Mary Poppins is a magical film and a story of redemption that might be placed alongside the Parable of the Prodigal Son or A Christmas Carol. Mary may be the star of the film, but George Banks is its subject. If the world ever seemed wonderful and filled with surprises for George Banks as a child, it has since been supplanted by a world that is mechanical, predictable, and subject to the demands of business and of propriety. From Jack the (...) Giant Killer people learn that when pride has grown to gigantic proportions it ought to be killed; Cinderella teaches that the humble are exalted; Beauty and the Beast demonstrates the principle that loving the unlovable may result in the transformation from the beastly to the beautiful; and Mary Poppins reminds them that “There is no greater joy than that seen through the eyes of a child,” as Walt Disney observes in Saving Mr. Banks. (shrink)

The medical biography of Ludwig van Beethoven remains enigmatic. Some of his health problems, such as his early and eventually profound deafness, are well documented and extensively discussed, although not necessarily well explained . Other medical problems, and his ultimate cause of death, remain unclear. Perhaps unsurprisingly for such an important musical figure, there has been no dearth of speculation about the illnesses that may have befallen Beethoven. Medical historians and physicians have suggested a myriad of illnesses, including but hardly (...) limited to .. (shrink)

Political corruption imposes substantial costs on shareholders in the U.S. Yet, we understand little about the basic factors that exacerbate or mitigate the value consequences of political corruption. Using federal corruption convictions data, we find that firm-level economic rents and monitoring mechanisms moderate the negative relation between corruption and firm value. The value consequences of political corruption are exacerbated for firms operating in low-rent product markets and mitigated for firms subject to external monitoring by state governments or monitoring induced by (...) disclosure transparency. Our results should inform managers and policymakers of the tradeoffs imposed on firms operating in politically corrupt districts. (shrink)

The coronavirus disease 2019 (COVID-19) pandemic has motivated medical ethicists and several task forces to revisit or issue new guidelines on allocating scarce medical resources. Such guidelines are relevant for the allocation of scarce therapeutics and vaccines and for allocation of ICU beds, ventilators, and other life-sustaining treatments or potentially scarce interventions. Principles underlying these guidelines, like saving the most lives, mitigating disparities, reciprocity to those who assume additional risk (eg, essential workers and clinical trial participants), and equal access may (...) compete with one another. We propose the use of a “categorized priority system” (also known as a “reserve system”) as an improvement over existing allocation methods, particularly because it may be able to achieve disparity mitigation better than other methods. (shrink)

In many research studies, tumor biopsies are an unavoidable requirement for achieving key scientific aims. Yet some commentators view mandatory research biopsies as coercive and suggest they should be optional, or at least optional until further data are obtained regarding their scientific usefulness. Further complicating the ethical picture is the fact that some research biopsies offer a potential for clinical benefit to trial participants. We interviewed and surveyed a convenience sample of participants in phase I clinical trials at a single (...) institution. Our primary aim was to describe phase I participants’ understanding of whether a research biopsy offered them the prospect of medical benefit. We also endeavored to describe participants’ views about biopsies—specifically, the benefits of biopsies, if any, and whether biopsies were acceptable, risky, or discouraged trial participation. Finally, we collected data on demographics and attitudes to see if any strong correlations with misunderstanding, acceptability, or riskiness existed. Overall, the respondents tended to view research biopsies as acceptable, though they did not succeed in identifying the lack of benefit of a research biopsy. These findings call for renewed efforts in consent conversations and documents to carefully describe the benefits, or lack thereof, of research biopsies. (shrink)

“Clinical ethics consultants” have been practicing in the United States for about 50 years. Most of the earliest consultants—the “pioneers”—were “outsiders” when they first appeared at patients' bedsides and in the clinic. However, if they were outsiders initially, they acclimated to the clinical setting and became “insiders” very quickly. Moreover, there was some tension between traditional academics and those doing applied ethics about whether there was sufficient “critical distance” for appropriate reflection about the complex medical ethics dilemmas of the day (...) if one were involved in the decision making. Again, the pioneers deflected concerns by identifying and instituting safeguards to assure professional objectivity in clinical ethics consultation services. One might suggest that in moving inside and establishing normative practices, the pioneer clinical ethics consultants anticipated adoption of their routines and professionalization of the field. (shrink)

This edited volume starts in on the task of integrating the problem of procrastination into philosophical inquiry.

