Theological and secular voices in bioethics have drifted into separate silos. Such a separation results in part from theologians focusing less on conveying ideas in ways that contribute to a pluralistic and public bioethical discourse and the dwindling receptivity of religious arguments within secular bioethics. This essay works against these drifts by putting forward an argument that does not bounce around a religious echo-chamber, but instead demonstrates how insights of Christian anthropology can be meaningfully responsive to secular bioethics’ rightful concerns (...) with inequality and injustice. We offer core concepts from Christian bioethics that encourage dialogue with secular and theological bioethicists. The theologically-grounded concepts, human dignity, sin, and the common good, provide intellectual resources to address major areas of bioethical concern that remain unresolved. (shrink)

The American Society for Bioethics and Humanities has created a quality attestation process for clinical ethics consultants; the pilot phase of reviewing portfolios has begun. One aspect of the QA process which is particularly challenging is assessing the interpersonal skills of individual clinical ethics consultants. We propose that using case simulation to evaluate clinical ethics consultants is an approach that can meet this need provided clear standards for assessment are identified. To this end, we developed the Assessing Clinical Ethics Skills (...) tool, which identifies and specifies specific behaviors that a clinical ethics consultant should demonstrate in an ethics case simulation. The aim is for the clinical ethics consultant or student to use a videotaped case simulation, along with the ACES tool scored by a trained rater, to demonstrate their competence as part of their QA portfolio. The development and piloting of the tool is described. (shrink)

As the field of clinical ethics consultation sets standards and moves forward with the Quality Attestation process, questions should be raised about what ethical issues really do arise in practice. There is limited data on the type and number of ethics consultations conducted across different settings. At Loyola University Medical Center, we conducted a retrospective review of our ethics consultations from 2008 through 2013. One hundred fifty-six cases met the eligibility criteria. We analyzed demographic data on these patients and conducted (...) a content analysis of the ethics consultation write-ups coding both the frequency of ethical issues and most significant, or key, ethical issue per case. Patients for whom ethics consultation was requested were typically male, white, between 50 and 69 years old, of non-Hispanic origin, and of Roman Catholic faith. Nearly half were in the intensive care unit and 44.2 % died in the hospital. The most frequent broad ethical categories were decision-making, goals of care/treatment, and end-of-life. More specifically, capacity, patient’s wishes/autonomy, and surrogate decision maker were the most frequent particular ethical issues. The most common key ethical issues were withdrawing/withholding treatment, patient wishes/autonomy, and capacity. Our findings provide additional data to inform the training of clinical ethics consultants regarding the ethical issues that arise in practice. A wider research agenda should be formed to collect and compare data across institutions to improve education and training in our field. (shrink)

The field of clinical ethics consultation has matured into a multidisciplinary profession, with clinical ethics consultants (CECs) being trained in bioethics, philosophy, theology, law, medicine, n...

Brummett argues that P2+ is necessary because it acknowledges the metaphysical claims ignored in P2’s approach in addressing parental refusal for treatment in certain pediatric cases that cl...

This book presents a sympathetic yet critical treatment of the major philosophical attempts to define a viable project for philosophy in the face of historical changes. McCarthy, then, proposes a comprehensive, critical, and methodological strategy of epistemic integration that fully respects the progressive and pluralistic character of contemporary science and common sense. The programs of Frege, Husserl, Wittgenstein, Carnap, Sellers, Dewey, Quine, and Rorty are carefully presented and an assessment is made of their merits and limitations. This assessment results in (...) a defense of Lonergan’s integrative strategy — a nuanced philosophical strategy around which a gathering center could be built. McCarthy presents Lonergan’s work as containing the firm outline and partial execution of a philosophical project continuous with philosophy’s historic purposes and equal to the exigences of the present. The book examines a broad range of seminal topics and, after extended dialectical treatment of them, develops a coherent account of their interdependence. These topics include psychologism, intentionality, the limits of naturalism, semantical and epistemic realism, historical belonging, epistemic invariance, foundational analysis, the limitation of logic and of the linguistic turn, generalized empirical method, the interdependence of mind and language, the interplay of nature and history, and the critical appropriation of tradition. (shrink)

