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)

Ketelaar and Ellis have provided a remarkably clear and succinct statement of Lakatosian philosophy of science and have also argued compellingly that the neo-Darwinian theory of evolution fills the Lakatosian criteria of progressivity. We find ourselves in agreement with much of what Ketelaar and Ellis say about Lakatosian philosophy of science, but have some questions about (1) the place of evolutionary psychology in a Lakatosian framework, and (2) the extent to which evolutionary psychology truly predicts new findings.

A long-standing theme in discussion of perception and thought has been that our primary cognitive contact with individual objects and events in the world derives from our perceptual contact with them. When I look at a duck in front of me, I am not merely presented with the fact that there is at least one duck in the area, rather I seem to be presented withthisthing (as one might put it from my perspective) in front of me, which looks to (...) me to be a duck. Furthermore, such a perception would seem to put me in a position not merely to make the existential judgment that there is some duck or other present, but rather to make a singular, demonstrative judgment, that that is a duck. My grounds for an existential judgment in this case derives from my apprehension of the demonstrative thought and not vice versa. (shrink)

Listening to someone from some distance in a crowded room you may experience the following phenomenon: when looking at them speak, you may both hear and see where the source of the sounds is; but when your eyes are turned elsewhere, you may no longer be able to detect exactly where the voice must be coming from. With your eyes again fixed on the speaker, and the movement of her lips a clear sense of the source of the sound will (...) return. This ‘ventriloquist’ effect reflects the ways in which visual cognition can dominate auditory perception. And this phenomenological observation is one what you can verify or disconfirm in your own case just by the slightest reflection on what it is like for you to listen to someone with or without visual contact with them. (shrink)

The issue of violent extremism has given rise to new policy debates in Norway. A key limitation of these debates, often grounded in naïve assumptions about the peacebuilding effect of education, is the downplay of emotions and dissent in democratic engagement. This article analyses how selected educators in Norway describe encountering and engaging with extremist students for educational interventional purposes. Previous research suggests that educational efforts to counter violent extremism can be exclusionary from the perspective of target audiences. In contrast, (...) this study draws on agonistic pluralism to provide an alternative to understand educational approaches that may help students disengage from violent extremism. The findings show that the selected educators argue the importance of trust, support and tolerance when engaging with extremist students. For these professionals, education should not downplay radical or extreme emotions but rather place them at the centre of educational engagement. Furthermore, it is suggested that educators’ empathic engagement may open the path for young people to disengage from violent extremism. (shrink)

What should be the role of an institutional ethics committee in resolving conflict concerning patient care decisions in the neonatal intensive care unit? This question takes on added importance in light of recent court decisions which suggest that IEC deliberations may serve as persuasive evidence in court, of proposed state regulations that would establish an IEC as an alternative to judicial review, and of recent Joint Commission on Accreditation of Healthcare Organizations guidelines that require an institutional policy on limitation or (...) withdrawal of treatment to include a specified mechanism for resolving conflict. Unfortunately, despite these developments, prospective case consultation remains one of the most controversial and poorly understood aspects of IEC functions. Questions and concerns persist about the relation the IEC has and should have to actual decisions in specific cases.We briefly examine the clinical, organizational, and regulatory complexity of the NICU environment and suggest five potential sources of uncertainty, disagreement, and conflict among parent and NICU staff. (shrink)