When we fail to achieve our goals, procrastination is often the culprit. But how exactly is procrastination to be understood? This edited volume integrates the problem of procrastination into philosophical inquiry, exploring the relationship of procrastination to agency, rationality, and ethics--topics that philosophy is well-suited to address.

As clinical ethics consultants move toward professionalization, the process of certifying individual consultants or accrediting programs will be discussed and debated. With certification, some entity must be established or ordained to oversee the standards and procedures. If the process evolves like other professions, it seems plausible that it will eventually include a written examination to evaluate the core knowledge competencies that individual practitioners should possess to meet peer practice standards. The American Society for Bioethics and Humanities has published core knowledge (...) competencies for many years that are accepted by experts as the prevailing standard. Probably any written examination will be based upon the ASBH core knowledge competencies. However, much remains to be done before any examination may be offered. In particular, it seems likely that a recognized examining board must create and validate examination questions and structure the examination so as to establish meaningful, defensible parameters after dealing with such challenging questions as: Should the certifying examination be multiple choice or short-answer essay? How should the test be graded? What should the pass rate be? How may the examination be best administered? To advance the field of health care ethics consultation, thought leaders should start to focus on the written examination possibilities, to date unaddressed carefully in the literature. Examination models—both objective and written—must be explored as a viable strategy about how the field of health care ethics consultations can grow toward professionalization. (shrink)

In "Behavioral Law and Economics: The Assault on Consent, Will, and Dignity," Mark D. White uses the moral philosophy of Immanuel Kant to examine the intersection of economics, psychology, and law known as "behavioral law and economics." Scholars in this relatively new field claim that, because of various cognitive biases and failures, people often make choices that are not in their own interests. The policy implications of this are that public and private organizations, such as the state and employers, can (...) and should design the presentation of options and default choices in order to "steer" people to the decision they would make, were they able to make choices in the absence of their cognitive biases and failures. Such policies are promoted under the name "libertarian paternalism," because choice is not blocked or co-opted, but simply "nudged." White argues that such manipulation of choice is impossible to conduct in people's true interests, and any other goal pursed by policymakers substitutes their own ends, however benevolent they may be, for people's true ends. Normatively, such manipulation should not be conducted because it fails to respect the dignity and autonomy of persons, what some hold to be the central idea in Kant's ethical system, and which serves to protect the individual from coercion, however subtle, from other persons or the state. (shrink)

The Book Provides A Genealogy Of `Dialectical Materialism` By Tracing The Development Of Marxist Ideas From Their Origins In German Philosophical Thought To The Ideology Of The Socio-Democratic Groups In Russia In The 1890S, From Which Lenin And The Revolutionary Generation Emerged. It Reconstructs Marx`S Original Conceptions And Examines The Modifications That Were Made To Them By Himself And By His Russian Followers, Which Eventually Gave Rise To The Doctrine Of `Dialectical Materialism`, Expounded By Plekhanov. Condition Good.

Fins and colleagues rightly note that “clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems” for which “progress in developing standards for q...

This book explores the steady decline in the status of the individual in recent years and addresses common misunderstandings about the concept of individuality. Drawing from psychology, neuroscience, technology, economics, philosophy, politics, and law, White explains how and why the individual has been devalued in the eyes of scholars, government leaders, and the public. He notes that developments in science have led to doubts about our cognitive competence, while assumptions made in the humanities have led to questions about our moral (...) competence. In this book, White goes on to argue that both of these views are mistaken and that they stem from overly simplistic ideas about how individuals make choices, however imperfectly, in their interests, which are multifaceted and complex. In response, he proposes a new way to look at individuals that preserves their essential autonomy while emphasizing their responsibility to others, inspired by the moral philosophy of Immanuel Kant and the legal and political philosophy reflected in the Bill of Rights to the U.S. Constitution. This book explains how individuality combines both rights and responsibilities, reconciles the popular yet false dichotomy between individual and society, and provides the basis for a humane and respectful civil society and government. This book is part of White's trilogy on the individual and society, which includes The Manipulation of Choice and The Illusion of Well-Being. (shrink)

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

This paper reframes the futility debate, moving away from the question “Who decides when to end what is considered to be a medically inappropriate or futile treatment?” and toward the question “How can society make policy that will best account for the multitude of values and conflicts involved in such decision-making?” It offers a pragmatist moral epistemology that provides us with a clear justification of why it is important to take best standards, norms, and physician judgment seriously and a clear (...) justification of why ample opportunity must be made for patients, families, and society to challenge those standards and norms. (shrink)

The article by Professor Fiester (2015) expresses concern about the long-term moral distress or negative moral emotions, both aspects of moral residue, that linger in some stakeholders’ experiences...

