Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 and X-linked CLDN2 through a two-stage genome-wide study. The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is (...) associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men. © 2012 Nature America, Inc. All rights reserved. (shrink)

On 12 May 1962, a frail Douglas MacArthur delivered his final public speech to the cadets at the United States Military Academy. A West Point graduate himself, MacArthur served as Superintendent of...

Researchers designing a clinical trial may be aware of disputed evidence of serious risks from previous studies. These researchers must decide whether and how to describe these risks in their model informed consent document. They have an ethical obligation to provide fully informed consent, but does this obligation include notice of controversial evidence? With ACCORD as an example, we describe a framework and criteria that make clear the conditions requiring inclusion of important controversial risks. The ACCORD model consent document did (...) not include notice of prior trials with excess death. We develop and explain a new standard labeled risk in equipoise. We argue that our approach provides an optimal level of integrity to protect the informational needs of the reasonable volunteers who agree to participate in clinical trials. We suggest language to be used in a model consent document and the informed consent discussion when such controversial evidence exists. (shrink)

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)

Volume 19, Issue 11, November 2019, Page 78-80.

Peter Abelard (1079–1142 ce) was the most wide‐ranging philosopher of the twelfth century. He quickly established himself as a leading teacher of logic in and near Paris shortly after 1100. After his affair with Heloise, and his subsequent castration, Abelard became a monk, but he returned to teaching in the Paris schools until 1140, when his work was condemned by a Church Council at Sens. His logical writings were based around discussion of the “Old Logic”: Porphyry's Isagoge, aristotle'S Categories and (...) On Interpretation and boethius'S textbook on topical inference. They comprise a freestanding Dialectica (“Logic”; probably c.1116), a set of commentaries (known as the Logica [Ingredientibus], c. 1119) and a later (c. 1125) commentary on the Isagoge (Logica Nostrorum Petititoni Sociorum or Glossulae). In a work Abelard called his Theologia, issued in three main versions (between 1120 and c.1134), he attempted a logical analysis of trinitarian relations and explored the philosophical problems surrounding God's claims to omnipotence and omniscience. The Collationes (“Debates,” also known as “Dialogue between a Christian, a Philosopher and a Jew”; probably c.1130) present a rational investigation into the nature of the highest good, in which the Christian and the Philosopher (who seems to be modeled on a philosopher of pagan antiquity) are remarkably in agreement. The unfinished Scito teipsum (“Know thyself,” also known as the “Ethics”; c.1138) analyses moral action. (shrink)

The rise of neurotechnologies, especially in combination with artificial intelligence (AI)-based methods for brain data analytics, has given rise to concerns around the protection of mental privacy, mental integrity and cognitive liberty – often framed as “neurorights” in ethical, legal, and policy discussions. Several states are now looking at including neurorights into their constitutional legal frameworks, and international institutions and organizations, such as UNESCO and the Council of Europe, are taking an active interest in developing international policy and governance guidelines (...) on this issue. However, in many discussions of neurorights the philosophical assumptions, ethical frames of reference and legal interpretation are either not made explicit or conflict with each other. The aim of this multidisciplinary work is to provide conceptual, ethical, and legal foundations that allow for facilitating a common minimalist conceptual understanding of mental privacy, mental integrity, and cognitive liberty to facilitate scholarly, legal, and policy discussions. (shrink)

Philosophy is shaped by life and life is shaped by philosophy. This is reflected in The Philosophical I, a collection of 16 autobiographical essays by prominent philosophers.

Rawls famously argues that the parties in the original position would agree upon the two principles of justice. Among other things, these principles guarantee equal political liberty—that is, democracy—as a requirement of justice. We argue on the contrary that the parties have reason to reject this requirement. As we show, by Rawls’ own lights, the parties would be greatly concerned to mitigate existential risk. But it is doubtful whether democracy always minimizes such risk. Indeed, no one currently knows which political (...) systems would. Consequently, the parties—and we ourselves—have reason to reject democracy as a requirement of justice in favor of political experimentalism, a general approach to political justice which rules in at least some non-democratic political systems which might minimize existential risk. (shrink)