Reflection in medical education is becoming more widespread. Drawing on our Jesuit Catholic heritage, the Loyola University Chicago Stritch School of Medicine incorporates reflection in its formal curriculum and co–curricular programs. The aim of this type of reflection is to help students in their formation as they learn to step back and analyze their experiences in medical education and their impact on the student. Although reflection is incorporated through all four years of our undergraduate medical curriculum, this essay will focus (...) on three areas where bioethics faculty and medical educators have purposefully integrated reflection in the medical school, specifically within our bioethics education and professional development efforts: 1) in our three–year longitudinal clinical skills course Patient Centered Medicine (PCM), 2) in our co–curricular Bioethics and Professionalism Honors Program, and 3) in our newly created Physician’s Vocation Program (PVP). (shrink)

This critical study of Arendt explores the sources and dangers of political alienation in the West from the citizen republics of classical antiquity to the consumer societies of modern liberal democracies. It is a sympathetic appraisal of the high promise and great perils of the political life.

Catholic health care has long been a key place where the Church embodies its social doctrine. However, the moral methodology that shapes Catholic bioethics relies on an act-based approach to decision making, which is rooted in the pre–Vatican II manualist tradition, focusing primarily on clinical issues related to the beginning and end of life. This essay argues that given the doctrinal status of Catholic social thought, Catholic bioethics must revisit its scope and methodology. It proceeds in three steps: a meta-analysis (...) of traditional Catholic bioethics, validating the claim made above; an overview of the limited literature published since 1980 engaging Catholic bioethics and CST; and a map of a Catholic bioethics informed by CST generated from a dual starting point. The essay concludes by focusing on both the places where marginalized persons encounter Catholic health care and the ethical issues presented, including race, health care disparities, immigration status, and gender inequality, as well as the interrelated perspective of the common good, expanding the array of issues to include environmental degradation, unions, health care financing, and more. (shrink)

Circadian rhythm abnormalities in bipolar disorder have led to a search for genetic abnormalities in circadian "clock genes" associated with BD. However, no significant clock gene findings have emerged from genome-wide association studies. At least three factors could account for this discrepancy: complex traits are polygenic, the organization of the clock is more complex than previously recognized, and/or genetic risk for BD may be shared across multiple illnesses. To investigate these issues, we considered the clock gene network at three levels: (...) essential "core" clock genes, upstream circadian clock modulators, and downstream clock controlled genes. Using relaxed thresholds for GWAS statistical significance, we determined the rates of clock vs. control genetic associations with BD, and four additional illnesses that share clinical features and/or genetic risk with BD. Then we compared the results to a set of lithium-responsive genes. Associations with BD-spectrum illnesses and lithium-responsiveness were both enriched among core clock genes but not among upstream clock modulators. Associations with BD-spectrum illnesses and lithium-responsiveness were also enriched among pervasively rhythmic clock-controlled genes but not among genes that were less pervasively rhythmic or non-rhythmic. Our analysis reveals previously unrecognized associations between clock genes and BD-spectrum illnesses, partly reconciling previously discordant results from past GWAS and candidate gene studies. (shrink)

DURING THE PAST TWO HUNDRED YEARS, uncertainty and suspicion about the philosophical enterprise have become acute. The educated public is confused about the intellectual and cultural importance of philosophy, and philosophers themselves are divided on its theoretical purpose and meaning. There are, to be sure, specifically philosophical sources of this condition. They include Kant’s critique of traditional metaphysics, the logical positivists’ debunking of ethics and theology, Wittgenstein’s restrictions on the scope of meaningful discourse, Richard Rorty’s call for an end to (...) epistemology, and the deconstructionist attempt to envisage a postphilosophical world. Yet it would be a mistake to assume that the unease of philosophers is solely the result of an intramural debate. The practice of philosophy has always been responsive to the cultural context in which it occurs. The extended crisis of philosophy through the last two centuries is the natural reflection of an ongoing crisis in modernity. (shrink)

