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)

BackgroundCommentators believe that the ethical decision-making climate is instrumental in enhancing interprofessional collaboration in intensive care units. Our aim was twofold: to determine the perception of the ethical climate, levels of moral distress, and intention to leave one's job among nurses and physicians, and between the different ICU types and determine the association between the ethical climate, moral distress, and intention to leave.MethodsWe performed a cross-sectional questionnaire study between May 2021 and August 2021 involving 206 nurses and physicians in a (...) large urban academic hospital. We used the validated Ethical Decision-Making Climate Questionnaire and the Measure of Moral Distress for Healthcare Professionals tools and asked respondents their intention to leave their jobs. We also made comparisons between the different ICU types. We used Pearson's correlation coefficient to identify statistically significant associations between the Ethical Climate, Moral Distress, and Intention to Leave.ResultsNurses perceived the ethical climate for decision-making as less favorable than physicians. They also had significantly greater levels of moral distress and higher intention to leave their job rates than physicians. Regarding the ICU types, the Neonatal/pediatric unit had a significantly higher overall ethical climate score than the Medical and Surgical units and also demonstrated lower moral distress scores and lower “intention to leave” scores compared with both the Medical and Surgical units. The ethical climate and moral distress scores were negatively correlated ; moral distress and "intention to leave" was positively correlated ; and ethical climate and “intention to leave” were negatively correlated.ConclusionsSignificant differences exist in the perception of the ethical climate, levels of moral distress, and intention to leave between nurses and physicians and between the different ICU types. Inspecting the individual factors of the ethical climate and moral distress tools can help hospital leadership target organizational factors that improve interprofessional collaboration, lessening moral distress, decreasing turnover, and improved patient care. (shrink)

Debates regarding clinical ethicists’ scope of practice are not novel and will continue to evolve. Rapid changes in healthcare delivery, outcomes, and expectations have necessitated flexibility in clinical ethicists’ roles whereby hospital-based clinical ethicists are expected to be woven into the institutional fabric in a way that did not exist in more traditional relationships. In this article we discuss three emerging roles: the ethicist embedded in the interdisciplinary team, the ethicist with an expanded educational mandate, and the ethicist as a (...) therapeutic presence in the patient care space. Such expanded capacities offer more robust, positive contributions to institutional culture, stakeholders’ relationships, and patient-centered care. (shrink)

Hastings Center Report, Volume 52, Issue 3, Page 37-48, May–June 2022.

Embryos and microscopes share a long, remarkable history and biologists have always been intrigued to watch how embryos develop under the microscope. Here we discuss the advances in microscopy which have greatly influenced our current understanding of embryogenesis. We highlight the evolution of microscopes and the optical technologies that have been instrumental in studying various developmental processes. These imaging modalities provide mechanistic insights into the dynamic cellular and molecular events which drive lineage commitment and morphogenetic changes in the developing embryo. (...) We begin the journey with a brief history of microscopy to study embryos. First, we review the principles and optics of light, fluorescence, confocal, and electron microscopy which have been key techniques for imaging cellular and molecular events during embryonic development. Next, we discuss recent key imaging modalities such as light‐sheet microscopy, which are suitable for whole embryo imaging. Further, we highlight imaging techniques like multiphoton and super resolution microscopy for beyond light diffraction limit, high resolution imaging. Lastly, we review some of the scattering‐based imaging methods and techniques used for imaging human embryos. (shrink)

Mrs. Smith's eyes filled with tears as she said, “I feel like I've done something wrong. Are they punishing me because I've been refusing therapy and won't go to a nursing home?” She acknowledged that she hadn't always listened to her doctors but said that she knew better now and wanted to go home and see if she could make it work. Many staff members at our rehabilitation hospital had explained their safety concerns to her, and some had enlisted her (...) adult daughter, with whom she lived, to convince her too. The rehabilitation team had called on the ethics consultation service, of which I am a part, to help figure out whether Mrs. Smith had the capacity to make an informed refusal of discharge recommendations. (shrink)

