The number of children with chronic critical illness (CCI) is a growing population in the United States. A defining characteristic of this population is a prolonged hospital stay. Our study assessed the proportion of pediatric patients with chronic critical illness in U.S. hospitals at a specific point in time, and identified a subset of children whose hospital stay lasted for months to years. The potential harms of a prolonged hospitalization for children with CCI, which include over treatment, infection, disruption of (...) family life, and the intensive utilization of resources—combined with the moral distress experienced by the clinicians who care for the children, suggest the need for ethical analysis of this growing issue to identify actions that could be taken at the clinical and health systems levels to reduce the harms associated with prolonged hospital stay.In this article we present three real cases from our study that involved a very long hospital stay. We applied a framework developed by Mackenzie, Rogers, and Dodds to analyze inherent, situational, and pathogenic vulnerabilities to examine the ways that interventions intended to remedy one source of harm for the children in our cohort inadvertently created other harms. We examined the complex ways that children with protracted hospitalization are vulnerable to the choices made by their family and clinicians, as well as by healthcare systems and communities. Finally, we used this analysis to summarize actions and ethical responses to this growing patient population. Such an understanding is essential to making clinical and ethical decisions that arise for children who are at risk for a very long stay in the hospital. (shrink)

We present a computational analysis of de re, de dicto, and de se belief and knowledge reports. Our analysis solves a problem first observed by Hector-Neri Castañeda, namely, that the simple rule -/- `(A knows that P) implies P' -/- apparently does not hold if P contains a quasi-indexical. We present a single rule, in the context of a knowledge-representation and reasoning system, that holds for all P, including those containing quasi-indexicals. In so doing, we explore the difference between reasoning (...) in a public communication language and in a knowledge-representation language, we demonstrate the importance of representing proper names explicitly, and we provide support for the necessity of considering sentences in the context of extended discourse (for example, written narrative) in order to fully capture certain features of their semantics. (shrink)

This project continues our interdisciplinary research into computational and cognitive aspects of narrative comprehension. Our ultimate goal is the development of a computational theory of how humans understand narrative texts. The theory will be informed by joint research from the viewpoints of linguistics, cognitive psychology, the study of language acquisition, literary theory, geography, philosophy, and artificial intelligence. The linguists, literary theorists, and geographers in our group are developing theories of narrative language and spatial understanding that are being tested by the (...) cognitive psychologists and language researchers in our group, and a computational model of a reader of narrative text is being developed by the AI researchers, based in part on these theories and results and in part on research on knowledge representation and reasoning. This proposal describes the knowledge-representation and natural-language-processing issues involved in the computational implementation of the theory; discusses a contrast between communicative and narrative uses of language and of the relation of the narrative text to the story world it describes; investigates linguistic, literary, and hermeneutic dimensions of our research; presents a computational investigation of subjective sentences and reference in narrative; studies children’s acquisition of the ability to take third-person perspective in their own storytelling; describes the psychological validation of various linguistic devices; and examines how readers develop an understanding of the geographical space of a story. This report is a longer version of a project description submitted to NSF. This document, produced in May 2007, is a L ATEX version of Technical Report 89-07 (Buffalo: SUNY Buffalo Department of Computer Science, August 1989), with slightly.. (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)

Addressing the issue of how to read Nietzsche, this book presents an accessible series of essays for students and general readers on Nietzsche's individual works, written by such distinguished Nietzsche scholars as Frithjof Bergmann, Arthur Danto, Bernd Magnus, Christopher Middleton, Eric Blondel, Lars Gustaffson, Alexander Nehamas, Richard Schacht, Gary Shapiro, Hugh Silverman, and Ivan Soll. Among the works discussed are On the Genealogy of Morals, Beyond Good and Evil, Thus Spoke Zarathustra, Twilight of the Idols and The Will to (...) Power. (shrink)