“Offsetting” habitat destruction has widespread appeal as an instrument for balancing economic growth with biodiversity conservation. Requiring proponents to pay the nontrivial costs of habitat loss encourages sensitive planning approaches. Offsetting, biobanking, and biodiverse carbon sequestration schemes will play an important role in conserving biodiversity under increasing human pressures. However, untenable assumptions in existing schemes are undermining their benefits. Policies that allow habitat destruction to be offset by the protection of existing habitat are guaranteed to result in further loss of (...) biodiversity. Similarly, schemes that allow trading the immediate loss of existing habitat for restoration projects that promise future habitat will, at best, result in time lags in the availability of habitat that increases extinction risks, or at worst, fail to achieve the offset at all. We detail concerns about existing approaches and describe how offsetting and trading policies can be improved to provide genuine benefits for biodiversity. Due to uncertainties about the way in which restored vegetation matures, we propose that the biodiversity bank should be a savings bank. Accrued biodiversity values should be demonstrated before they can be used to offset biodiversity losses. We provide recommendations about how this could be achieved in practice. (shrink)

In memoriam of Vernon Venable, American philosopher who for four decades was a master teacher in the history of Western philosophy, author of an important study of Marx, and the seminal spirit in the development and flourishing of the program in philosophy at Vassar College.

Catholic health care is one of the key places where the church lives Catholic social teaching (CST). Yet the individualistic methodology of Catholic bioethics inherited from the manualist tradition has yet to incorporate this critical component of the Catholic moral tradition. Informed by the places where Catholic health care intersects with the diverse societal injustices embodied in the patients it encounters, this book brings the lens of CST to bear on Catholic health care, illuminating a new spectrum of ethical issues (...) and practical recommendations from social determinants of health, immigration, diversity and disparities, behavioral health, gender-questioning patients, and environmental and global health issues. (shrink)

Michael H. McCarthy has carefully studied the writings of Bernard Lonergan (Canadian philosopher-theologian, 1904-1984) for over fifty years. In his 1989 book, The Crisis of Philosophy, McCarthy argued for the superiority of Lonergan's distinctive philosophical project to those of his analytic and phenomenological rivals. Now in Authenticity as Self-Transcendence: The Enduring Insights of Bernard Lonergan, he develops and expands his earlier argument with four new essays, designed to show Lonergan's exceptional relevance to the cultural situation of late modernity. The essays (...) explore and appraise Lonergan's cultural mission: to raise Catholic philosophy and theology to meet the intellectual challenges and standards of his time. (shrink)

At the beginning of the third Section of the Groundwork, Kant appears to state the synthetic a priori proposition which it is the business of that Section to justify. It is: “An absolutely good will is one whose maxim can always have as its content itself considered as a universal law.” I shall contend that a consideration of Kant's use of analytic method shows that he is committed to regard this proposition not as synthetic, but rather as analytic. Hence, I (...) shall contend that his statement of the proposition to be justified in the third Section is a slip, which hinders the study of the third Section and which, therefore, requires a textual emendation. Kant, I claim, does not attempt to justify this proposition but another. (shrink)

Kant's aim in Section III of the Groundwork is to establish the supreme principle of morality. To accomplish his aim he finds it necessary to present a justification of freedom. Commentators generally regard Kant's overall argument as a failure, because they regard his justification of freedom as a failure. In this paper I shall present three arguments. First, I shall argue that commentators, for the most part, look to the wrong text for Kant's Groundwork justification of freedom. They look to (...) pars. 10–16 for an argument for freedom, but the collection of propositions, which Kant presents there, is aimed at showing something other than freedom. Second, I shall argue that to the extent that they look to the correct text, namely, par. 4, they misinterpret Kant. Third, I shall set out and evaluate the actual justification of freedom which Kant presents in par. 4. (shrink)

This essay applies recent scholarly insights on disillusionment as a cultural and psychological phenomenon to the problem of religious disillusionment as experienced by US Catholics in the wake of scandals of clergy sexual abuse. First, it sets forth disillusionment as a category for exploring the theological issue of sinfulness in the church. Second, it considers examples of how Vatican documents and acts of reconciliation in the last decade have been careful to draw distinctions between the faults of individual Christians and (...) the holiness of the Church itself. Third, it presents Augustine as one for whom significant disillusionment, even with the Church, became an avenue for embracing the cross in the broadest ecclesiological context. (shrink)

The global landscape in which we wrote this essay has fundamentally changed. Given how these changes have altered the rhythm of life, particularly the added responsibilities that many of you have a...

