, hospitalists have the potential to teach medical ethics in real time on the wards, but most hospitalists have not received formal training in clinical ethics. We believe it is time to strengthen the ties between hospital medicine and medical ethics, and in this article we outline how clinical ethicists might collaborate with hospitalists to identify routine issues that do not rise to the level of an “ethics consult,” but nonetheless require an intellectual grounding in normative reasoning. We use a clinical vignette to explore how this approach might enhance and broaden the scope of medical education that occurs in the inpatient setting: A patient with an intra-abdominal abscess is admitted to the academic hospitalist teaching service for drainage of the fluid, hemodynamic support, and antimicrobial therapy. During the initial encounter with the hospitalist and his team of medical students and residents, the patient reports night sweats and asks if this symptom could be due to the abscess. How should the hospitalist approach this question? (shrink)

: This essay appropriates the understanding of ethics developed by Michel Foucault in his courses at the Collège de France from 1980 until his death in 1984, with the aim of formulating a progressive environmental politics. As such, it attempts to navigate some of the long–standing divides between the movement for animal rights and environmental ethics proper, finding in the practice of vegetarianism a form of self-relation that is conducive to critical forms of speech and politics. The final phase of (...) Foucault's work is replete with insights into how the care of the self can serve as a resistance to forms of power and political stasis. This paper presents these unpublished materials, allowing for a glimpse of the unknown Foucault, and reinterprets vegetarianism as a form of self-practice that is linked with truth and critical speech. (shrink)

The problem concerning the manner in which truth is found in the statements of the natural sciences is an important one. It has been discussed from the very beginning of modern science, but in each phase of the development the issue was raised in a different way and for a different reason, such as the seeming conflict between reason and faith, the question concerning the limits of scientific knowledge, the meaning of induction, the probabilistic nature of many scientific statements, the (...) realization that even scientific theories and claims are inherently historical in character, etc. In this essay some contemporary positions are examined briefly. Then the thesis is defended that scientific theories that are well-established and accepted by the majority of the scholars in the relevant field of research, can be said to be true; and the same holds true for the statements derived from such theories to the degree that they are not yet falsified by experiment or observation. It is argued that in this case it will be necessary to rethink the essence of truth, not in terms of the classical correspondence theory, but rather in terms of the hermeneutic theory of truth as unconcealment. Theories and scientific statements are not true in the sense that they present us with mirror-images of what is in the „real” world. They are true, rather, in the sense that they make it possible for us to give a rational explanation of the states, relations, and forms of interaction of natural entities, which reveal these entities, their characteristics, and interactions in such a way, as they appear to show themselves independently of the theory in question in experiment and observation. (shrink)

In this presentation I take a close look at Kant’s notion of “orientation” as it arises in a minor essay of 1786 in order to show how this relatively obscure moment forces us to reconsider the central division between epistemology and aesthetics. What makes Kant’s notion orientation difficult to place in a critical system that separates conceptually grounded cognition from the affective nature of aesthetics is that orientations turn out to be claims to knowledge which can not be had without (...) an irreducible aesthetic or “felt” discrimination. So what is philosophically at issue in examining Kant’s notion of orientation is the question of whether there are indeed some features of objects or states of affairs which are not properly recognized prior to or independently of feeling a certain way about them. In other words, are our feelings epistemologically relevant? The official Kantian answer is, of course, a resounding “no”. By reconstructing the logic of “orientation” as deployed in the 1786 essay I show where the attempt to separate cognition from feelings leads into a vicious “Kantian Circle”. This logical circularity anticipates similar problems in the third critique’s explanation of beauty and life. I end by returning to the notion of “orientation” in order to suggest a way out of this “Kantian Circle”. (shrink)

Spiritualist ethics: The problem of evil, by L. Lavelle. On conscience, or On the pain of having-done-it, by V. Jankélévitch. Value and immortality; and, Dangerous situation of ethical values, by G. Marcel. The concept of fallibility, by P. Ricoeur.--Axiological ethics: Ethics and metaphysics, by R. Le Senne. Good and evil, by H. Reiner. Values and truths, by R. Polin. Values as principles of action, by G. Gusdorf.--Three contemporary conceptions of humanism: Jean-Paul Sartre: Sartre on humanism, by J. J. Kockelmans. Moral (...) perspectives in Sartre's thought, by F. Jeanson. Ambiguity, by S. de Beauvoir. Albert Camus: Albert Camus and the ethic of absurdity, by H. Hochberg. On humanism, by M. Heidegger. Existentialism's basic ethical position, by O. Bollnow.--Situation ethics: Systematic essentialist ethics and existential situation ethics, by T. Steinbüchel. The question of the Single One, by M. Buber. What is a Christian ethic? By D. Bonhoeffer. Meaning and analysis of the borderline situation, by H. Thielicke. (shrink)

