Recently published consensus recommendations on pediatric decision-making by Salter and colleagues (2023) did not address neonatal decision-making, due to the unique complexities of neonatal care. This essay explores three areas that impact neonatal decision-making: legal and policy considerations, rapid technological advancement, and the unique emotional burdens faced by parents and clinicians during the medical care of neonates. The authors evaluate the six consensus recommendations related to these considerations and conclude that the consensus recommendations apply to neonates.

Donation after circulatory determination of death (DCDD) is an accepted practice in the United States, but heart procurement under these circumstances has been debated. Although the practice is experiencing a resurgence due to the recently completed trials using ex vivo perfusion systems, interest in thoracoabdominal normothermic regional perfusion (TA-NRP), wherein the organs are reanimated in situ prior to procurement, has raised many ethical questions. We outline practical, ethical, and equity considerations to ensure transplant programs make well-informed decisions about TA-NRP. We (...) present a multidisciplinary analysis of the relevant ethical issues arising from DCDD-NRP heart procurement, including application of the Dead Donor Rule and the Uniform Definition of Death Act, and provide recommendations to facilitate ethical analysis and input from all interested parties. We also recommend informed consent, as distinct from typical “authorization,” for cadaveric organ donation using TA-NRP. (shrink)

The use of complementary and alternative medicine (CAM) by US consumers has grown in recent years. CAM therapies often utilize medicinal herbs as part of the treatment process; however, research on US practitioner preferences for medicinal herbs is limited, despite growing concern surrounding the sustainability of wild-harvested medicinal herbs. In order better to understand consumer preferences for this emerging market, a mail survey of US practitioners (licensed acupuncturists) was conducted to examine the importance of five herb attributes in practitioners’ herb (...) selection decisions: (1) country of origin, (2) freshness, (3) production method (organic versus conventional), (4) price, and (5) traceability. The significance of these five traits is investigated using discrete choice analysis, and the implications for US medicinal herb growers are discussed. (shrink)

Listening and responding to patients’ stories for over 20 years as an emergency physician has strengthened my appreciation for the many ways that the skills and principles drawn from writing fiction double as necessary clinical skills. The best medicine doesn’t work on the wrong story, and the stories patients tell sometimes feel like first drafts—vital and fragile works-in-progress. Increasingly complex health challenges compounded by social, financial, and psychological burdens make for stories that are difficult to articulate and comprehend. In this (...) essay, I argue that healthcare providers need to think like creative writers and the skills and sensitivities necessary to story construction deserve a vital space in medical education. A thorough understanding of story anatomy and the imaginative flexibility to work stories into open spaces serve as antidotes to the reductive nature of clinical decision making and have implications as patient safety and risk management strategies. The examples that I have selected demonstrate how thinking like a creative writer functions at the bedside, providing tools for clinical excellence and empathy. This approach asks that we re-imagine the importance of story in clinical care: from a vehicle to a diagnosis to its place as a critical destination. (shrink)

“I'm not afraid of dying,” he says, despite his plea on arrival. “Listen up, douchebag. Are you calling my cousin or what?” The emergency department might be the only sphere of human exchange where one party—patients (and sometimes family)—are permitted to insult, threaten, and even spit at the very people on whom they depend for help, while the offended parties—physicians, nurses, and other health care providers—must not only tolerate the abuse, but treat their tormentors. Does the ED's collective duty to (...) greater numbers of patients demand a revised ethos of tough love for extreme cases of misbehavior? Can we ask these patients to leave without legal recourse after extending genuine, compassionate efforts to participate in their care—barring evidence of a medical explanation for their toxic comportment or a mental illness that puts them at risk of harming themselves or others? (shrink)

Workplace ethics perceptions drive ethical behaviors, but our understanding of how context shapes the nature of this relationship is limited. Consequently, this article uses contingency theory to explore how perceptions of ethical priorities in the workplace—ethical work climate (EWC)—are differentially associated with ethical behavior based on the broader context. Specifically, we meta-analytically test theoretically relevant cultural values (i.e., collectivism, power distance) and work context factors (i.e., consequence of errors, job autonomy) as moderators of the connection between EWC perceptions and ethical (...) behavior. Our findings reveal that while higher power-distance societal contexts strengthen the connection between EWC perceptions and ethical behavior, work contexts with higher autonomy _weaken_ the connection. We found mixed support for collectivism as a contextual moderator, with results supporting theoretical expectations with one cultural conceptualization but not another. Contrary to expectations, the consequences of errors in work contexts did not moderate the association between EWC perceptions and ethical behavior. Taken together, this meta-analytic investigation highlights the meaningful role of the broader organizational context as a potential boundary condition for the influence of EWC perceptions on ethical behavior. (shrink)

