This two-part essay was published anonymously in the English periodical The Repository in two separate issues in 1788. According to the first part, the author is a free Black man living in England who was enslaved in his youth. The text is remarkable in its philosophical sophistication. The first part focuses on refuting the racist claim that Black people are inferior to White people and naturally destined for slavery. It also examines the effects of enslavement on the intellects, moral character, (...) and self-conception of enslaved people, theorizes about the necessary conditions for human virtue, and analyzes racist ideas and internalized racism. The second part rebuts other common defenses of transatlantic slavery, such as the contention that enslaved Black people were already enslaved in Africa as a punishment for crimes or as prisoners of war, or that they are better off in European plantations than they would have been in Africa. (shrink)

This chapter is an excerpt from an antislavery pamphlet that was published anonymously in New Hampshire in 1795, arguing for the immediate abolition of slavery throughout the United States. It lays out a concrete plan for nationwide abolition and refutes several proslavery arguments. The author’s plan for post-abolition America is to create a new US state specifically for Black people in the Northwest Territory. After a period of adjustment in which formerly enslaved people are prepared for citizenship, this state would (...) have representatives in Congress and its inhabitants would have the full rights of citizens. A separate state is necessary, according to this author, because Black people will never be treated equally if they live among White people. Until slavery is abolished, the author adds, American voters should refuse to vote for any politician who owns enslaved people. This is notable because many prominent American politicians at this time were enslavers. (shrink)

This chapter is the pamphlet An Answer to a Pamphlet Intituled an Address to the People of England Against the Use of the West India Produce. It was written in 1791 by an anonymous author who indicates that she is a woman, in opposition to William Fox’s antislavery pamphlet that called for a boycott of sugar and rum (previous chapter). The author downplays the badness of slavery by pointing out that it has been practiced since antiquity and is allowed in (...) the Bible. She also argues that if we consistently followed Fox’s principles, we would be allowed to consume practically nothing. In addition, she insists that Britons should care more about the misery of their fellow citizens—for instance, British laborers and soldiers—than about the suffering of Africans. The text raises important questions about consumer ethics and complicity; it also elucidates the reasons why many eighteenth-century Europeans condoned transatlantic slavery. (shrink)

This chapter is a text that was first published in 1709 as an appendix to the anonymous antislavery pamphlet A Letter from a Merchant at Jamaica to a Member of Parliament in London, Touching the African Trade (see selection 21). We do not know anything about the author of either text. This text may be a genuine funeral oration, but it may also be fictional. If it was composed by a Black orator, it is among the earliest antislavery texts by (...) Black authors that have come down to us. One thing that makes this text important, independently of its authorship, is that it systematically goes through several standard justifications for enslavement in the natural law tradition (war slavery, penal slavery, debt slavery, parental sale, and hereditary slavery) and argues that none of them can justify transatlantic slavery. (shrink)

This chapter is a selection from Two Dialogues on the Man-Trade, published anonymously in London in 1760. The author is unknown. This text consists of conversations between two presumably fictitious characters, both of whom appear to be White Englishmen: Mr. Allcraft, who has invested in the transatlantic slave trade but is starting to have scruples, and Mr. J. Philmore, the anonymous author’s spokesperson, who slowly convinces Allcraft that this trade is morally impermissible. Some of Philmore’s claims are remarkably radical, for (...) instance his claim that enslaved people have the right to kill their enslavers. The dialogues were presumably meant as a model for how proponents of slavery can be convinced to change their minds and how those who used to be involved in the slave trade might atone for their crimes. (shrink)

This chapter is an open letter composed by at least one anonymous enslaved Black author from New Jersey and addressed to state legislators. It was first published in the newspaper Woods’s Newark Gazette and New-Jersey Advertiser in 1796. The letter contains notable descriptions of the experiences of enslaved people in New Jersey as well as eloquent explanations of the unbearableness of enslavement and the ways in which it affects the epistemic situation of enslaved people. It asks legislators to at least (...) implement a plan for gradual abolition, which some other states had already done. The term ‘prayer’ in the title of this letter probably does not refer to a prayer in the religious sense but simply means ‘entreaty’ or ‘earnest request,’ which are historical senses of the word. The authors are primarily addressing their request to legislators rather than God. (shrink)

This chapter is a selection from an anonymous pamphlet titled A Letter from a Merchant at Jamaica to a Member of Parliament in London, Touching the African Trade. This antislavery text starts by providing graphic depictions of the brutality of transatlantic slavery. In the portion that is included in this chapter, which comprises the letter’s last few pages, the author engages in philosophical reflections, drawing on ideas from the natural law tradition and specifically Hugo Grotius. This text is notable because (...) it is among the first to categorically question the permissibility of enslaving prisoners of war, rather than merely advocating for more leniency toward war slaves. (shrink)