In this technology-driven Digital Age, Management Education is primarily engaged in development of skills and techno-economic competence of students with dominant thrust on sharpening their rational faculties and quantitative ability. Deeper questions and nobler qualittative issues like Spirituality, Corporate Social Responsibility and Ethics are naturally assigned low priority in the rush for money, career, fame, power and position both at the individual and organizational levels. The present paper engages in a Qualitative Research by conducting Focus group Interviews among Participants at (...) the Undergraduate level who had taken up Management Education. After content analysis of the responses the authors highlight their observations on the existing gaps in prevailing management education leading to failure of the present system in charging the students with a deeper Meaning of Work and a higher Purpose of Life. The paper then delves into exploration in pertinent tenets of Classical Indian Wisdom to enrich the spectrum of Management education with insights on Humanistic Philosophy, Holistic Learning, Enlightened CSR and Ethics, and Inspirational Leadership towards creating a better and more humane future for modern organizations. (shrink)

In the late nineteenth century, Jagadish Chandra Bose devised millimeter- and micro-wave experiments to record responses of plants to electromagnetic stimuli. Based on these experiments, Bose conceptualized his thesis of the unity of living and nonliving entities through their different sensitivities to electromagnetic vibrations. By relating Bose’s thesis of the unity of life based on electromagnetic vibrations to Alfred North Whitehead’s process philosophy and N. Katherine Hayles’s work on the cognitive nonconscious, I argue for a processual media theory that connects (...) both human and plant intelligence to electromagnetic signaling. In doing so, I examine how discourses about different living bodies (plants, animals, humans) variously sensing their environments are formulated into claims about which species have what degree of cognitive capability and intelligence. I trace the influence of Bose’s work on the ecological thinking of the 1970s espoused by cyberneticists and countercultural environmentalists and on contemporary plant neurobiologists who are closely working with Internet of Things designers and researchers. This enables me to emerge with an understanding of electrosensitivity that acknowledges that there is more to the intensities and energies of signals than mere data and that such infra-informatic signals can create both capacities and incapacities, capabilities and debilities, in bodies. (shrink)

Unconscious thought theory (UTT) states that all information is taken into account and the attributes are weighted optimally resulting in better decisions in complex decision problems during unconscious thought. Very few studies have investigated the actual amount of information processed in the unconscious thought condition. We hypothesized that only a small subset of information might be considered during unconscious thought (like conscious thought). To test this possibility and to explore the way attribute information is selected and combined, we performed computer (...) simulations on the datasets used by previous researchers. The simulations showed that considering a small subset (3-4) of attributes, yields results comparable to previous studies. There is no need to posit infinite capacity in the unconscious thought condition. The results also suggest that weight information is used for attribute selection that could potentially explain the difficulties in replicating the deliberation-without-attention effect. (shrink)

Rabindranath Tagore is remembered today chiefly as a poet, and his fame as a poet has often eclipsed his great contributions to other fields of literature and life — especially education. Tagore pondered deeply on the fundamental problems of education — aims, curriculum, method, discipline, values and medium — and wrote and experimented on them freely and extensively. Tagore is perhaps the only literary genius in contemporary history who devoted a major part of his life to thinking about education and (...) creating an educational institution of international significance. Also, the institution he created at Santiniketan proved to be the most global and sustainable among the progressive educational institutions launched by individual thinkers such as Froebel and Russell. This edition revives a classic work, the first comprehensive, full-length account of Tagore’s educational thought and activity, commemorating his 150th birth anniversary. It presents a detailed chronological survey of Tagore’s educational writings and institutional activities in the perspective of his life and thought in general. The book also contains a detailed review and critical discussion on almost all major aspects of his educational work. Through an overall evaluation of Tagore’s unique contribution to education and his message to the world, it seeks to correct some common misconceptions that have existed from time to time about Santiniketan and Visva-Bharati. The book will help form a more complete view of Tagore’s life and work, filling as it does the gaps and voids in the literature that has grown around him, and reinforcing its relevance today. It will be of value to educationists, teachers, policymakers, those interested in modern Indian history and philosophy of education._ _. (shrink)