This paper uses neo-Fregean-style abstraction principles to develop the integers from the natural numbers (assuming Hume’s principle), the rational numbers from the integers, and the real numbers from the rationals. The first two are first-order abstractions that treat pairs of numbers: (DIF) INT(a,b)=INT(c,d) ≡ (a+d)=(b+c). (QUOT) Q(m,n)=Q(p,q) ≡ (n=0 & q=0) ∨ (n≠0 & q≠0 & m⋅q=n⋅p). The development of the real numbers is an adaption of the Dedekind program involving “cuts” of rational numbers. Let P be a property (of (...) rational numbers) and r a rational number. Say that r is an upper bound of P, written P≤r, if for any rational number s, if Ps then either s<r or s=r. In other words, P≤r if r is greater than or equal to any rational number that P applies to. Consider the Cut Abstraction Principle: (CP) ∀P∀Q(C(P)=C(Q) ≡ ∀r(P≤r ≡ Q≤r)). In other words, the cut of P is identical to the cut of Q if and only if P and Q share all of their upper bounds. The axioms of second-order real analysis can be derived from (CP), just as the axioms of second-order Peano arithmetic can be derived from Hume’s principle. The paper raises some of the philosophical issues connected with the neo-Fregean program, using the above abstraction principles as case studies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 249 larger sections of the work will be translated-preferably not from the Latin, but from the Arabic original. JOSEPHL. B~u Columbia University Commentary on the Metaphysics of Aristotle. By St. Thomas Aquinas. Trans. by John P. Rowan. (Chicago, Illinois: Henry Regnery Company, 1961. Pp. xxiii + 955.2 vols., boxed, $25.00.) Generally speaking, the two Summae of St. Thomas, long available in English translation, contain all that is (...) most personal and most profound in his philosophical thought. Nonetheless, it is quite impossible to get a fully adequate conception of St. Thomas' place in the history of western thought from a consideration of his theological writings alone. Hence, by translating St. Thomas' Commentary on the Metaphysics of Aristotle into English, Professor J. P. Rowan has provided the non-Latin reading student of the history of philosophy an invaluable service. For it is in his r61e as Aristotelian commentator that we see St. Thomas creating for the Schoolmen a version of Aristotle which served to render the Stagirite's thought into terms which became fundamental to the philosophical defense of Christianity. Further, by keeping in mind the fully-developed notions of St. Thomas on the existence of God and the nature of being as these are given us to understand in the Summae, the reader becomes better enabled, by a critical reading of Thomas' Commentary, to grasp the sense in which the Saint's theological writings are said by his enthusiasts to represent a "completing" and "perfecting" of Aristotle's thought. Professor Rowan's translation is based upon the Turin, 1950, edition of R. M. Spiazzi. This edition is itself fundamentally the older edition of M. R. Cathala, containing but few emendations. Although the translator was obliged to check Spiazzi occasionally against the Parma and Viv6s editions of Thomas' Opera Omnia, the usefulness of such consultation was, as Professor Rowan himself states, "limited inasmuch as both the editions of Viv~s and that of Cathala use Parma as their basic text" (p. vii). Further, since the edition from which he worked was not critical, Professor Rowan found it necessary in some instances to himself emend the reading of the Spiazzi text. However, where such alterations were made, and where indeed they were not obviously required, Professor Rowan indicated his iustification for the change in a footnote. It is unfortunate that no critical edition of Thomas' work was available to his translator; still, although a final evaluation of his emendations must, of course, attend the future appearance of a critical edition of Thomas' work, so far as we were able to judge, Professor Rowan's 250 HISTORY OF PHILOSOPHY changes were in all instances quite reasonable and well ]ustified. Professor Rowan has wisely included a translation of that version of the Aristotelian text upon which St. Thomas (in all probability) based his commentary. As this Latin version frequently departs from such currently available English translations as those of W. D. Ross, H. Tredennik, and others which are based upon Greek sources, a good deal of confusion as to Thomas' actual point of departure would have been introduced had this inclusion not been made. The general value and utility of Professor Rowan's work is further increased by his footnoted indications of the more important variations obtaining between the Greek text (as given in Bekker), and the Latin version employed by St. Thomas. For the reader who wishes to compare the Latin version, the Greek text, and the English translations, Professor Rowan has provided the standard Bekker reference numbers at the beginning of each of Thomas' Lectiones. To further simplify the whole matter of reference and cross-reference, Professor Rowan has used the letter C, followed by a numeral, to designate sections of Thomas' Commentary. These sections are the same as those established originally by Cathala. Numbers not preceded by C designate the appropriate sections of the Latin version of Aristotle's text, and correspond with those given by Spiazzi in his revision of the Cathala edition. Thus, as example, in such a reference as (241:C345), the first number designates the section of the version of Aristotle employed by St. Thomas, and the second, the section of St. Thomas... (shrink)