This chapter is a selection from an anonymous text published in New Jersey in 1715 as an appendix to John Hepburn’s work The American Defence of the Christian Golden Rule (see the next chapter). Both the text’s format and its content are noteworthy. It consists primarily of twenty syllogisms (i.e., deductive arguments in a traditional format) against the permissibility of slavery, a series of short answers to nine objections, and four concrete proposals for ending involuntary slavery. The objections and answers (...) are a valuable source of common defenses of slavery as well as possible rebuttals. All four proposals as well as some of the philosophically most significant arguments and answers to objections are included in this selection. The text contends that slavery is categorically wrong and proposes giving enslaved Black people the choice to either be freed and sent to Africa, or remain in slavery. (shrink)

PentaPhi is a timeless, irreducible structureform defining the minimal conditions of existence. It consists of five ontologically distinct roles that are mutually necessary and jointly sufficient. The structure exists independently of time, consciousness, and language. Time acts as the sole operator, enabling realization without altering the structure itself. PentaPhi is not a theory or model but a self contained ontological form.

This paper proposes Utistonihilism, a secular philosophical framework designed to resolve the existential crisis inherent in the "post-astronomy" realization of a silent and indifferent universe. While modern existentialism, traditional Stoicism, and classical Utilitarianism offer partial solutions to the problem of meaning, each possesses a significant failure state when practiced in isolation: Stoicism risks a state of total indifference indistinguishable from death; Utilitarianism creates a psychologically unsustainable "guilt trap"; and Camusean rebellion remains a directional-less "performance" or aesthetic choice. By synthesizing these (...) three schools—using Optimistic Nihilism as a foundational release from cosmic pressure, Stoicism as an internal filter for psychological resilience, and Utilitarianism as an objective mission for agency—Utistonihilism provides a logically consistent rationale for existence. This paper further explores the framework’s parallels with the concept of Nishkam Karma in the Bhagavad Gita, arguing that Utistonihilism functions as a "Secular Gita" for the modern age. Ultimately, the framework offers a rigorous alternative to the "leap of faith," providing a sustainable model for ethical action and a logical deterrent to suicidal ideation in an indifferent cosmos. (shrink)