A development in Management research is observed in recent years: interface of literature and management. The paper highlights the possibility of constructive impacts on human development through philosophy and experiments of Rabindranath Tagore, the Nobel Laureate literary genius from India (1913), in the field of education. The essential equality of all, preservation of cultural diversity, and the infinite possibility of deepening our understanding of each other form the core of Tagorean values. Tagore was a visionary and, throughout his life, he (...) tried to bring about a radical change in society through education which would enable the world to come together—irrespective of diversity of language, identity, race, nationality, or religion. He recognized the need to promote a culture that fosters intellectual, social, and cultural growth in the global community. Using the classic example of Tagore the paper will examine how embracing of diversity in leadership and organizational development can contribute to holistic effectiveness through the introduction of non-conventional and alternative learning as advocated by Tagore that makes him all the more relevant in the present globalized context. The paper will also attempt to outline a learning path and unfold a voyage from knowledge to wisdom for leaders and organizations in future. (shrink)

Restorative practices are gaining traction as alternative approaches to student conflict and harm in schools, potentially surpassing disciplinary methods in effectiveness. In the current article, we contribute to the evolving understanding of restorative practices in schools by examining qualitative responses from educators regarding restorative interventions for online-mediated conflict and harm, including cyberbullying and sexting. Participants include pre-service educators, as well as junior and senior teachers with varying levels of familiarity with restorative practices. Our findings highlight how educators who have implemented (...) these practices largely hold positive perspectives of their effectiveness for resolving cyber conflicts and restoring a positive classroom environment. Educators emphasize the value of meaningful changes in student behaviour and acknowledge the potential of face-to-face mediation in mitigating online harm and promoting digital citizenship, though some educators raise questions about the appropriateness of restorative responses to serious incidents of online-mediated harm. This research offers fresh insights into the challenges and potential of restorative practices in schools, particularly in addressing cyber-based conflicts. We emphasize implementation challenges related to the distinct contexts in which schools operate and the influence of broader societal and systemic factors on the success of restorative practice initiatives. (shrink)

In this paper the sameness and difference between two distinguished Indian authors, Rokeya Sakhawat Hossain (1880–1932) and Mahasweta Devi (b. 1926), representing two generations almost a century apart, will be under analysis in order to trace the generational transformation in women’s writing in India, especially Bengal. Situated in the colonial and postcolonial frames of history, Hossain and Mahasweta Devi may be contextualized differently. At the same time their subjects are also differently categorized; the former is not particularly concerned with subalterns (...) whereas the latter specifically focuses on the effect of race and class on gender. The quest for the ‘self’ and ‘subjectivity’ is more pertinent in the latter and consequently the appeal for agency is based on a crude power struggle. Hossain, a philanthropist who championed the woman question, believed that striving for equality should be a collective process which could be achieved by spreading awareness among fellow-inmates inhabiting the prison of patriarchy. Like Euro-American first-wave feminists, Rokeya advocated the necessity of education among women in order for them to be able to comprehend their plight and ‘awake’ for the cause. She addresses fundamental issues of feminism like education and the systematized claustrophobia within the domestic space. Whereas Mahasweta Devi, has been an activist writer who is regarded as the brand ambassador for the support of the marginalized, deprived and denotified tribes of India. It is her mission to provide succour to the marginalized sections, especially tribes from the Purulia district of West Bengal, like the Kherias and Shabars. As an activist writer she explores tribal life and allied socio-political issues which reflect their agony. (shrink)

