Throughout March and April 2020, debate raged about how best to allocate limited intensive care unit resources in the face of a growing COVID-19 pandemic. The debate was dominated by utility-based arguments for saving the most lives or life-years. These arguments were tempered by equity-based concerns that triage based solely on prognosis would exacerbate existing health inequities, leaving disadvantaged patients worse off. Central to this debate was the assumption that ICU admission is a valuable but scarce resource in the pandemic (...) context.In this paper, we argue that the concern about achieving equity in ICU triage is problematic for two reasons. First, ICU can be futile and prolong or exacerbate suffering rather than ameliorate it. This may be especially true in patients with COVID-19 with emerging data showing that most who receive access to a ventilator will still die. There is no value in admitting patients with poor prognostic indicators to ICU to meet an equity target when intensive critical care is contrary to their best interests. Second, the focus on ICU admission shifts focus away from important aspects of COVID-19 care where there is greater opportunity for mitigating suffering and enhancing equitable care.We propose that the focus on equity concerns during the pandemic should broaden to include providing all people who need it with access to the highest possible standard of end-of-life care. This requires attention to culturally safe care in the following interlinked areas: palliative care, communication and decision support and advanced care planning. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bioethics Commissions: Town Meetings with a “Blue, Blue Ribbon”Susan Cartier Poland (bio)Town meetings are characteristic of New England. In theory, a quorum of registered voters in a small municipality meets annually to decide local public policy. In fact, special interests and the town bureaucracy control the meeting.Like a town meeting, a commission (or committee or council) comes into being, whether on an ad (...) hoc or permanent basis, to direct a government function. Bioethics commissions specialize in one area: the intersection of public policy with developments, either real or anticipated, in the basic and applied sciences.That specialization of commissions carries over into the selection of the members. More often than not commission members are appointed on the basis of expertise in a specific area. Although some commissions are still made up entirely of one kind of expert, usually medical, the majority of these government bodies seek breadth between the fields of law, religion, ethics, and science (including medicine and the social sciences).In the words of Mrs. Rigenbach, the law clerk to Chief Judge Carl B. Rubin of the United States District Court for the Southern District of Ohio, selection of persons “knowledgeable in the field” constitutes a “blue, blue ribbon” jury. In contrast, a “blue ribbon” jury is composed of those persons having “the greatest amount of formal education” (In re Richardson-Merrill, Inc. (Bendectin litigation), 624 Federal Supplement 1212 at 1217 (1985)). The problem with persons knowledgeable in the field is that their minds may have already been made up. For a jury, this is a disaster; for a bioethics commission, this directs and shapes the research, investigation, and discussion, or, in short, it makes for more efficient decision making.For this Scope Note, the definition of commission begins with the Bioethicsline description of its index term “advisory committees” as committees or commissions set up to advise government bodies on public policy. Furthermore, a commission [End Page 91] (or committee) receives government funding and support in exchange for its expertise in research, investigation, reporting, and recommendations.Six functions served by bioethics commissions have been clearly and succinctly described by LeRoy Walters (Commissions and Bioethics. Journal of Medicine and Philosophy 14 (4): 363–68, August 1989). The functions are: (1) to legitimize action; (2) to delay action or resolution; (3) to identify duplication; (4) to be representative; (5) to do research and find facts; and (6) to provide education and support (pp. 364–65). Since 1989, however, another government function has moved to the forefront. Instead of remaining within the legislative arena, government commissions serve the judiciary as well, in cases involving complex and technical questions. The now defunct Law Reform Commission of Canada recognized this use when it included in its annual reports a section on its “Influence on Law Reform through Judicial Decisions.”In mid-1997, the United States Supreme Court in its consolidated cases on assisted suicide used extensively the writings from a state commission, the New York State Task Force on Life and the Law, to support its rationale. Not only did the Court make use of the Task Force’s work, but in so doing the Court extended the efforts of the commission beyond its jurisdiction of New York into another jurisdiction on the opposite coast, Washington state. Furthermore, although the commission was chartered by one state, through the federal court system, its influence became national.Outside the U.S., the United Nations recently adopted its first bioethics text on the ethics of genetic research, and Canada is reworking its human research guidelines into a single set of guidelines that will apply to research in both the natural sciences and the social sciences.This Scope Note attempts to compile for the researcher and the reference librarian those commissions, existing and defunct, that have addressed bioethics issues. Only one other such attempt is known to the author, an Office of Technology Assessment [OTA] Background Paper, Biomedical Ethics in U.S. Public Policy (1993). Due to space limitations, not all publications could be listed; the selections included represent the range of topics from a particular group or the more frequently cited sources. Future updates of this compilation are planned, so please notify the... (shrink)

