Multiple studies have been performed to identify the most common ethical dilemmas encountered by ethics consultation services. However, limited data exists comparing the content of ethics consultations requested by specific hospital specialties. It remains unclear whether the scope of ethical dilemmas prompting an ethics consultation differ between specialties and if there are types of ethics consultations that are more or less frequently called based on the specialty initiating the ethics consult. This study retrospectively assessed the incidence and content of ethics (...) consultations called by surgical vs. non-surgical specialties between January 1, 2013 to December 31, 2018 using our RedCap Database and information collected through the EMR via our Clinical and Translational Science Center. 548 total ethics consultations were analyzed. Our results demonstrate that more surgical consults originated from the ICU, as opposed to lower acuity units, and surgical patients were more likely to have a DNR in place. Surgical specialties were more likely to call about issues relating to withholding/withdrawing life-sustaining treatment, while non-surgical specialties were more likely to call about issues related to discharge planning. There appear to be morally relevant differences between consults classified as the “same” that are not entirely captured by the usual ethics consultations classification system. In conclusion, this study highlights the unique ethical issues experienced by surgical vs. non-surgical specialties. Ultimately, our data can help ethics consultation services determine how best to educate various hospital specialties to approach ethical issues commonly experienced within their field. (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)

Studies investigating memory for events during anesthesia show a confusing pattern of positive and negative results. To establish whether there are any consistent patterns of findings across studies, we conducted a meta-analysis of the data from 2517 patients in 44 studies. The meta-analysis included two measures of the effects of positive suggestions on postoperative recovery: the duration of postoperative hospitalization and the amount of morphine administered via patient-controlled anesthesia, as well as two measures of memory for specific information presented during (...) anesthesia: direct tests and indirect tests. The meta-analysis indicated that positive suggestions presented during anesthesia have little or no effect on postoperative recovery. On the other hand, the meta-analysis showed that specific information is remembered following surgery, as long as testing is not delayed longer than 36 h. Studies of memory for events during anesthesia provide a useful avenue for exploring unconscious cognition. (shrink)

The paper shows the standard definition of time at a distance to be beset with ambiguities that may be solved by making a fresh start taking its point of departure in the idea of a cosmic time as proposed by the British tradition of relativistic cosmology.

Theory of Mind is the ability to predict and understand the mental state of another. While ToM is theorized to play a role in language, we examined whether such a mentalizing ability plays an important role in establishing shared understanding in conversation. Pairs of participants engaged in a Lego model building task in which adirectorinstructed abuilderon how to create duplicate models from a prototype that only the director could see. We manipulated whether the director could see or could not see (...) the builder’s workspace. As predicted, the Mind in the Eyes test predicted accuracy when the workspace was hidden. A high mentalizing ability was an advantage when instructing, resulting in fewer errors, but may be a disadvantage when following instructions. This research indicates that ToM plays a key role in communicating information effectively in conversation. (shrink)

Theory of Mind is the ability to predict and understand the mental state of another. While ToM is theorized to play a role in language, we examined whether such a mentalizing ability plays an important role in establishing shared understanding in conversation. Pairs of participants engaged in a Lego model building task in which a director instructed a builder on how to create duplicate models from a prototype that only the director could see. We manipulated whether the director could see (...) or could not see the builder’s workspace. As predicted, the Mind in the Eyes test predicted accuracy when the workspace was hidden. A high mentalizing ability was an advantage when instructing, resulting in fewer errors, but may be a disadvantage when following instructions. This research indicates that ToM plays a key role in communicating information effectively in conversation. (shrink)

It is perhaps significant that one of the more informative texts on ancient shipbuilding predates the period in which Greco-Roman shipping flourished. It is Homer's description of how Odysseus built a ship () on the island of the nymph Calypso, with which he intended to return to his native island of Ithaca. The text is of exceptional interest because it gives as early as the eighth century B.C. a stepby- step description of the tenon-and-dowel ‘shell-first’ method typical of Greco- Roman (...) ship-building, which has been so amply confirmed in the last few decades by underwater archaeology in the Mediterranean. (shrink)

