It is generally agreed that physicians should not provide futile interventions, for the obvious reason that an intervention without utility causes harm without benefit. However, despite efforts to standardize a definition, there is a lack of universal consensus as to what constitutes “futility.” Two recent policy statements object to the terminology of futility based on the lack of a universal definition. Schneiderman, Jecker, and Jonsen object to the proposed alternative terminology of “inappropriate.” These differing opinions about the most apt terminology (...) raise the question of whether definitions are helpful or counterproductive in addressing disputes that... (shrink)

The nature of envy has recently been the subject of a heated debate. Some researchers see envy as a complex, yet unitary construct that despite being hostile in nature can lead to both hostile and...

A forty-year-old man is brought to the emergency room by his wife at five in the morning, two hours after he fell down the stairs at home, hitting his head and injuring his arm. He tells the ER physician that he got up to get a drink of water and tripped in the dark. His speech is slurred, and he smells strongly of alcohol. Lab results reveal elevated liver enzymes, and his blood alcohol level is 0.1. His medical history is (...) unremarkable. When asked about his alcohol consumption, he says he usually has one or two drinks a night with dinner but that he drinks more on holidays and special occasions. He admits he had more to drink than usual last night because it had been a stressful day at work, but he is vague about how much he drank. His wife takes the ER physician aside and describes a very different situation. She says that her husband regularly has three or four drinks a night. She always goes to bed before he does and thinks he stays up later so he can continue to drink. She says that he often has no memory of conversations they had the night before and is concerned because he makes work-related calls at night. When asked what he does for a living, she hesitates, and then answers that he is an internist. He does not work at this hospital but works at one of its affiliated clinics. The ER doctor is concerned that his patient is an impaired physician. Yet when the admitting hospitalist, to whom he explains the situation, asks if he really wants to “go there,” he shrugs his shoulders. “I suppose,” she replies, “you might as well call an ethics consult.”. (shrink)

We prove that for every Scott set S there are S-saturated real closed fields and S-saturated models of Presburger arithmetic.

Anderson and Csima :245–264, 2014) defined a jump operator, the bounded jump, with respect to bounded Turing reducibility. They showed that the bounded jump is closely related to the Ershov hierarchy and that it satisfies an analogue of Shoenfield jump inversion. We show that there are high bounded low sets and low bounded high sets. Thus, the information coded in the bounded jump is quite different from that of the standard jump. We also consider whether the analogue of the Jump (...) Theorem holds for the bounded jump: do we have A≤bTB\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$A \le _{bT}B$$\end{document} if and only if Ab≤1Bb\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$A^b \le _1 B^b$$\end{document}? We show the forward direction holds but not the reverse. (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)

This paper proposes several concepts of efficient solutions for multicriteria decision problems under uncertainty. We show how alternative notions of efficiency may be grounded on different decision ‘contexts’, depending on what is known about the Decision Maker's (DM) preference structure and probabilistic anticipations. We define efficient sets arising naturally from polar decision contexts. We investigate these sets from the points of view of their relative inclusions and point out some particular subsets which may be especially relevant to some decision situations.

This book assesses the impact of the work of Chris Brown in the field of International Political Theory. The volume engages with general issues of IPT as well as basic issues such as the use and role of practical reasoning and presents a nuanced understanding about issues regarding the legitimacy of war and violence. It explores questions that pertain to human rights, morality, and ethics, and generally an outlook for devising a ‘better’ world. The project is ideal for audiences with (...) interest in International Relations, Ethics and Morality Studies and International Political Theory. (shrink)

Hannah Arendt's approach to politics focuses on action and conduct, rather than institutions, constitutions, and states. In light of Arendtian conceptions of politics, essays in this book challenge conventional IR theories. The contributions on agency explore concepts and categories of political action that enable individuals to act politically and to re-make the world in new, unpredictable ways. The contributions on structure explore how Arendt provides new critical purchase upon often reified structures and categories.