Debates in the philosophy of science typically take place around issues such as realism and theory change. Recently, the debate has been reformulated to bring in the role of experiments in the context of theory change. As regards realism, Ian Hacking’s contribution has been to introduce ‘intervention’ as the basis of realism. He also proposed, following Imre Lakatos, to replace the issue of truth with progress and rationality. In this context we examine the case of the vitalism — reductionism debate (...) in biology inspired by the works of Indian physicist-turned-biologist Jagadish Chandra Bose (1858–1937), in the early twentieth century. Both camps had their characteristic hardcores. Vitalists led by John S. Burdon-Sanderson and Augustus D. Waller accepted religious metaphysics to support their research programme, which ultimately degenerated. Bose worked more with the ideals of science such as Occam’s razor, large-scale systematization of phenomena and novel prediction. I argue that his religious metaphysics, instead of acting as a protective shield, helped him to consolidate his position and allowed further problem shift resulting in a research programme that involved consciousness too. His research programme remains relevant even today. (shrink)

The process of obtaining informed consent to participate in a clinical study presents many challenges for research conducted in a population of patients with schizophrenia. Morally valid, informed consent must include information sharing, decisional capacity, and capacity for voluntarism. This paper examines the unique features of schizophrenia that may threaten each of these elements of informed consent, and it proposes additional safeguards in the process of gaining informed consent from individuals with schizophrenia in order to maximise the decision-making potential of (...) this patient population. (shrink)

Spirit connotes the life-breath that enlivens both individuals and organizations. The role of a leader is to unleash in followers this primal creative energy and guide it towards enlightened governance. Although learning organizations grow and evolve in knowledge, conflicts also arise between material knowledge and spiritual wisdom. Using insight from classical Indian wisdom, a more harmonious pursuit of both personal fulfilment and organizational enrichment will be addressed. This article will highlight the importance of exploring non-conventional methods of learning beyond cognition (...) that may improve leadership clarity, decision making and relationship management. Discovering deeper levels of consciousness via meditation also strengthens personal mastery and purpose as well as system thinking and a sense of interconnectedness. The spirit of entrepreneurship draws deeply from such inner inspiration, finding expression in sustained commitment and high-energy performance. Such leaders must ignite a fire within themselves and their followers. Hence, the article begins with asking deep, uneasy questions for wisdom to emerge in leadership consciousness, charting a road map for future enlightenment in learning organizations, and concludes with examples of wisdom leadership from modern India. (shrink)

As ethics consultants on a busy consult service in a large urban setting, we would approach this case by gathering more information and context. This involves clarifying the clinical facts, underst...

This paper proposes relative and absolute measures of deprivation using social satisfaction functions. The relative measure gives us the amount by which social satisfaction can be increased in proportional terms by redistributing incomes equally. We also demonstrate the existence of a relationship between summary indices of deprivation and social satisfaction.

Single-sided deafness (SSD) or profound unilateral hearing loss obligates the only serviceable ear to capture all acoustic information. This loss of binaural function taxes cognitive resources for accurate listening performance, especially under adverse environments or challenging tasks. We hypothesized that adults with SSD would manifest both functional and structural brain plasticity compared to controls with normal binaural hearing. We evaluated functional alterations using magnetoencephalographic imaging (MEGI) of brain activation during performance of a moderately difficult auditory syllable sequence reproduction task and (...) assessed structural integrity using diffusion tensor magnetic resonance imaging (DTI). MEGI showed the SSD cohort to have increased induced oscillations in the theta band over the left superior temporal cortex and decreased induced gamma band oscillations over the frontal and parietal cortices between 175-475 ms following stimulus onset. DTI showed the SSD cohort to have extensive fractional anisotropy reduction in both auditory and non-auditory tracts and regions. Overlaying functional and structural changes revealed by the two imaging techniques demonstrated close registration of cortical areas and white matter tracts that expressed brain plasticity. Hence, complete loss of input from one ear in adulthood triggers both functional and structural alterations to dorsal temporal and frontal-parietal areas. (shrink)

In this paper we introduce the concept of interval valued neutrosophic soft topological space together with interval valued neutrosophic soft finer and interval valued neutrosophic soft coarser topology. We also define interval valued neutrosophic interior and closer of an interval valued neutrosophic soft set. Some theorems and examples are cites. Interval valued neutrosophic soft subspace topology are studied. Some examples and theorems regarding this concept are presented.