Newly edited by Konrad Koerner (University of Ottawa), with an introduction by Clemens Knobloch (Universitat Siegen)The importance of Wegener's Untersuchungen uber die Grundfragen des Sprachlebens can only be compared to that of Karl Buhler's Sprachtheorie. Even now, however, Wegener's work remains virtually unknown to the English speaking world. Wegener's main work was published in 1885. It has its origin in two lectures given in 1883 and 1884 at school teacher meetings held in the Magdeburg area and it (...) still recalls those original occasions and maintains much of the oral style. Part of the volume treats the subject in a systematic and theoretical manner; other sections contain vivid examples and are characterized by a considerable didactic effort. The book is held together by leitmotif-questions, such as 'How do we understand language?' and 'How does language function as a means of everyday communication?'. We witness the experiences of the talented school teacher and the observations of the innovative dialect researcher combined, condensed, and conceptually ordered.In spite of the relatively unsystematic form of presentation, the book remains thoroughly consistent in thought and argument. In the Untersuchungen we have before us the outline of a communicative and functional view of language structure, of the analysis of speech, and of semantics. (shrink)

The paper shows the standard definition of time at a distance to be beset with ambiguities that may be solved by making a fresh start taking its point of departure in the idea of a cosmic time as proposed by the British tradition of relativistic cosmology.

The paper shows the standard definition of time at a distance to be beset with ambiguities that may be solved by making a fresh start taking its point of departure in the idea of a cosmic time as proposed by the British tradition of relativistic cosmology.

Abstract.In the wake of the Franco-Prussian war, scientific nationalism became a subject of scientific controversy in Germany. This paper explores the controversy between the cosmopolitan physiologists Hermann von Helmholtz and Emil du Bois-Reymond on the one hand, and the nationalistic economist-philosopher Eugen Dühring and the astrophysicist Johann Carl Friedrich Zöllner on the other. It argues that Helmholtz’ frequent visits to Britain helped him keep abreast of scientific developments there and shaped his ideas of science and society. They also changed his (...) conception of the conservation of energy. German nationalists objected to his British contacts with offensive accusations. They alleged that he had plagiarized his fellow-German Julius Robert Mayer and tried to imitate British physicists. Thus Dühring and Zöllner defended and constructed enduring national stereotypes of German and British science. Whereas Helmholtz put scientific cosmopolitanism into practice, Du Bois-Reymond defended it as an ideology. In contrast to the received view of Du Bois-Reymond as a fervent nationalist, it is argued that he was actually an untimely scientific cosmopolitan. He placed himself in the tradition of Goethe and Schiller's Weimar cosmopolitanism. (shrink)

Musing in Florence in June of 1858, Nathaniel Hawthorne said of himself, "I am sensible that a process is going on--and has been, ever since I came to Italy--that puts me in a state to see pictures with less toil, and more pleasure, and makes me more fastidious, yet more sensible of beauty where I saw none before." This is a book devoted to the reflective analysis of the enterprise in which many of us, like Hawthorne, find ourselves engaged: the (...) cultivation of our taste. Charles Wegener writes for and from the standpoint of thoughtful amateurs, those who, loving the beautiful and the sublime, wish to become more fully the sort of person to whom these goods reliably disclose themselves. Here traditional aesthetic analysis is redirected to a search for the norms that tell us how we use our intelligence, our imagination, and our senses in becoming "more fastidious, yet more sensible," exploring such concepts as disinterestedness, catholicity, communicability, austerity, objectivity, and authority. Finally, Wegener discusses questions about the relation of our aesthetic lives to other activities, norms, and human goods, arguing that taste, far from being a mere grace or luxury, is a necessary expression of that freedom which is at once the fruit and the condition of all culture. "This book should be required reading for anyone concerned with aesthetic education, for this is exactly what it is about, and I have come across no more searching investigation of the topic."--Hugo Meynell, Journal of Aesthetic Education "Using the analysis of aesthetic experience found in Kant's Critique of Judgment as a point of departure, Wegener has written a remarkably intelligent book which presents meaningful encounter with art as the "discipline of taste and feeling. The book reads not simply as an exposition but as a conversation in which the author thoughtfully and meticulously explores with the reader those norms that structure and define aesthetic experience. . . . The book occupies an important place in contemporary aesthetic discussion."--M. Feder-Marcus, Choice. (shrink)

A Priestley duality is developed for the variety j of all modal lattices. This is achieved by restricting to j a known Priestley duality for the variety of all bounded distributive lattices with a meet-homomorphism. The variety j was first studied by R. Beazer in 1986.The dual spaces of free modal lattices are constructed, paralleling P.R. Halmos'' construction of the dual spaces of free monadic Boolean algebras and its generalization, by R. Cignoli, to distributive lattices with a quantifier.