Regulating war has long been a concern of the international community. From the Hague Conventions to the Geneva Conventions and the multiple treaties and related institutions that have emerged in the twentieth and twenty-first centuries, efforts to mitigate the horrors of war have focused on regulating weapons, defining combatants, and ensuring access to the battlefield for humanitarians. But regulation and legal codes alone cannot be the end point of an engaged ethical response to new weapons developments. This short essay reviews (...) some of the existing ethical works on lethal autonomous weapon systems (LAWS), highlighting how rule- and consequence-based accounts fail to provide adequate guidance for how to deal with them. I propose a virtue-based account, which I link up with an Aristotelian framework, for how the international community might better address these weapons systems. (shrink)

Background: The American Medical Association, the British Medical Association and the Canadian Medical Association have guidelines that specifically discourage physicians from self-prescribing or prescribing to family members, but only the BMA addresses informal prescription requests between colleagues. Objective: To examine the practices of paediatric providers regarding self-prescribing, curbsiding colleagues, and prescribing and refusing to prescribe to friends and family. Methods: 1086 paediatricians listed from the American Academy of Paediatrics 2007 web-based directory were surveyed. Results: 44% of eligible survey respondents returned (...) usable surveys. Almost half of respondents had prescribed for themselves. An equal number had informally requested a prescription from a colleague. Three-quarters stated they had been asked to prescribe a prescription drug for a first-degree or second-degree relative, and 51% had been asked by their spouse. Eighty-six per cent stated that they had refused to write a prescription on at least one occasion for a friend or family member. The following reasons “strongly influenced” their decision to refuse a prescription request: outside of provider’s expertise ; patient’s need for his or her own physician ; not medically indicated ; need for a physical examination. Conclusion: These data confirm that most physicians have engaged in self-prescribing or curbside requests for prescriptions. It can be argued that curbsiding is more morally problematic than self-prescribing because it implicates a third party, and should be discouraged regardless of whether the requester is a colleague, family member or friend. (shrink)

This work describes the concept of bond order. It shows that covalent bond energy is correlated to bond order. Simple expressions which included bond order are introduced to calculate bond energies of homo-nuclear and hetero-nuclear bonds. Calculated values of bond energies are compared with literature values and show there is very good agreement between and calculated and experimental values in the vast majority of cases. Bond order reveals the strength of a bond and shows the number of bonds in both (...) homo-nuclear and hetero-nuclear covalent bonds. (shrink)

This essay explores the possibility of universal values. Universal values do not exist as Platonic ideals nor do they exist in clearly defined lists of rules or laws. Rather, universal ethical claims are constructed through the actions of individual political leaders, scholars, and activists. This essay explores how such normative constructions take place. It uses an initiative undertaken by the UN Office of Drugs and Crime to further education around corruption as an example of how such universal values come into (...) existence. The initiative focused on developing teaching materials for higher education. The essay focuses on two particular modules, both their content and the process by which they were written. (shrink)

Theories of global justice range from the utilitarian philosophy of Peter Singer to the institutional design arguments of Thomas Pogge. These works have grappled with a wide range of issues, but almost all of them have been driven by the recognition of two core problems: the huge numbers of people mired in poverty and the increasing levels of inequality. Much of this literature begins with these two problems and then proposes schemes to resolve them. This problem-solving approach to the issue (...) of global poverty and inequality has tended to avoid engagements with figures in the history of political thought. One thinker who has certainly inspired much of this literature, either explicitly or implicitly, is Immanuel Kant. With his rigorous method, systemic structure of metaphysics and morality, and celebration of Enlightenment reason over staid authority structures, Kant presents a model for how to undertake rational arguments in response to moral dilemmas. (shrink)

Despite the salient experience of encoding threatening events, these memories are prone to distortions and often non-veridical from encoding to recall. Further, threat has been shown to preferentially disrupt the binding of event details and enhance goal-relevant information. While extensive work has characterised distinctive features of emotional memory, research has not fully explored the influence threat has on temporal memory, a process putatively supported by the binding of event details into a temporal context. Two primary competing hypotheses have been proposed; (...) that threat can impair or enhance temporal memory. We analysed two datasets to assess temporal memory for an in-person haunted house experience. In study 1, we examined the temporal structure of memory by characterising memory contiguity in free recall as a function of individual levels of heart rate as a proxy of threat. In study 2, we replicated marginal findings of threat-related increases in memory contiguity found in study 1. We extended these findings by showing threat-related increases in recency discriminations, an explicit test of temporal memory. Together, these findings demonstrate that threat enhances temporal memory regarding free recall structure and during explicit memory judgments. (shrink)

A brief introduction to the roundtable on William Bain, Political Theology of International Order.