The causal exclusion argument supports the notion that causation should be thought of as a purely low-level affair. Here we argue instead in favour of high-level causation as a natural and meaningful notion that may even be more useful than causation at more fundamental physical levels. Our argument is framed in terms of a broadly interventionist conception of causation. Its essence is that causal relations at an appropriately high level can in a certain sense be less sensitive than those at (...) a fundamental, microscopic level. This means that in settings where causal relations at the physical level are not considered in the context of some suitable macro-level interpretation, statements concerning the low-level relations may be highly sensitive with respect to changes in background conditions. Using an example of accelerator experiments in particle physics, we consider what it means to characterize extremely sensitive low-level events as causal. (shrink)

The ontological model framework for an operational theory has generated much interest in recent years. The debate concerning reality of quantum states has been made more precise in this framework. With the introduction of generalized notion of contextuality in this framework, it has been shown that completely mixed state of a qubit is preparation contextual. Interestingly, this new idea of preparation contextuality has been used to demonstrate nonlocality of some \(\psi \) -epistemic models without any use of Bell’s inequality. In (...) particular, nonlocality of a non maximally \(\psi \) -epistemic model has been demonstrated from preparation contextuality of a maximally mixed qubit and Schrödinger’s steerability of the maximally entangled state of two qubits (Leifer and Maroney, Phys Rev Lett 110:120401, 2013). In this paper, we, show that any mixed state is preparation contextual. We, then, show that nonlocality of any bipartite pure entangled state, with Schmidt rank two, follows from preparation contextuality and steerability provided we impose certain condition on the epistemicity of the underlying ontological model. More interestingly, if the pure entangled state is of Schmidt rank greater than two, its nonlocality follows without any further condition on the epistemicity. Thus our result establishes a stronger connection between nonlocality and preparation contextuality by revealing nonlocality of any bipartite pure entangled states without any use of Bell-type inequality. (shrink)

We show that within the class of ontological models due to Harrigan and Spekkens, those satisfying preparation-measurement reciprocity must allow indeterminism comparable to that in quantum theory. Our result implies that one can design quantum random number generator, for which it is impossible, even in principle, to construct a reciprocal deterministic model.

In this review article we discuss some of the applications of noncommutative geometry in physics that are of recent interest, such as noncommutative many-body systems, noncommutative extension of Special Theory of Relativity kinematics, twisted gauge theories and noncommutative gravity.

Electroencephalography provides a non-invasive means to advancing our understanding of the development and function of the brain. However, the majority of the world’s population residing in low and middle income countries has historically been limited from contributing to, and thereby benefiting from, such neurophysiological research, due to lack of scalable validated methods of EEG data collection. In this study, we establish a standard operating protocol to collect approximately 3 min each of eyes-open and eyes-closed resting-state EEG data using a low-cost (...) portable EEG device in rural households through formative work in the community. We then evaluate the acceptability of these EEG assessments to young children and feasibility of administering them through non-specialist workers. Finally, we describe properties of the EEG recordings obtained using this novel approach to EEG data collection. The formative phase was conducted with 9 families which informed protocols for consenting, child engagement strategies and data collection. The protocol was then implemented on 1265 families. 977 children and 1199 adults provided resting-state data for this study. 259 children refused to wear the EEG cap or removed it, and 58 children refused the eyes-closed recording session. Hardware or software issues were experienced during 30 and 25 recordings in eyes-open and eyes-closed conditions respectively. Disturbances during the recording sessions were rare and included participants moving their heads, touching the EEG headset with their hands, opening their eyes within the eyes-closed recording session, and presence of loud sounds in the testing environment. Similar to findings in laboratory-based studies from high-income settings, the percentage of recordings which showed an alpha peak was higher in eyes-closed than eyes-open condition, with the peak occurring most frequently in electrodes at O1 and O2 positions, and the mean frequency of the alpha peak was found to be lower in children as compared to adults. We observed a deterioration in the EEG signal with prolonged device usage. This study demonstrates the acceptability, feasibility and utility of conducting EEG research at scale in a rural low-resource community, while highlighting its potential limitations, and offers the impetus needed to further refine the methods and devices and validate such scalable methods to overcome existing research inequity. (shrink)