Open peer commentary on the article “Second-Order Science: Logic, Strategies, Methods” by Stuart A. Umpleby. Upshot: The evaluation of what we knew is an urgent and evolving issue. The issues discussed by Umpleby have been raised earlier, particularly in the social sciences. Arguably, in some quarters they are exaggerated. But an awareness of observer effects is of great importance and is greatly enhanced by second-order cybernetics applied more widely as second-order science.

A frequent objection to the fine-tuning argument has been that although certain necessary conditions for life were admittedly exceedingly improbable, still, the many possible alternative sets of conditions were all equally improbable, so that no special significance is to be attached to the realization of the conditions of life. Some authors, however, have rejected this objection as fallacious. The object of this paper is to state the objection to the fine-tuning argument in a more telling form than has been done (...) hitherto, and to meet the charge of fallacy. (shrink)

In the Dialogues Hume attaches great importance to an objection to the design argument which states, negatively, that from phenomena which embody evil as well as good there can be no analogical inference to the morally perfect deity of traditional theism and, positively, that the proper conclusion as regards moral character is an indifferent designer. The first section of this paper sets out Hume's points, and the next three offer an updating of Hume's objection which will apply to Swinburne's Bayesian (...) form of the design argument. The final section concludes that Hume's objection, suitably developed, holds against most of the main theistic arguments, even in their Bayesian form. (shrink)

Purpose: Yerkish is an artificial language created in 1971 for the specific purpose of exploring the linguistic potential of nonhuman primates. The aim of this paper is to remind the research community of some important issues and concepts related to Yerkish that seem to have been forgotten or appear to be distorted. These are, particularly, its success, its promising aspects for future research and last but not least that it was Ernst von Glasersfeld who invented Yerkish: he coined the term (...) “lexigrams,” created the first 120 of them and designed the grammar that regulated their combination. Design: The first part of this paper begins with a short outline of the context in which the Yerkish language originated: the original LANA project. It continues by presenting the language itself in more detail: first, its design, focusing on its “lexigrams” and its “correlational” grammar, and then its use by the chimpanzee Lana in formulating sentences. The second part gives a brief introduction to the foundation of Yerkish in Silvio Ceccato’s Operational Methodology, particularly his idea of the correlational structure of thought and concludes with the main insights that can be derived from the Yerkish experiment seen in the light of Operational Methodology. Findings: Lana’s success in language learning and the success of Yerkish during the past decades are probably due to the characteristics of Yerkish, particularly its foundation in operational methodology. The operation of correlation could be what constitutes thinking in a chimpanzee and an attentional system could be what delivers the mental content that correlation assembles into triads and networks. Research implications: Since no other assessment or explanation of Lana’s performances has considered these foundational issues, a new research project or program should validate the above-mentioned hypotheses, particularly the correlational structure of chimpanzee thinking. (shrink)

Considering the lack of substantive scientific or theoretical studies about ethics in small and medium sized enterprises (SMEs) in Latin America, this paper examines the context of an existent paradox, based upon the perspective of experts and academicians of Latin America and the Caribbean. These countries live different realities, due to their respective European cultural influences, as well as to racial and economic issues. Such facts impact the size and characteristics of their industries. On the other hand, the SMEs face (...) more similarities in the region, so they will be treated as a group in the discussion of ethics and corporate social responsibility (CSR) in Latin American SMEs. As this topic has not been sufficiently investigated in this geographic area, the objective of this exploratory study is to offer a contribution for future research. It raises the main dilemmas and intends to explain how legislation and common practices enable and perhaps lead SMEs to choose unethical strategies to survive and compete in the market. These enterprises are growing in number and in job creation, but do not participate in the Gross National Product in the same proportion. Informality, tax evasion and corruption are gradually caused or erode morality in business, but can contribute to corporate social responsibility in the region. The paper tries to show positive and negative aspects of apparently unethical practices and discusses challenging ways to solve complex problems that are common in most Latin America. (shrink)