Experience has recently reemerged as an important analytical category for historians of the Old Regime and the French Revolution. Reacting against the perceived excesses of discourse analysis, which made political language independent of any social determinants, certain post-revisionists are now seeking to contextualize political language by relating it to the experience of those who use it. Political agency, in these analyses, is understood to be the effect of particular formative experiences. This article suggests that the search for an experiential antidote (...) to discourse is misconceived because it perpetuates an untenable dichotomy between thought and reality. Access to the phenomenon of historical agency should be pursued not through experience or discourse but through the category of consciousness, since the make-up of the subject's consciousness determines how he/she engages the world and decides to attempt changing it. After a brief discussion of an important study that exemplifies both the allure and the functionality of the notion of experience, Timothy Tackett's Becoming a Revolutionary, the article focuses on the evolving political consciousness of a man who became a revolutionary agitator in 1789, J.-M.-A. Servan. Analysis of his writings between 1769 and 1789 shows that the way in which his perspective was constructed, rather than the lessons of experience per se, determined the shape of his revolutionary intentions in 1789. (shrink)

The modal interpretation of quantum mechanics allows one to keep the standard classical definition of realism intact. That is, variables have a definite status for all time and a measurement only tells us which value it had. However, at present modal dynamics are only applicable to situations that are described in the orthodox theory by projective measures. In this paper we extend modal dynamics to include positive operator measures. That is, for example, rather than using a complete set of orthogonal (...) projectors, we can use an overcomplete set of nonorthogonal projectors. We derive the conditions under which Bell's stochastic modal dynamics for projective measures reduce to deterministic dynamics, showing that Brown and Hiley's generalization of Bohmian mechanics [quant-ph/0005026, ] cannot be thus derived. We then show how deterministic dynamics for positive operators can also be derived. As a simple case, we consider a Harmonic oscillator, and the overcomplete set of coherent state projectors. We show that the modal dynamics for this POM in the classical limit correspond to the classical dynamics, even for the nonclassical number state |n>. This is in contrast to the Bohmian dynamics, which for energy eigenstates, the dynamics are always non-classical. (shrink)

Intracellular pH (pHi) regulation is a homeostatic function of all cells. Additionally, the plasma membrane‐based transporters controlling pHi are involved in growth factor activation, cell proliferation and salt transport – all processes active in early embryos. pHi regulation in the early embryos of many species exhibits unique features: in mouse preimplantation embryos, mechanisms for correcting excess acid apparently are inactive, while excess base is removed by the mechanism common in differentiated cells. Additionally, unlike differentiated cells, mouse preimplantation embryos are highly (...) permeable to H+ until the blastocyst stage, where the epithelial cells surrounding the embryo are impermeable. In several non‐mammalian species, of which the best‐studied is sea urchin, cytoplasmic alkalinization at fertilization is necessary for development of the embryo, and elevated pHi must be maintained during early development. Thus, pHi regulatory mechanisms appear to be important for early embryo development in many species. (shrink)