What should be the role of an institutional ethics committee in resolving conflict concerning patient care decisions in the neonatal intensive care unit? This question takes on added importance in light of recent court decisions which suggest that IEC deliberations may serve as persuasive evidence in court, of proposed state regulations that would establish an IEC as an alternative to judicial review, and of recent Joint Commission on Accreditation of Healthcare Organizations guidelines that require an institutional policy on limitation or (...) withdrawal of treatment to include a specified mechanism for resolving conflict. Unfortunately, despite these developments, prospective case consultation remains one of the most controversial and poorly understood aspects of IEC functions. Questions and concerns persist about the relation the IEC has and should have to actual decisions in specific cases.We briefly examine the clinical, organizational, and regulatory complexity of the NICU environment and suggest five potential sources of uncertainty, disagreement, and conflict among parent and NICU staff. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Abailard and Non-Things MARTIN M. TWEEDALE On SEVERAL OCCASIONSin his logical writings Abailard extracts himself from embarrassing ontological implications of his analyses of language by resorting to the notion of a something that is not a thing. I shall note here two such occasions and then discuss Abailard's explanations of this procedure based on the grammatical distinction of personal and impersonal constructions. Since the texts on this latter (...) topic are especially confusing, a considerable portion of my effort will be spent on making sense of them as preparation for drawing some conclusions about Abailard's overall approach. My purpose here is to show how Abailard's grammatical analyses are fundamental to his defence of a number of metaphysical positions. I also want to suggest that Abailard's grammatical approach, especially on the question of dicta, contains insights of continuing interest. Not all of Abailard's non-things are particularly associated with analyses of language. For instance, there are the likenesses the mind supposedly constructs for itself in order to think of things that are not being perceived. These Abailard calls fictive things (res ficta), and he refuses to give them the status of real psychological entities. ~ The likenesses are compared to mirror images which Abailard is also willing to treat as non-things. However, I wish to restrict my discussion here to cases which arise from Abailard's analysis of the reference of certain words. One such instance occurs in his discussion of universals. The peculiar nonthing here is the "state" (status), which, Abailard maintains, is "the common cause by which the universal word is imposed"7 Abailard is very careful to dis1Glossae super Porphyrium, in Peter Abelards philosophische,.gchriIten, edited by Geyer (henceforth referred ~o as Geyer), Miinster i. W., 1919 (BGPM, vol. 21), pp. 20-21, ll. 23-32: Intellectus autem sicut nec corporeo indigens instrumento est, ita /nec/ necesse est eum subiectum corpus habere in quod mittatur, sed rei ~dmilitudine contentus est, quam sibi ipse animus conficit, in quam suae intelligentiae actionem dirigit. Unde turr,~ destructa vel remota sensus qui in earn agebat, perit, inteUectus autem permanet rei similitudine auimo retenta. Sigut autem sensus non est res sentita, in quam dirigitur, sic nec intellectus forma est rei quam concipit, sed intellectus actio quaedam est animae, unde intelligens dicitur, forma vero in quam dirigitur, res imaginaria quaedam est et ficta, quam sibi, quando vult et qualm vult, animus conficit.... 11.9-17: Quaero enim, utrum flla quadratura et ilia altitudo vera forma sit intellectus, qui ad similitudinem quantitatis turris ducatur et compositionis eius. Sed profecto vera quadratura et vera altitudo non nisi corporibus insunt, ficta etiam qualitate nec intellectus nec ulla vera essentia forrnari potest. Restat igitur, ut sicut ficta eat qualitas, ficta substantia sit ei subiecta. Fortasae autem et ea speculi imago, quae visui subiecta apparere videtur, nihil esse vere dici potest, quoniam scilicetin alba speguli superficie contrarii coloris qualitas saepe apparet. Ibid., pp. 19-20,II. 14-16- ~ad nunc ea quae breviter tetigimus, diligenter perquiramus, scilicet quae sit iIla communis causa, secundum quam universale nomen impositum est.... 11. 21-29. Singuli homines discreti ab invicem, gum in propriis differant tam essentiis quam formis, ut supra meminimus rei physicam inquirentes, in eo tamen conveniunt, quod homines aunt. Non dico in homine, gum res nulla sit homo uisi discreta, sed in esse hominem. Esse autem hominem non est homo nec res aliqua, si diligentius consideremus, [329] 330 HISTORY OF PHILOSOPHY tinguish three different questions frequently confused in discussions on universals. The first is "What is 'universal' predicated of?", and the answer is simply words --words not in the sense of mere marks or sounds, but of meaningful marks or sounds. Another is "How do we have an idea associated with universals?" Here the aforementioned likenesses enter as that by which the mind can have an idea applicable to many individuals. But there is also the question of what makes a certain word correctly applicable to many things. Abailard does not make the error of thinking that an idea in the mind or some operation of the mind could possibly be the cause, as some conceptualists seem to think. This would lead to the conclusion that... (shrink)

This book is an extensive review & analysis of Aristotelian thought as received & adapted by such medieval commentators as Ammonius, Philoponus, Boethius, al-Farabi, Yahya ibn 'Adi, Avicenna, Albertus Magnus, Thomas Aquinas, Martin of Dacia, Simon of Faversham, John Duns Scotus, Peter of Spain, Robert Kilwardby, William of Ockham, & Giles of Rome. The discussions range from metaphysics to logic, linguistics, & epistemology, encompassing such topics as being, god, causation, actuality, potentiality, universals, individuation, signification, cognition, certainty, infallibility, error, ignorance, (...) analogy, grammar, interpretation, foundationalism, & the eucharist & transubstantiation. (shrink)