A Priestley duality is developed for the variety jω of all modal lattices. This is achieved by restricting to jω a known Priestley duality for the variety of all bounded distributive lattices with a meet-homomorphism. The variety jω was first studied by R. Beazer in 1986.The dual spaces of free modal lattices are constructed, paralleling P.R. Halmos' construction of the dual spaces of free monadic Boolean algebras and its generalization, by R. Cignoli, to distributive lattices with a quantifier.

The article presents the concept of a digital edition of late-medieval mystical mosaic treatises. These widespread publication, which are usually labelled as ‘pseudo-Eckhart’, are characterised by an almost unfathomable fluctuation between the manuscripts. Until today, this variance has prevented the publication of any traditional book editions and complicated any critical evaluation. The intended edition focusses on Pfeiffer’s treatise XI/2 (‘Von der übervart der gotheit 2’) as a test case. It will provide access to divergent versions of this treatise and enable (...) modern readers to compare them on different textual levels. (shrink)

Present-day medievalists regard it as an undisputed fact that Arabic culture - especially science - influenced the Latin Middle Ages in a multitude of ways. However, more detailed research is needed into the conditions, background and context of this 'cultural exchange', a task undertaken by the present volume in 44 papers from a variety of disciplines.

While it is not explicitly included in capacity assessment tools, “consistency” has come to feature as a central concern when assessing patients’ capacity. In order to determine whether inconsistency indicates incapacity, clinicians must determine the source of the inconsistency with respect to the process or content of a patient’s decision-making. In this paper, we outline common types of inconsistency and analyze them against widely accepted elements of capacity. We explore the question of whether inconsistency necessarily entails a deficiency in a (...) patient’s capacity. While inconsistency may count as _prima_ _facie_ evidence of incapacity—enough evidence to justify a closer look—when making such determinations, it is important for clinicians to slow down, inquire about the reasons underlying the inconsistency and clearly show which of the elements of capacity the patient fails to satisfy. (shrink)

While it is not explicitly included in capacity assessment tools, “consistency” has come to feature as a central concern when assessing patients’ capacity. In order to determine whether inconsistency indicates incapacity, clinicians must determine the source of the inconsistency with respect to the process or content of a patient’s decision-making. In this paper, we outline common types of inconsistency and analyze them against widely accepted elements of capacity. We explore the question of whether inconsistency necessarily entails a deficiency in a (...) patient’s capacity. While inconsistency may count as prima facie evidence of incapacity—enough evidence to justify a closer look—when making such determinations, it is important for clinicians to slow down, inquire about the reasons underlying the inconsistency and clearly show which of the elements of capacity the patient fails to satisfy. (shrink)

Stellt sich beispielsweise in Ermittlungsverfahren heraus, dass es sich bei solchen Terroristen und gewalttätigen Radikalen, die für schwere Gewalt- und Hassverbrechen zur Verantwortung gezogen werden, zugleich um formal hoch gebildete und qualifizierte Menschen handelt, dann reagiert die Öffentlichkeit oftmals besonders irritiert darauf. Unschwer ließe sich das auf eine weitverbreitete Auffassung zurückführen, wonach Bildung und Gewalt einander ausschlössen. Der vorliegende Essay geht hingegen von einer anderslautenden These aus. Diese besagt: Auch Radikalisierungsprozesse lassen sich als Bildungsprozesse beschreiben – und individuelle Radikalisierungsprozesse ließen (...) sich auf diese Weise an vielleicht entscheidenden Punkten besser verstehen, als wenn man sie sich über Bezugsideologien, Gruppenstrukturen oder kritische Sozialisationsverläufe zu erklären versucht. Zwar greifen nur die wenigsten Radikalen auch zu gewaltsamen Mitteln, um ihre Ziele durchzusetzen. Doch selbst in solchen Fällen, argumentiert der Essay, wo es zur Gewaltanwendung kommt, widerspricht dies nicht zwingend der hier vertretenen These. Die Annahme, dass sich Radikalisierungsprozesse genauer noch als transformatorische Bildungsprozesse rekonstruieren lassen, könnte nicht nur eine Erklärung für das unausgesetzte Attraktionspotenzial bedeuten, über das die Radikalität selbst in Gesellschaften verfügt, die nicht vorrangig von gewaltsamen Konflikten oder materieller Not gezeichnet sind. Sie lässt sich zudem als produktiver Beitrag zu einer grundlagentheoretischen Debatte in der Extremismus- und politischen Gewaltforschung aufgreifen, in der das Konzept der Radikalisierung wegen seiner Gewaltgebundenheit, Subjektferne und seiner sicherheitspolitischen Agenda grundlegend in Frage gestellt wird. Doch vor allem möchte der Essay dazu anregen, sich vermehrt mit bildungstheoretischen Zugängen zum Phänomen der Radikalität auseinanderzusetzen; und zwar insbesondere auch dann, wenn dies selbst gewaltsame Formen mit einschließt. Auf diese Weise ließen sich womöglich neue und weiterführende Erklärungsansätze zur Genese von radikaler Gewalt entwickeln. (shrink)