We are increasingly exposed to polarized media sources, with clear evidence that individuals choose those sources closest to their existing views. We also have a tradition of open face-to-face group discussion in town meetings, for example. There are a range of current proposals to revive the role of group meetings in democratic decision-making. Here, we build a simulation that instantiates aspects of reinforcement theory in a model of competing social influences. What can we expect in the interaction (...) of polarized media with group interaction along the lines of town meetings? Some surprises are evident from a computational model that includes both. Deliberative group discussion can be expected to produce opinion convergence. That convergence may not, however, be a cure for extreme views polarized at opposite ends of the opinion spectrum. In a large class of cases, we show that adding the influence of group meetings in an environment of self-selected media produces not a moderate central consensus but opinion convergence at one of the extremes defined by polarized media. (shrink)

American Health Decisions, a movement that started in Oregon, has spread to several other states. Through the media and widespread public discussion, the projects aim to increase public awareness about the individual and societal dimensions of ethical choices in health care.

Melanie presented at twenty weeks of gestation to an obstetrics clinic in a critical access hospital in rural Vermont. She was excited to undergo routine fetal ultrasonography, but her obstetrician gave her grave news: the ultrasound revealed hypoplastic left heart syndrome, a devastating congenital heart defect. Initially, Melanie agreed in general to pursue surgical care for her fetus—a three‐stage process that has somewhat uncertain results and could only be done in tertiary care facilities far from her home in Vermont. A (...) week later, while the maternal fetal medicine and pediatric cardiology units made arrangements with colleagues in Boston, Melanie began having second thoughts. An ethics meeting was called to discuss conflicting clinician reactions to Melanie's dilemma. Most of the clinicians were stunned that the patient would change her mind. What advice should the ethics consultant offer the team about caring for Melanie? (shrink)

Debate on the potential and uses of human stem cells tends to be conducted by two constituencies—ethicists and scientists. On many occasions there is little communication between the two, with the result that ethical debate is not informed as well as it might be by scientific insights. The aim of this paper is to highlight those scientific insights that may be of relevance for ethical debate.Environmental factors play a significant role in identifying stem cells and their various subtypes. Research related (...) to the role of the microenvironment has led to emphasis upon “plasticity”, which denotes the ability of one type of stem cell to undergo a transition to cells from other lineages. This could increase the value given to adult stem cells, in comparison with embryonic stem cell research. Any such conclusion should be treated with caution, however, since optimism of this order is not borne out by current research.The role of the environment is also important in distinguishing between the terms totipotency and pluripotency. We argue that blastocysts and embryonic stem cells are only totipotent if they can develop within an appropriate environment. In the absence of this, they are merely pluripotent. Hence, blastocysts in the laboratory are potentially totipotent, in contrast to their counterparts within the human body which are actually totipotent. This may have implications for ethical debate, suggesting as it does that arguments based on potential for life may be of limited relevance. (shrink)

This groundbreaking book provides an analytical tool to understand how and why evil works in the world as it does. Deconstructing memory, history, and myth as received wisdom, the volume critically examines racism, sexism, poverty, and stereotypes.