The continuing power of racist ideology threatens liberal democracy, for racism is more than a personal bias or a social construction. It is an ideological framework that reduces human beings to an existence along a color-coded spectrum, with people designated as “white” at the top of the hierarchy and people designated as “black” at the bottom. One has to see this ideology clearly in order to choose a proper response and then act accordingly. First, the reality of “race” has been (...) exposed as unscientific and illusory, and as based not on biology or genetics, but on a legacy of empowerment for some and enslavement for others. Second, this racist ideology, part of our disenchanted, secular age, is exposed as a continuing form of enchantment in its manner of seeing the world, opening the possibility for a spiritual response. Third, dismantling this racist ideology requires a reimagining of “blackness” as a source of life and spirituality, as a way of countering and rewriting the dominant racist narrative. Fourth, a postsecular spiritualty, based on the work of Pope Francis—that emphasizes the importance of protecting our common human dignity, of caring for each other, and of “walking together”—can be engaged as a path for action in the battle against racism. (shrink)

This reader-friendly book examines philosophies and philosophers using an engaging, non-condescending approach that speaks to you at your level.

In order to improve our understanding of the components that reflect functionally important processes during reward anticipation and consumption, we used principle components analyses (PCA) to separate and quantify averaged ERP data obtained from each stage of a modified monetary incentive delay (MID) task. Although a small number of recent ERP studies have reported that reward and loss cues potentiate ERPs during anticipation, action preparation, and consummatory stages of reward processing, these findings are inconsistent due to temporal and spatial overlap (...) between the relevant electrophysiological components. Our results show three components following cue presentation are sensitive to incentive cues (N1, P3a, P3b). In contrast to previous research, reward‐related enhancement occurred only in the P3b, with earlier components more sensitive to break‐even and loss cues. During feedback anticipation, we observed a lateralized centroparietal negativity that was sensitive to response hand but not cue type. We also show that use of PCA on ERPs reflecting reward consumption successfully separates the reward positivity from the independently modulated feedback‐P3. Last, we observe for the first time a new reward consumption component: a late negativity distributed over the left frontal pole. This component appears to be sensitive to response hand, especially in the context of monetary gain. These results illustrate that the time course and sensitivities of electrophysiological activity that follows incentive cues do not follow a simple heuristic in which reward incentive cues produce enhanced activity at all stages and substages. (shrink)

Cutting and parsing the corpus of a great author’s work is properly a delicate and exacting task, particularly when executed by numerous authors within the limits of a three-hundred-page academic b...

There has been a significant shift in the way terrorist violence is organized. Advocates of extreme violence no longer organize first in person and through word of mouth and utilize the internet an...

In a wonderfully written and engaging text, Christopher Clark has crafted both a specific analysis of German politics and history over three-hundred years and a broad review of the changes in histo...

Religious beliefs influence the making of war and war-making influences religious belief, but religion is not a cause of war. That would be the general conclusion one can take from this work by Arn...

Moral judgments can occur either in settings that call for impartiality or in settings that allow for partiality. How effective are impartiality settings such as hospitals in suppressing personal biases? Portrayed as decision-makers in an emergency department, 431 college students made judgments on which of two victims of a mass shooting should receive immediate, life-saving care. Patients differed in ways that could reveal biases, e.g., age, kinship, gender, and villain/hero. Participants rated each patient’s moral deservingness to receive immediate care and (...) the likelihood they would choose the patient. Both scales showed young favored over old, cousin over stranger, and policeman over shooter. In a hospital-room scenario with high risk of injury from falling, age bias disappeared. With moderate fall risk, age bias reversed and kinship deservingness bias disappeared. Bias decreases when there is a decrease in severity of potential harm to the preferred stakeholder. Settings that call for impartiality are not reliable “boundary conditions” against expressions of bias. In the absence of explicit guidelines for allocating scarce resources, a systematic, objective method of random selection offers a potentially useful strategy. (shrink)

Pharmacists, physicians, and other health care personnel practice within an integrated system of laws and regulations that influence many treatment modalities. Capitation, managed care, and other controls strain these relationships by mandating greater oversight of how health care is delivered. From a pharmacists’s perspective, any use of medication requites knowledge of three omnipresent factors: regulatory control, formularies, and economic decision making. My objective is to raise awareness of these issues as they relate to the prescription of pain medication and to (...) pain management generally.All practice-oriented drug law and regulation is based on the federal Controlled Substances Act of 1970. The Act, also known as Title II, is part of a much larger piece of legislation, the Comprehensive Drug Abuse Prevention and Control Act of 1970. CSA was enacted to regulate the manufacturing, distribution, dispensing, and delivery of drugs or substances that are subject to, or have the potential for, abuse or physical or psychological dependence. (shrink)