Der Streit darüber, ob es objektive Wahrheitskriterien gibt, wird oft mit der Frage vermengt, ob Wissenschaft immer fortschreite. Vor allem Popper in "Objective Knowledge" unterstellt in starkem Maße einen allgemeinen Trend der Wissenschaft zum Fortschritt. In diesem Beitrag wird gezeigt, daß Wissen verloren gehen kann: 1. Weil es nicht aufgezeichnet wird; 2. weil die Dokumente, in denen es niedergelegt wurde, verloren gehen; 3. weil das Wissen um die Sprache der Dokumente, in denen es niedergelegt wurde, verloren gegangen ist, 4. weil (...) die spätere Wissenschaftlergemeinschaft die Dokumente nicht genügend beachtet, in denen es niedergelegt wurde. Der Verlust nichtaufgezeichneten Wissens ist äußerst üblich. Der Verlust veröffentlichter Dokumente war besonders vor der Erfindung der Drucktechnik häufig und hat besonders in manchen Zweigen der Geisteswissenschaften einen Rückschritt bedeutet, weil entweder Dokumente, die das Objekt dieser Wissenschaften ausmachen , oder Aufzeichnungen historischer Ereignisse verloren gingen. Der Verlust veröffentlichter Dokumente nach der Erfindung der Drucktechnik war etwas weniger bedeutend, aber er kam dennoch vor. Der Verlust unveröffentlichter Dokumente geschah häufig, und zwar sowohl vor wie nach der Erfindung der Drucktechnik. Ob in unentzifferten Dokumenten definitiv Wissensverlust vorliegt, ist einigermaßen zweifelhaft. Einige unentzifferte Sprachen mögen eines Tages entziffert werden, aber einige unentzifferte Sprachen mögen auch für immer unentziffert bleiben. Der Verlust von Wissen wegen unzureichender Aufmerksamkeit gegenüber dem Werk eines früheren Wissenschaftlers kann behoben werden, wenn man seine Behauptungen nochmals untersucht. Wissensverlust kommt hauptsächlich in den Geisteswissenschaften vor. In der Mathematik und einigen Naturwissenschaften gibt es fast nur Zunahme an Wissen wegen der Wiederholbarkeit der Experimente. (shrink)

This article discusses explanations behind theory choice, that is, ultimately, what leads people to accept a certain claim as valid. There has been a recent debate as to how closure was achieved in the continental-drift discussion. The controversy had found its usual explanation under rationalist terms: Wegener’s 1912 continental-drift theory was accepted 50 years later only after the plate tectonic theory had provided more evidence or a more in-depth problem-solving capacity. Nevertheless, a re-examination of the controversy under constructivist terms (...) argued that closure was achieved by a change in the style of thought. This analysis prompted some authors to react calling to a ‘defence of rationalism’ and insisting on explaining that the continental-drift theory was only accepted because of epistemic reasons. As the debate impacts on the way to explain scientific controversies, in this article I analyze rationalist and constructivist approaches with respect to ways to explain the social acceptance or rejection of a theory. The analytical perspectives will be contextualized within a broader theoretical discussion in philosophy and social sciences about the role of different factors that condition knowledge, which will also include an empirical approximation in the analysis of GMO and continental-drift controversies. Ultimately, the debate with rationalism is situated in a broader context about the ways of explaining the social acceptance of a theory, arguing that the problem with the rationalism that confuses a purely logical explanation with a sociological one is that it tends to judge rather than understand. (shrink)