Customer orientation and the development of long-term relationships with customers are known conditions for growth and profit sustainability. Businesses use special treatments, inducements, and personal gestures to show their appreciation to customers. However, there are concerns about whether these inducements really create the right perceptions in customer’s mind. This study suggests that when customers believe that the firm is ethical, the inducements and special treatments received are seen in a positive light and can help develop loyalty. The hypotheses were tested (...) with responses from 299 customers of financial institutions in Chile. Results support the hypotheses that firm’s ethical reputation helps in retaining customers. Managerial implications are provided. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:BonaventureJay M. HammondChristopher M. Cullen, Bonaventure, Great Medieval Thinkers Series. Oxford: Oxford University Press, 2006. ISBN: 0-19-514925-4 (paperback); 0-19-514926-2 (hardback). Pages: xviii + 251.This volume makes a valuable contribution to the "great medieval thinkers" series from OUP by providing an accessible introduction to the philosophy and theology of the great Franciscan St. Bonaventure († 1274). The Preface presents the book's organizing principle: "to analyze Bonaventure's thought by following (...) his own division of the branches of philosophy and theology" (xi) as found in the Bonaventure's classic text On the Reduction of the Arts to Theology (text explained on 29-32; oddly the book never addresses the discrepancy in the dating of the text, c. 1254 or c. 1270). This text considers how the new core subjects of the arts, heavily influenced by Aristotle and expanding beyond the trivium and quadrivium, are illuminations that should lead back to theology, that is to Scripture, which "lies hidden in all knowledge and in all nature."Part I, contains two chapters: the Introduction and another on the definition of Christian Wisdom, the ultimate goal of the Reduction of the Arts. Part II, "The Light of Philosophical Knowledge," contains three chapters on Bonaventure's physics, metaphysics, and moral philosophy. Part III, "The Light of Theological Knowledge," includes seven chapters organized according to Bonaventure's Breviloquium: the Trinity, Creation, Sin, the Incarnation, Grace, the Sacraments, and the Last Things.The preface sets out three claims that color the rest of the book. First, as mentioned, the book attempts an "introduction to the philosophy and theology" of Bonaventure, which the book calls "Christian Philosophy" (a term introduced by Étienne Gilson, Leon Veuthey and later adopted by John Quinn). Yet, I agree with the preface that "it is not easy to say precisely what this means in practice" (xi). Although Bonaventure did employ the phrase "Christian Wisdom" throughout his writings, he never used the phrase "Christian [End Page 541] Philosophy." More explanation of this key term would have been helpful because it seems to relate more to the neo-scholastic disputes of the early to mid twentieth century than to Bonaventure's thirteenth century thought. Second, the book claims that "his Commentary on the Sentences should have a priority of place in any accurate reading" of his thought. On this point the book delivers by citing more from the Sentence Commentary than any other of Bonaventure's works (139 times overall, 63 from Book II alone), but with the much shorter Breviloquium coming in a close second (128 times). Four works come in a distant third (Hexaemeron 38, Itinerarium 32, De mysterio Trinitatis 21, and De scientia Christi 21). Unfortunately little attention is given to Bonaventure's sermons, scripture commentaries, hagiographies and spiritual tracts. Third, whatever shortcomings the book has regarding the coverage of Bonaventure's many works, the book still fulfills its claim to provide "an overview of [Bonaventure's] synthesis," which is "an elaborate and sophisticated synthesis, created in a specific historical context" (xiv).The book begins with an introductory sketch of Bonaventure's life framed by three key historic movements of the thirteenth century: the rediscovery of Aristotle, the emergence of the "universities," and the rise of the mendicant orders. These overlapping contexts are indispensable to understanding Bonaventure's writings, which the introduction surveys in general chronological order and according to genre. After reviewing his life and works, the Introduction concludes with a consideration of Bonaventure's influence. The Introduction is helpful in orienting the modern reader to Bonaventure's thought, particularly his unique synthesis of Augustine and Aristotle. However, some of the dating is imprecise. For example, in October 1255 (not 1256) Bonaventure responded to William of Saint-Amour's attacks against the mendicants with Q.1 De humilitate of his De perfectione evangelica. Thus, Bonaventure entered the secular-mendicant controversy before Thomas Aquinas and Thomas of York (12, 17). Likewise, Bonaventure most likely incepted into the Parisian consortium of masters in April 1254 not October 1257 (11).While all of Part II provides good information on the intricacies of Bonaventure's philosophy, the sections explaining [End Page 542] his hylomorphic metaphysics (42... (shrink)