Theorists, historians, and artists address the precarious futurity of the notion of the future. Not long ago, a melancholic left and a manic neoliberalism seemed to arrive at an awkward consensus: the foreclosure of futurity. Whereas the former mourned the failure of its utopian project, the latter celebrated the triumph of a global marketplace. The radical hope of realizing a singularly different, more equitable future displaced by a belief that the future had already come to pass, limiting post-historical society to (...) an uneventful life of endless accumulation. Today, amidst an abundance of neofuturisms, posthumanisms, futurologies, speculative philosophies and accelerationist scenarios, there is as well an expanding awareness of a looming planetary catastrophe driven by the extractionist logic of capitalism. Despite this return to the future, the temporal horizon of our present moment is perhaps more aptly characterized by the “shrinking future” of just-in-time production, risk management, high-frequency trading, and the futures market. In Futurity Report, theorists, historians, and artists address the precarious futurity of the notion of the future itself. Contributors McKenzie Wark, China Miéville, Kerstin Stakemeier, Diedrich Diederichsen, Natascha Sadr Haghighian, Marina Vishmidt, Johannes Paul Raether, Felicity D. Scott, Silvia Maglioni, Graeme Thomson, Doreen Mende, Pedro Neves Marques, Achille Mbembe, Kodwo Eshun, Haytham El-Wardany, T. J. Demos, Ana Teixeira Pinto. (shrink)

A 47-year-old woman with a history of anxiety disorder is admitted to the hospital for shortness of breath. On the third day of hospitalization, she asks her physician for a copy of all documents pertaining to her care. What expectation should she have for full disclosure? Are there limits on her access to her medical records and do her physician's concerns about professional privilege matter?The virtues of transparency in medicine have been well described. As proponents of transparency, we favor patient (...) access to their medical records, but we are increasingly troubled by the ease and extent of disclosure in current practice as technology advances and... (shrink)

While COVID-19 has generated a massive burden of illness worldwide, healthcare workers (HCWs) have been disproportionately exposed to SARS-CoV-2 coronavirus infection. During the so-called ‘first wave’, infection rates among this population group have ranged between 10% and 20%, raising as high as one in every four COVID-19 patients in Spain at the peak of the crisis. Now that many countries are already dealing with new waves of COVID-19 cases, a potential competition between HCW and non-HCW patients for scarce resources can (...) still be a likely clinical scenario. In this paper, we address the question of whether HCW who become ill with COVID-19 should be prioritised in diagnostic, treatment or resource allocation protocols. We will evaluate some of the proposed arguments both in favour and against the prioritisation of HCW and also consider which clinical circumstances might warrant prioritising HCW and why could it be ethically appropriate to do so. We conclude that prioritising HCW’s access to protective equipment, diagnostic tests or even prophylactic or therapeutic drug regimes and vaccines might be ethically defensible. However, prioritising HCWs to receive intensive care unit (ICU) beds or ventilators is a much more nuanced decision, in which arguments such as instrumental value or reciprocity might not be enough, and economic and systemic values will need to be considered. (shrink)

Der folgende Artikel ist im Jahr 2003 unter dem Titel „Clinical Pragmatism: A Method of Moral Problem Solving“ in dem Sammelband „Pragmatic bioethics“ erschienen, welcher sich mit der Bedeutung der pragmatistischen Philosophie für die Praxis befasst. In dem vom Internisten und Bioethiker Joseph J. Fins, dem Thoraxchirurgen Matthew D. Bacchetta und dem Philosophen und Medizinethiker Franklin G. Miller verfassten Beitrag wird der pragmatistische Ansatz in der klinischen Ethik anhand eines Fallbeispiels gleichzeitig beschrieben, begründet und demonstriert. Obgleich die Denkrichtung der (...) pragmatistischen Philosophie sowohl wissenschaftstheoretisch wie praktisch hoch bedeutsam ist – ohne diese ist weder die heutige sozialwissenschaftliche Forschung noch die angewandte, insbesondere die klinische Ethik denkbar –, werden pragmatistische Ansätze im deutschsprachigen Raum bis heute eher rudimentär rezipiert. (shrink)

Recent trends in business ethics along with growing attacks upon unions, suggest that employee rights will be a major social concern for business managers during the next decade. However, in most of the discussions of employee rights to date, the very meaning and legitimacy of such rights are often uncritically taken for granted. In this paper, we develop an account of employee rights and defend this conception against what we take to be the strongest in-principle objections to it.

We review de Finetti’s two coherence criteria for determinate probabilities: coherence1defined in terms of previsions for a set of events that are undominated by the status quo – previsions immune to a sure-loss – and coherence2 defined in terms of forecasts for events undominated in Brier score by a rival forecast. We propose a criterion of IP-coherence2 based on a generalization of Brier score for IP-forecasts that uses 1-sided, lower and upper, probability forecasts. However, whereas Brier score is a strictly (...) proper scoring rule for eliciting determinate probabilities, we show that there is no real-valuedstrictly proper IP-score. Nonetheless, with respect to either of two decision rules – Γ-maximin or E-admissibility-+-Γ-maximin – we give a lexicographic strictly proper IP-scoring rule that is based on Brier score. (shrink)