This work investigates the complexity of ethics as a field of inquiry and practice across a principal's career. Fully contextualized, and thus carrying the contradictions and requirements of any school, the issues realistically do not usually lead to a single, beat-all answer, as any solution will likely have positive and negative consequences. Drawn from the authors' experiences and studies of schools over decades, the central figure is a fictional principal of a magnet school, whose dilemmas reflect the questions educators must (...) be prepared for. Each decision takes into account the principal's and staff's identities and values because they are all human and their opinions influence the outcomes. The work injects analytic, virtue, feminist, care, deontological, and critical theory insights as Deweyan ethics provides a lens for examining dilemmas. This accessible work blends reflective theory, the ordinary worlds of schools, and engaging pedagogical practice to guide those planning to enter the education sector. (shrink)

This book illuminates contemporary educational reform discussions regarding teacher education programs and pre-K-12 schools by providing a clear analysis and application of John Dewey's relevant educational writings and ideas. The volume addresses issues of how future teachers should be liberally educated as well as prepared to be professional educators. Pre-K-12 education is evaluated through a Deweyan lens, involving a discussion of such topics as the teacher's responsibilities, charter schools, a common curriculum, professional development schools, new curricula, school administration, and cooperative (...) learning. In the concluding chapter, the authors point out many of the questions and concerns that those who are interested in educational reform are well-advised to ask and discuss. (shrink)

Anthony Ashley Cooper, the Third Earl of Shaftesbury, was the grandson of the First Earl of Shaftesbury. The First Earl, along with John Locke, was a leader and founder of the Whig movement in Britain. Locke was the First Earl's secretary and also the tutor of the Third Earl. Both the First and Third Earls were members of parliament and supporters of Whig causes. Although both the First and Third Earls were involved in politics, the Third Earl is better known (...) for intellectual pursuits. Indeed, the Third Earl is second only to Locke in terms of influence during the eighteenth century. Yet if one takes into account effects upon literature, the arts, and manners, as well as upon philosophical trends and theories, Shaftesbury might be even more influential. Even if we restrict ourselves to philosophy, Shaftesbury's ideas were admired by thinkers as different as Leibniz and Montesquieu—something which could obviously not be said about Locke. Within ethics, Shaftesbury influenced Francis Hutcheson, David Hume, Samuel Butler, and Adam Smith and is credited with founding the “moral sense” school of thought. (shrink)

As each individual abandons himself to the solicitous aid of the State,so, and still more, he abandons to it the fate of his fellow-citizens.Wilhelm Von Humboldt,On the Limits of State Action.

John Dewey is a well-known proponent of certain aspects of progressive education, including the idea that students and teachers should be reflective co-inquirers, not just acquirers of information.1 Among his many other educational ideas are the continuing need to reconstruct school conditions and environments, pedagogical thinking and practice, curricular planning and development, and educational activities and outcomes.2 In the field of education, however, his ideas of ethical inquiry, thinking, and decision-making are not as widely known as his views of teaching (...) and learning. Moreover, some advocates and critics of his ideas often confuse or blur his ethical deliberations.3 Since we think his ethical... (shrink)

Sallust used Fortuna to. give his story specialized political meaning and to incorporate materials and judgments that extend the purview of his narrative to all of Roman history. Fortuna is a configuration of events that appears at certain moments in a state's existence and presents demands for careful application of intelligence, virtus, animus or ingenium, if things are to proceed well and a new era is to begin . If virtus is not present, fortuna rages and destroys . Admirable men (...) seek gloria through virtus, but also require an historian to reconstruct actions. Fortuna offers men of leisure the opportunity to apply intelligence to a course of events and to write and therefore to create history in a secondary but more lasting sense. (shrink)

"An Illini book." Includes bibliographical references and index.

_ Source: _Volume 37, Issue 1, pp 1 - 15 A reconstruction is attempted of the printing process of the first edition of _De iure belli ac pacis_, and of the circumstances thereof, on the basis of a study of various copies still extant. It is argued that a distinction should be drawn between variations that resulted from a hurried printing process and those that were interventions by the author himself.

_ Source: _Volume 37, Issue 1, pp 1 - 15 A reconstruction is attempted of the printing process of the first edition of _De iure belli ac pacis_, and of the circumstances thereof, on the basis of a study of various copies still extant. It is argued that a distinction should be drawn between variations that resulted from a hurried printing process and those that were interventions by the author himself.