Because of his preoccupation with the formal aspects of music and literature, Theodor W. Adorno is often regarded as the most aesthetically oriented thinker of the Frankfurt School theorists. It is Adorno’s perceived commitment to aestheticism—the study of art for art’s sake and the study of art as a source of sensuous pleasure, rather than as a vehicle for culturally constructed morality or meaning—that many scholars have criticized as hostile to genuine, concrete, substantive political, social, and ethical engagement with the (...) arts. _Adorno and Ethics_—the first issue of _New German Critique_ to be published by Duke University Press—takes issue with Adorno’s critics. These essays reconsider Adorno’s unique brand of aestheticism, revealing a “politics of aestheticism” and exploring the political and ethical dimensions of his writings. One contributor links the ethical turn taken in Adorno criticism with related developments in American poetry and poetics. Another examines Adorno’s aphorism “Gold Assay” for the ways in which it anticipates one of his seminal works, _The Jargon of Authenticity_. Focusing on Auschwitz and the testimony of its survivors, one contributor explores the impact of the Holocaust on modern philosophy and reason, a relationship that he argues Adorno never specified. Another contributor considers the figure of the animal in the writings of Kant, Adorno, and Lévinas, exploring what it might mean to live, as Adorno suggests, as “a good animal.” _Contributors_. J. M. Bernstein, Detlev Claussen, Samir Gandesha, Alexander García Düttmann, Christina Gerhardt, Martin Jay, Robert Kaufman, Michael Marder, Gerhard Richter. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:I would like to begin by thanking Gregory LaNave for his analysis of Bonaventure's Itinerarium. His interpretation has helped me clarify my own understanding of that rich text. I would also like to thank the editors of Franciscan Studies who invited this response. It focuses on LaNave's misreading of "symbolic theology," his own "scientific" interpretation of the Itinerarium, and the relationship between scientific and symbolic theology as explained by (...) Bonaventure. Accordingly, I divide my response into three parts: Clarifying the Meaning of Symbolic Theology, Critique of Dr. LaNave's Analysis, and Scientific and Symbolic Theology.Clarifying the Meaning of Symbolic TheologyIn Divine and Created Order in Bonaventure's Theology, I employ the term "symbolic theology" to help the modern reader approach and appreciate Bonaventure's profuse use of symbols in the Itinerarium. Dr. LaNave acknowledges that such an accommodation is valuable: "The symbolic reading of Bonaventure has undoubted merits, not least of which is its attempts to do justice to his deft use of an array of symbols in his theology."In my "attempts to do justice" to the ubiquitous symbols throughout the Itinerarium, I describe "symbolic theology" in two ways. First, I claim that Bonaventure:does not employ symbols to prove anything, rather, he resorts to the effusive nature of symbols to demonstrate ineffable mysteries that elude easy description … symbolic thinking, in its most authentic form, is not a second-best mode of grasping reality but a penetration of its most profound metaphysical structure and dynamics.LaNave seems to have two concerns. On the one hand, since symbols do not "prove anything" he deems them as rather inadequate in describing metaphysical realities. For LaNave, symbols can not be "merely symbolic" if "they are in fact ways to penetrate the real metaphysical structure of the realities in question." The "merely" points to the need for something more, which LaNave identifies as the "objectivity of sensation" according to the "canons of a scientific theology ," In effect, he emphasizes by a threefold repetition that the "objectivity of sensation" can better examine "what is really there." It seems that symbols are less equipped for such a task.On the other hand, LaNave's contrast of "symbolic" with "scientific" seems to confuse what I identified as a general characteristic for the actual methodology I employed to analyze the Itinerarium: an analysis of the analogical triads produced by the threefold method of doubling. Like LaNave, I base my interpretation upon the dialectic of seeing God through and in a mirror . Hence, I disagree that I employ a "symbolic approach to theology." Rather, my approach primarily examines the text's analogical triads.Second, I also comment, "Bonaventure uses symbols to provide the imagination with powerful images with which one may ponder the deepest and highest levels of knowing." As an example, I provide the two symbols of the Seraph and Temple from Isaiah 6:1-2. However, LaNave does not comment on this second description of Bonaventure's "symbolic theology." Instead he states:the mystery revealed in any such symbol points to the whole of the mystery, never to any one part in isolation. For example, one may speak about creation and its relationship to the single creative activity of the Creator; but one must at the same time know that Creator to be the Trinity, and see the analogous presence of the Trinity in the creature. Analytical thinking might try to separate these elements; symbolic thinking always strives to see them implied in each other.To justify his claim, he cites pages 228-29 of Divine and Created Order.These pages do not treat or even mention "symbolic theology." Rather, they explain the terms principium, primum, and primitas, and their relation to the notion of ordo. These three terms concern foundational concepts that shape the ontology, metaphysics, and epistemology of Bonaventure's theology. In effect, LaNave correctly.. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:In light of the careful work of Joshua Benson who argues that the De reductione is the second part to Bonaventure's inception sermon, this article will date the De reductione by determining when he incepted. This is not an easy task because the date of his inception has been a point of confusion within Bonaventurian scholarship. Scholars date it as early as 1248 and as late as 1257. Within (...) those nine years they assign various scenarios regarding his status as regent master. For example, the most common scenario has Bonaventure incepting in 1253 or 1254 and assuming the Franciscan Chair in theology, but only teaching in the Franciscan convent, unrecognized by the university until either 1256 or 1257.My thesis is that Bonaventure incepted in April 1254 to replace William of Middleton who relinquished the Franciscan chair in the wake of the Lenten riot of 1253. To argue this thesis, the paper divides into three parts. The first will briefly present the various dating for Bonaventure's inception. The second will examine all the thirteenth and fourteenth century sources that are used for determining Bonaventure's chronology so as to establish the evidence for calculating his inception. And third, building upon the evidence gleaned from those witnesses, I will present a narrative chronology that details events surrounding Bonaventure's inception in April 1254.I. Various Dating of Bonaventure's inception as MasterScholars assign various dates to his inception, which has caused much confusion. The Quaracchi editors of the Opera omnia, Robinson, Gilson, Moorman, and Crowley claim Bonaventure incepted in 1248; Robson alone gives a 1252 date; Callebaut, Longpré, the Spanish editors of the Obras de San Buenaventura, Abate, Bonafede, the earlier Brady, the later Hayes, and Hammond give a date of 1253; Pelster, Glorieux, the Quaracchi editors of the Opera theologica selecta, Veuthey, the earlier Bougerol, Cousins, Schlosser and Delio opt for 1253 or 1254; the later Bougerol, Quinn, the earlier Hayes, Noone, Hauser, and Cullen hold for a 1254 date; the later Brady posits a 1255 date; Bettoni and Dufeil push the inception back to 1257.Table 1 highlights the disparity between the last two studies that focus specifically on Bonaventure's chronology during his time at Paris. Click for larger viewTable 1. Disputed dates in Bonaventure's ChronologyAt least the two studies have one date in common, and with that one fixed date of 1257, we turn to examine the thirteenth and fourteenth century witnesses so as to dispel the disparity.II. Examining the SourcesEven though the dating for Bonaventure's inception spans nine years, there are only seven sources that scholars can use to calculate those dates. More specifically, the majority of scholars support a 1253 or 1254 dating, with the year discrepancy likely deriving from how they calculate the dates in the sources according to medieval/modern calendars. Thus, to sort through the tangle of dating, all the evidence will first be presented in full. Then, in light of all the evidence, a scenario for dating Bonaventure's inception can be advanced.The thirteenth and fourteenth century sources fall into four groups: the Chronica fratris Salimbene de Adam ; the two independent, short lists of General Ministers: Series Magistrorum Generalium Ordinis Fratrum Minorum , and Chronicon Abbreviatum de Successione Generalium Ministrorum ; the three interdependent texts of the Catalogus Generalium Ministrorum,Catalogus XV Generalium , and the Chronica XXIV Generalium , which contain significant variances from one another; and the Chronica Franciscis Fabrianensis . As will become clear, scholars who advance a 1248 date read Salimbene in light of Fabriano, while those who favor 1253 or 1254 read Salimbene in light of the Catalogus Generalium Ministrorum and related texts. Those who favor a 1257 dating, seem to.. (shrink)