This article explores union attempts to control pension fund investment for the debate on financial restructuring in the United States. It puts popular control of finance into comparative and historical perspective and argues that laws and politics help explain why the flow of finance is corporate controlled. First, changes in the legal regime—the Taft-Hartley Act of 1947 and the Employee Retirement Income Security Act of 1974—put constraints on labor’s ability to influence investment decisions. This is evident when comparing single- and (...) multi-employer plans, where the laws had different consequences. Second, attempts to reform these laws failed. Had they been successful, Carter’s proposed economic revitalization plan in the run-up to his failed reelection in 1980 would have created new ways for unions to control and redirect retirement investment for social purposes. The reform failure is treated as a “suppressed historical alternative” through a comparison with a successful reform in Quebec, Canada, which gave unions broad controls over the Solidarity Fund in 1983. The findings suggest, somewhat counter-intuitively, that legal restrictions need to be loosened for democratic control of finance to be possible. For pension funds, more regulations led to more corporate control, not less. (shrink)

The moth snowstorm, a phenomenon Michael McCarthy remembers from his boyhood when moths 'would pack a car's headlight beams like snowflakes in a blizzard,' is a distant memory. Wildlife is being lost, not only in the wholesale extinctions of species but also in the dwindling of those species that still exist. The Moth Snowstorm records in painful detail this rapid dissolution of nature's abundance and proposes a radical solution: that we recognize our capacity to love the natural world. Arguing that (...) neither sustainable development nor ecosystem services have proven adequate as defenses against pollution, habitat destruction, species degradation, and climate change, McCarthy asks us to consider nature as an intrinsic good and an emotional and spiritual resource, capable of inspiring joy, wonder, and even love. An award-winning environmental journalist, McCarthy presents a clear, well-documented picture of what he calls 'the great thinning' around the world, while interweaving the story of his own early discovery of wilderness and a childhood saved by nature. Drawing on the truths of poets, the studies of scientists, and the author's long experience in the field, The Moth Snowstorm is part elegy, part ode, and part argument, resulting in a passionate call to action. (shrink)

How can finance be durably democratized? In the centers of financial power in both the United States and the United Kingdom, proposals now circulate to give workers and the public more say over how flows of credit are allocated. This article examines five democratization proposals: credit union franchises, public investment banks, sovereign wealth funds, inclusive ownership funds, and bank nationalization. It considers how these plans might activate worker and public engagement in decision making about finance by focusing on three modes (...) of public participation: representative democracy, direct democracy, and deliberative minipublics. It then considers the degree to which democratization plans might be resilient to de-democratization threats from business. It argues that of the five, bank nationalization goes furthest in guarding against de-democratization threats but is still pocked with pitfalls if it relies solely on representative democracy. It argues that two criteria appear necessary for democratically durable alternatives: the active direct participation of workers and citizens and the weakening of businesses’ capacity for democratic retrenchment. (shrink)

Summary 1. Ecologists and conservation biologists consider many issues when designing a field study, such as the expected value of the data, the interests of the study species, the welfare of individual organisms and the cost of the project. These different issues or values often conflict; however, neither animal ethics nor environmental ethics provides practical guidance on how to assess trade-offs between them. -/- 2. We developed a decision framework for considering trade-offs between values in ecological research, drawing on the (...) field of ecological ethics. We used a case study of the population genetics of three frog species, in which a researcher must choose between four methods of sampling DNA from the study animals. We measured species welfare as the reduction in population growth rate following sampling, and assessed individual welfare using two different definitions: (i) the level of suffering experienced by an animal, and (ii) the level of suffering combined with loss of future life. -/- 3. Tipping the tails of tadpoles ranked as the best sampling method for species welfare, while collecting whole tadpoles and buccal swabbing of adult frogs ranked best for the first and second definitions of individual welfare, respectively. Toe clipping of adult frogs ranked as the worst sampling method for species welfare and the first definition of individual welfare, and equal worst for the second definition of individual welfare. -/- 4. When considering species and individual welfare simultaneously, toe clipping was clearly inferior to the other sampling methods, but no single sampling method was clearly superior to the other three. Buccal swabbing, collecting tadpoles and tail tipping were all preferred options, depending on the definition of individual welfare and the level of precision with which we assessed species welfare. -/- 5.Synthesis and applications. The decision framework we present can be used by ecologists to assess ethical and other trade-offs when planning field studies. A formal decision analysis makes transparent how a researcher might negotiate competing ethical, financial and practical objectives. Defining the components of the decision in this way can help avoid errors associated with human judgement and linguistic uncertainty. (shrink)