Most laboratory experiments studying Tullock contest games find that bids significantly exceed the risk-neutral equilibrium predictions. We test the generalisability of these results by comparing a typical experimental implementation of a contest against the familiar institution of a ticket-based raffle. We find that in the raffle initial bid levels are significantly lower and bids adjust more rapidly towards expected-earnings best responses. We demonstrate the robustness of our results by replicating them across two continents at two university labs with contrasting student (...) profiles. (shrink)

In 1893, The World’s Parliament of Religions met in Chicago from the 15th of May until the 28th of October. 2013 marked the 120th anniversary of this gathering where the leading representatives of the religions of the world engaged in dialogue. To commemorate this event, Special Collections Research Center at Southern Illinois University Carbondale in conjunction with the Hegeler Carus Foundation hosted a symposium on the relationship between science, religion, and philosophy. One of the themes of the Parliament was “…the (...) actual harmony of science and religion; and the origin and nature of the alleged conflict between them.” Featured speakers addressed these issues igniting fascinating conversations. These are the papers that were presented. (shrink)

Coronavirus disease 2019 is a fast-developing viral pandemic spreading across the globe. Due to lack of availability of proven medicines against COVID-19, physicians have resorted to treatments through large trials of investigational drugs with poor evidence or those used for similar diseases. Large trials randomize 100–500+ patients at multiple hospitals in different countries to either receive these drugs or standard treatment. In order to expedite the process, some regulatory agencies had also given permission to use drugs approved for other diseases, (...) despite a lack of evidence of efficacy in COVID-19. In this review, we highlight the potential ethical issues that should be addressed during the use of investigational drugs with little prior evidence as a treatment options during a pandemic. We discuss the impact of design of randomized clinical trials using LOTUS trial as an example and that of off-label use of drugs like chloroquine/hydroxychloroquine on the safety of patients during COVID-19. We conclude that the adaptive randomized clinical trial designs offer a flexible and efficient approach, enabling patients to quickly switch to successful treatments, while minimizing the number of patients on standard of care. Randomized clinical trial design should consider blinding of investigators and only representative patients who can provide consent should be included. We also conclude the emergency approvals of drugs should be carefully issued and off-label use should be restricted in pandemics. Streamlined regulatory guidelines for emergency drug use in a pandemic can also help in providing benefit and minimizing harm to patients in the future. (shrink)

When encountering a set of alternatives displayed in the form of a list, the decision maker usually determines a particular alternative, after which she stops checking the remaining ones, and chooses an alternative from those observed so far. We present a framework in which both decision problems are explicitly modeled, and axiomatically characterize a ‘divide-and-choose’ rule which unifies successive choice and satisficing choice.

Vijay is a forty-eight-year-old man with profound mental retardation and cerebral palsy. He uses a wheelchair, cannot speak or eat by mouth, and requires constant care. He lived in a group home for twenty-eight years. During the last year, Vijay has required two visits to the emergency room on average per month and has been hospitalized for two hundred days in total. These hospitalizations are the result of a number of painful and dangerous complications related to the gastrostomy tube that (...) provides his nutrition. The last time he was in the hospital, doctors had to give him a peripherally inserted central catheter, or PICC line, to provide nutrition because the gastrostomy tube was no longer effective .. (shrink)

This volume contains 17 articles on various aspects of Islamic thought in the Middle East and in Southeast Asia. The first 9 articles concentrate especially on the Qur’ān and its exegesis, Kalām and Sufism; the second 8 articles deal with Javanese Islam, and with Islam and modernity in Southeast Asia.

In their article “Implementing Expanded Prenatal Genetic Testing: Should Parents Have Access to Any and All Fetal Genetic Information?” Bayefsky and Berkman briefly mention that: “[s]ome are...