This investigation examines several key factors believed to promote human flourishing, specifically: Factor 1: Age, Education, & Healthcare, Factor 2: Labor Force Participation, Factor 3: Crime, Factor 4: Income, Factor 5: Youth Unemployment and Factor 6: Voting Behavior. Data was examined at the county level, and collected from a variety of US government and non-governmental organizations. Our investigation into the conditions necessary to promote human flourishing uses internal migration within the United States as the indicator of “unhappy” communities. The findings (...) reveal that all factors are important in emigration somewhere, but the factors vary for different counties. As a result, attempts to address the ills of society require an appreciation of geography and context. (shrink)

African American distrust of medicine has consequences for treatment seeking and healthcare behaviour. Much work has been done to examine acute events that have contributed to this phenomenon and a sophisticated bioethics discipline keeps watch on current practices by medicine. But physicians and clinicians are not the only actors in the medical arena, particularly when it comes to health beliefs and distrust of medicine. The purpose of this paper is to call attention not just to ethical shortcomings of the past, (...) but to the structural contexts of those events and the contributions and responsibilities of popular media and academic disciplines in the production of knowledge. We argue that ignoring context and producing inaccurate work has real impacts on health and healthcare, particularly for African Americans, and thus engenders ethical obligations incumbent on disciplines traditionally recognised as purely academic. (shrink)

For Plato and Aristotle, arete (traditionally translated as "virtue") was the essential object of human admiration and striving, and even the key to happiness. Their work continues to inspire reflection on fundamental questions of ethics and politics today, as the fourteen new essays collected here demonstrate. -/- Contributors: Lidia Palumbo, Eva Anagnostou-Laoutides, Ryan M. Brown, Jay R. Elliott, Guilherme Domingues da Motta, Federico Casella, Jonathan A. Buttaci, George Harvey, Mark Ralkowski, Gary S. Beck, Paula Gottlieb, Giulio di Basilio, Audrey L. (...) Anton, and Elena Bartolini. (shrink)