Business and Society Review, Volume 127, Issue S1, Page 253-282, Spring 2022.

SETTING: Previous health policies in South Africa neglected the teaching of ethics and human rights to health professionals. In April 1995, a pilot course was run at the University of Cape Town in which the ethical dimensions of human rights issues in South Africa were explored. OBJECTIVES: To compare knowledge and attitudes of participating students with a group of control students. DESIGN: Retrospective cohort study. SUBJECTS: Seventeen fourth-year medical students who participated in the course and 13 control students from (...) the same class, matched for gender. INTERVENTIONS: Students participated in a one-week module on ethics and human rights. Five months after the course had been run, students completed a semi-structured questionnaire exploring their knowledge and attitudes with regards to ethics and human rights issues. MAIN OUTCOME MEASURES: Knowledge scores, attitude scores and various individual indicators of attitude. RESULTS: Clear benefits for overall knowledge score, for four out of five individual knowledge questions and for one of the attitude questions, were demonstrated. Participating students also appeared to be more convinced of the need for teaching on the ethical dimensions of human rights at postgraduate level and that such teaching should also be integrated in the curriculum. The low response rate amongst controls may have selected students who were more socially conscious, thereby leading to an underestimate of the true impact of the course. CONCLUSION: The evaluation indicates clear benefits of the course for undergraduate students, and supports arguments for the inclusion of such courses in the training of health professionals. This is particularly important given the challenges posed by the Truth and Reconciliation Commission to the health professions to address past complicity in human rights abuses through reorientation of medical training in South Africa. (shrink)

. In this article I review the efforts of eighteen scientists and theologians, recorded in this book, to describe the relation of God to the universe during a conference sponsored by the John Templeton Foundation at Windsor Castle in 2001. Theologians from several branches of Christian faith articulate their understanding of panentheism, revealing a considerable diversity. I deal with each author in relation to six issues: the way God acts, how God's intimate relation to the world is to be described, (...) the relation of God to spacetime, whether God is dependent upon the world, what type of language is used, and the problem of dipolar panentheism. I identify significant differences between these authors, suggest where fruitful dialogue is possible, and distinguish between intelligibility and plausibility in comparing dipolar panentheism with other types. (shrink)

The practice of placing men and women in the same hospital room (mixed gender rooms) has been prohibited in the UK National Health Service for over a decade. However, recent research demonstrates that the practice is common and increasing in a major New Zealand public hospital. Reports and complaints show that the practice also occurs in Australia. We argue that mixed gender rooms violate the fundamental human rights of personal security and dignity. The high rates of cognitive impairment, sensory impairment (...) and frailty in hospital wards exacerbates the risk for these violations and subsequent harm. We argue for the adoption of specific national policies prohibiting mixed gender rooms and public reporting of breaches. Importantly, these guidelines can be adopted without compromising the rights of gender minorities. In the long term, hospitals should be built with single occupancy rooms. (shrink)

What I call ambiguities of system due to the sheer complexity of Whitehead’s metaphysics and his analysis of process in terms of concrescence and transition threaten its coherence in terms of what we know empirically of the quantum and classical dimensions of nature. Ambiguities of equivocation pertaining to Whitehead’s use of the terms “contemporary” and “objectification,” as the latter is employed in relation to prehension and satisfaction, also threaten its coherence. The article proposes ways to reduce these threats and uncertainty (...) about coherence by clarifying ambiguities and by attending to the way Whitehead’s terms are predicated on the quantum and classical dimensions. (shrink)

Armond R. Towns demonstrates that humanity in media philosophy has implicitly referred to a social Darwinian understanding of the human as a Western, white, male, and capitalist figure. Building on concepts from Black studies and cultural studies, Towns develops an insightful critique of this dominant conception of the human in media philosophy and introduces a foundation for Black media philosophy.