The first look at the philosophy behind the _Captain America_ comics and movies, publishing in advance of the movie release of _Captain America: The Winter Solider_ in April 2014. In _The Virtues of Captain America_, philosopher and long-time comics fan Mark D. White argues that the core principles, compassion, and judgment exhibited by the 1940’s comic book character Captain America remain relevant to the modern world. Simply put, "Cap" embodies many of the classical virtues that have been important to us (...) since the days of the ancient Greeks: honesty, courage, loyalty, perseverance, and, perhaps most importantly, honor. Full of entertaining examples from more than 50 years of comic books, White offers some serious philosophical discussions of everyone’s favorite patriot in a light-hearted and accessible way. Presents serious arguments on the virtues of Captain America while being written in a light-hearted and often humorous tone Introduces basic concepts in moral and political philosophy to the general reader Utilizes examples from 50 years of comics featuring Captain America, the Avengers, and other Marvel superheroes Affirms the value of "old-fashioned" virtues for the modern world without indulging in nostalgia for times long passed Reveals the importance of the sound principles that America was founded upon Publishing in advance of _Captain America: The Winter Soldier _out in April 2014. (shrink)

The thymus is a unique primary lymphoid organ that supports the production of self‐tolerant T‐cells essential for adaptive immunity. Intrathymic microenvironments are microanatomically compartmentalised, forming defined cortical, and medullary regions each differentially supporting critical aspects of thymus‐dependent T‐cell maturation. Importantly, the specific functional properties of thymic cortical and medullary compartments are defined by highly specialised thymic epithelial cells (TEC). For example, in the medulla heterogenous medullary TEC (mTEC) contribute to the enforcement of central tolerance by supporting deletion of autoreactive T‐cell (...) clones, thereby counterbalancing the potential for random T‐cell receptor generation to contribute to autoimmune disease. Recent advances have further shed light on the pathways and mechanisms that control heterogeneous mTEC development and how differential mTEC functionality contributes to control self‐tolerant T‐cell development. Here we discuss recent findings in relation to mTEC development and highlight examples of how mTEC diversity contribute to thymus medulla function. (shrink)

This chapter looks at another executive virtue that Captain America exemplifies: the judgment he needs to arrive at the best action in a difficult situation. Despite his humility, Captain America exemplifies both sound judgment and unshakeable determination, which are often misunderstood as representing “black‐and‐white” ethics or stubbornness. Just like judges as Dworkin describes them, we can use our own judgment to find the “right answer” to each moral dilemma, the decision that is consistent with our own principles and maintains the (...) integrity of our own moral character. There is a special category of situations that superheroes all too often find themselves in. Such choices are what philosophers call tragic dilemmas. Applying basic moral virtues and principles to specific circumstances, including all of their context, nuance, and subtlety, is the key to sound judgment, and that is important to everyone in the real world and to Cap in the comics. (shrink)

The criticism has been made that Kant looks racist, at least in his early work. This, however, is to insist on a literal reading. I explore Kant’s use of irony and satire as he battles to defend his vision. I show the rhetoric of irony in a pivotal text, looking at what happens and why.

This chapter investigates into what makes Captain America a great role model by describing some of his basic virtues. By looking at how Captain America embodies virtues such as courage and humility, he serves as a role model not only in terms of the virtues themselves but also in how he puts them into practice. The chapter argues that Captain America's supposed “black‐and‐white” ethics weren't simplistic in the 1940s, they are just as applicable now as they were then. One persistent (...) wrong about which Cap expresses righteous indignation is prejudice towards minorities. Captain America's tremendous willingness to sacrifice can be traced to his oversized sense of responsibility. Perseverance is what philosophers call an executive virtue because it helps people follow through on their judgment made in light of their virtues and principles. The virtues described in this chapter are only the ones most commonly attributed to Captain America in the comics. (shrink)