The continental drift controversy has been deeply analysed in terms of rationalist notions, which seem to find there a unique topic to describe the weight of evidence for reaching consensus. In that sense, many authors suggest that Alfred Wegener’s theory of the original supercontinent Pangea and the subsequent continental displacements finally reached a consensus when irrefutable evidence became available. Therefore, rationalist approaches suggest that evidence can be enough by itself to close scientific controversies. In this article I analyse continental (...) drift debates from a different perspective which is based on styles of thought. I’ll argue that continental drift debate took much longer than it was usually recognized with two styles of thought coexisting for hundreds of years. These were fixism and mobilism and they were always confronting their own evidence and interpretations and functioning as general frameworks for the acceptability of a specific theory. Therefore, this text aims to bring much broader sociological elements than usually involved in the analysis of the continental drift theory. (shrink)

Der Streit darüber, ob es objektive Wahrheitskriterien gibt, wird oft mit der Frage vermengt, ob Wissenschaft immer fortschreite. Vor allem Popper in "Objective Knowledge" unterstellt in starkem Maße einen allgemeinen Trend der Wissenschaft zum Fortschritt. In diesem Beitrag wird gezeigt, daß Wissen verloren gehen kann: 1. Weil es nicht aufgezeichnet wird; 2. weil die Dokumente, in denen es niedergelegt wurde, verloren gehen; 3. weil das Wissen um die Sprache der Dokumente, in denen es niedergelegt wurde, verloren gegangen ist, 4. weil (...) die spätere Wissenschaftlergemeinschaft die Dokumente nicht genügend beachtet, in denen es niedergelegt wurde. Der Verlust nichtaufgezeichneten Wissens ist äußerst üblich. Der Verlust veröffentlichter Dokumente war besonders vor der Erfindung der Drucktechnik häufig und hat besonders in manchen Zweigen der Geisteswissenschaften einen Rückschritt bedeutet, weil entweder Dokumente, die das Objekt dieser Wissenschaften ausmachen, oder Aufzeichnungen historischer Ereignisse verloren gingen. Der Verlust veröffentlichter Dokumente nach der Erfindung der Drucktechnik war etwas weniger bedeutend, aber er kam dennoch vor. Der Verlust unveröffentlichter Dokumente geschah häufig, und zwar sowohl vor wie nach der Erfindung der Drucktechnik. Ob in unentzifferten Dokumenten definitiv Wissensverlust vorliegt, ist einigermaßen zweifelhaft. Einige unentzifferte Sprachen mögen eines Tages entziffert werden, aber einige unentzifferte Sprachen mögen auch für immer unentziffert bleiben. Der Verlust von Wissen wegen unzureichender Aufmerksamkeit gegenüber dem Werk eines früheren Wissenschaftlers kann behoben werden, wenn man seine Behauptungen nochmals untersucht. Wissensverlust kommt hauptsächlich in den Geisteswissenschaften vor. In der Mathematik und einigen Naturwissenschaften gibt es fast nur Zunahme an Wissen wegen der Wiederholbarkeit der Experimente. (shrink)

During the past year, the European integration process steadily continued along familiar as well as less familiar paths. This contribution gives an overview of the core decisions made within the three pillars of the European construction in the year 2000. Although the vast majority of these decisions were closely linked to the approaching Eastern enlargement of the European Union, new avenues have been followed during the past year as well. The debate about the finality of the European integration process gained, (...) by way ofspeeches of European leaders like Joschka Fischer, Jacques Chirac, Tony Blair and Guy Verhofstadt, fifty years after the Schuman declaration, a new momentum. (shrink)

Du 23 au 28 septembre 2003, à Erfurt (Land de Thuringe), sous la direction d’A. Speer, une étape importante des études eckhartiennes a été franchie. Pour la première fois, une cinquantaine parmi les chercheurs confirmés autant que les nouveaux furent conviés à réfléchir ensemble à l’importance du séjour de Maître Eckhart (ME) à Erfurt, ou à l’examen plus général de leurs questions et de leurs réponses sur la pensée du penseur thuringien. C’est dire avec quelle impatience étaient attendus les ..

Der wachsenden Bedeutung psychologischer Beratung und Planung steht ein nur begrenztes theoretisches Wissen gegenüber. Die sozialwissen- schaftliche Grundlagendiskussion der sechziger Jahre, die Kuhn-Lakatos-Kontroverse sowie der Versuch Sneeds, den Theoriebegriff modelltheoretisch neu zu konstruieren, haben das damit aufgegebene methodologische Problem unberücksichtigt gelassen. Die Arbeit entwickelt die Grundlagen für eine Theorie falsifizierbarer Handlungsbewertung, die diese methodologische Lücke für den psychologischen Praktiker schliessen soll.