The title above identifies two issues in Charles Hartshorne's panentheistic understanding of God that, in my judgment, have not been sufficiently clarified. The purpose of this paper is to provide additional clarification, that the adequacy of this type of theism may be more carefully judged by its admirers and by its detractors from their respective perspectives. The first part will identify central elements of Hartshorne's reasoning about God's relation to the world. The second part examines how Hartshorne speaks of a (...) divine "transcendence" in a naturalistic metaphysics that is thoroughly empirical. The third part will examine the ways that God is related to the world's evil and whether God is in some way .. (shrink)

Marcella Althaus-Reid puts in print a discussion of sex, gender, and politics. For womanist theologian and ethicist, Townes, black women's experiences have been left out of the theoretical and material constructs of both black and feminist theologies in the United States. Townes argues that Althaus-Reid casts the reader in the role of voyeur as she describes the women lemon vendors in Indecent Theology. The reader observes them from the safety of their own cultural, economic, theo-ethical and sociopolitical mud huts in (...) the same way as the Europeans who queued to view the so-called'Hottentot Venus' in the early 1800s. Nevertheless, Althaus-Reid offers an integrated, interstructured analysis that helps pry open the dynamics of oppressions. (shrink)

G.H. Mead and A.N. Whitehead agree that all causation occurs in a present, that the self is social, and that philosophical description of the new physics of relativity and quantum mechanics is a complicated task. I explore this complexity in relation to the knowledge of events unable to be observed here and now, especially past historical events. The integration of the two philosophers’ views is shown in reference to Whitehead’s criteria of respect for facts and coherence. By reference to the (...) work of Palmyre Oomen I show the inconsistency of Whitehead’s treatment of the prehensibility of God’s consequent nature with his claim that God is not an exception to the metaphysical principles. The integration of Mead’s and Whitehead’s views permits plausible talk about past, present, and future consisent with our scientific knowledge. (shrink)

Bernard MacDougall Loomer (1912–1985) is well known for his influence on process theology, or as he preferred, “process-relational” theology. Less well known is his interpretation of the philosophy of Alfred North Whitehead (1861–1947) and its influence in the promotion of that philosophy not only among his students but also more recently beyond that circle. He presents his own views as one who has made Whitehead’s his own. Yet he is not uncritical of Whitehead. He has articulated an empirical naturalism in (...) Whiteheadian terms that is theistic and controversial by that fact. The analysis of his interpretation of Whitehead allows us to probe his theistic naturalism and to identify new possibilities in the .. (shrink)

Finding the heart of God -- Finding God's heart -- Have you seen God's face? -- Why does God sing? -- Searching God's mind -- When God is silent -- Did you know God thinks about you? -- God has unique plans for every unsaved person -- God remembers no longer -- Did you know God reads and writes? -- The unknowable of God -- God whispers -- DoesGod have a nose? -- Wax in God's ears -- God loves to (...) provide for our needs -- God's eyes see all -- What God hates -- God heals protectively -- A laughing God -- A tired Jesus -- What angers God? -- God is love -- The holiness of God -- God is good -- God is person -- God is the all-powerful God -- God is all-knowing -- God is everywhere present -- God is spirit -- God does not change -- The Trinity three in one. (shrink)

A beginning question can organize our thoughts on Kara Keeling’s book, Queer Times, Black Futures. It is a question unasked explicitly in the book but one that lies implicit on each page: why should finance capitalism monopolize the future? For Keeling, the answer is undoubtedly that finance capitalism should not monopolize the future because it is wedded to a narrow conception of time that assumes linearity, predictability, and output. The goals of finance capitalism are to increase the bottom line of (...) corporations in efficient fashion and to position all forms of unknown futurity as a major threat to profit. But despite efforts of predictability, finance capitalism’s futurity lies in speculation; capitalism is... (shrink)

This book examines cultural recognition and the struggle for identity in America's schools. In particular, the contributing authors focus on the recognition and misrecognition as antagonistic cultural forces that work to shape, and at times distort identity.