This research is developed primarily within the framework of first-order formal logic. Going beyond the limitations of prior analyses by philosophers such as Galen Strawson, it rigorously examines the problem of free will through a fundamentally different logical approach. Through precise formal investigation, it demonstrates that only deterministic causation and non-subjective randomness are possible, and that no entity capable of ultimate responsibility can exist. Consequently, in fields including ethics, law, theology, and theories of free will, any notion of an agent (...) possessing subjectivity and ultimate moral or legal responsibility is logically impossible. The paper presents fundamental definitions and concepts, such as Autonomy, Contribution, and Existence. It lays out formal premises and propositions, examines the possibility of Autonomy (Au), analyzes counterexamples and equivalence relations, and concludes with the logical implications regarding the impossibility of autonomy and free will. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:My Father Dies AloneAnonymous OneThis is a story about my dying father, me, and our experiences with clinical ethics consultation (CEC). Some details have been changed to protect anonymity. I am a professional bioethicist who has served for decades on hospital ethics committees, so I have a twofold point of view—that of a son with a dying parent, but also that of a trained bioethicist.At the time of (...) these events, my father was over eighty. He had numerous medical problems, all well-managed, and he was not actively dying. My father’s life was enjoyable. He liked going to the movies, visiting with friends, and taking short trips around the city. He loved to eat out and to have my wife and me over to his house to play cards. His biggest barrier to greater enjoyment was reduced mobility, which made his life somewhat confined and narrow.About a year into the pandemic, my father developed COVID. He was hospitalized at a major, well-funded medical center, which I will call Metro. Metro’s hospital had about 450 beds and was not triaging patients. The doctors treating my father judged that, because of COVID and his comorbidities, he was inevitably dying. Nothing that happened subsequently ever led me to think they were incorrect.I could arrange calls with my father while he was in the ER, but Metro prohibited family visits unless the patient was dying. On a call with the attending, I requested to visit my father. Metro was a long distance from me, but with notice, I could drive and make the visit. The doctor refused. The doctor—who I will call Dr. Stewart—said that he was certain my father would recover well enough to be discharged, then live “for weeks” before dying at home. I could visit my father after discharge, Dr. Stewart said. I explained that I was worried that Dr. Stewart’s prediction could turn out to be incorrect and that I would miss my last chance to see my father. Dr. Stewart again refused to authorize a visit.Most patients would have been largely helpless at that point. Metro did nothing to advertise whether they offered ethics consultation, patient advocacy, or any similar service. Because of my professional background, I asked Metro’s operator to page the head of the ethics committee. He did not call me back. I went through this same process several times but never received a return call. Nothing on Metro’s website said anything else about [End Page 16] an ethics committee or ethics consultation. Typing “ethics consultation,” “ethics committee,” and related terms into Metro’s website search engine to this day produces zero results.I spoke with Dr. Stewart again. I revealed that I was a bioethicist and offered to send him the extensive literature on how bad doctors are at prognostication, despite their confidence that they are good at it. (I put the point far more diplomatically when speaking to Dr. Stewart.) There was no uptake—it was like speaking to a customer service representative who repeats the script over and over. I asked for an ethics consultation. Dr. Stewart said he would not request one because there was “no ethical issue”: this was simply a medical question about whether my father would survive to discharge. I pointed out the obvious ethical issues, but Dr. Stewart still refused.Technically, my father survived to discharge, in the sense that Metro was able to load him into an ambulance and drive him to his house. He died almost immediately after arriving, and well before any family could make the lengthy drive to see him. After he died, I remember my last phone conversation with him. His final words were, “I wish I could be with you to hold your hand.” He wanted me to be there to comfort him, and to this day I live with the overwhelming guilt that I let him die alone, frightened, and in pain.Looking back, I’m not sure why I gave in after Dr. Stewart refused an ethics consultation, but my best guess is that, like all children facing the death of a parent, the stress... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Parenting Children With Autism Spectrum Disorders Through the Transition to AdulthoodAnonymous One, Anonymous Two, Lorri Centineo, Anonymous Three, Virginia Clapp, Catherine Cornell, Nancy Coughlin, David McDonald, Mark Osteen, Laura Shumaker, Julie Van der Poel, Anonymous FourMy Son's Life with Autistic Spectrum DisorderAnonymous OneThis is the story of how my son, David, has tried to become independent. David is now 25–years–old. His immediate family is his dad, a brother (age (...) 22) and myself (his mother). He was diagnosed with an autism spectrum disorder (ASD) when he was 13. We looked up all the information and decided not to make a big deal of it. Looking back, he displayed all the classic signs of a high functioning autistic disorder. Would he have been diagnosed with the new DSM 5 guidelines? He probably would have. His life would be much, much different if he had been diagnosed at an early age.I'll start with David at age 13 when he was able to harness his big interest in computer science into a career for himself. He was expelled from middle school for threatening some kid that had been picking on him all year. He had a meltdown and wasn't able to communicate his side of the story and that was it.During the summer of that year he took classes in computer engineering (Microsoft) and became an engineer when he was 13. At that time it was quite an accomplishment because he was the youngest person in the United States to do so at such a young age. (By the way, the administration of the school that expelled him sent him a congratulatory card when he was written up in the paper).His father and uncle are in business running a computer company so David had a ready–made job waiting for him when he graduated from high school and was able to keep it during difficult times. David finished high school (mainstreamed special education as emotionally disturbed) and he also received another engineering certification (Cisco).I have to mention here that I truly did not understand what it was like for my son until one day when he was in high school, as I was lecturing him again for some stupid reason, he said, "You don't know how hard it is for me to not sit in a corner and rock every day." Think about that. ASD individuals get up and keep going every day when they know they are going to be misunderstood and picked on. They all deserve a medal for bravery.David became really upset that he had never had a date and that girls were not even interested in talking to him. He started cutting himself and shaving his head. That got him some attention from the stoner group. He had someone to sit with at lunch anyhow. Parents, I think it's better to have no friends than the wrong friends. They introduced him to drugs.We did not mention any trouble David was having to any relatives. We had lived 800 miles from our families in a very unspoiled part of northern America. In hindsight this was not good either. [End Page 151]Another thing, and I think every parent will agree with this—teachers, school staff, health care industry staff, doctors and every one that comes into contact with an ASD individual—take the time to get to know them. It may be difficult and some may appear non–caring and rude. You must overlook this and look to the person underneath. They are great people. They have been through stuff and it means so much to them. Like I said—parents, you know this. Please remember it when times get tough.During David's senior year he started work release so he could start earning money to buy a car and move out as soon as he turned 18. Things were made easy for David since the company was owned by his father and his uncle and I worked there also. David enjoyed the work but had the occasional meltdown and had difficulties fitting in with other employees. He wasn't able to communicate... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Narrative SymposiumPersonal Narratives Experiences of Psychiatric HospitalizationV. Barnard, J. Carson, Eugene Doe, Robin Driben, Anonymous One, Anonymous Two, Charles Kelley, Michael Kerins, D. Millman, Anonymous Three, Viesia Novosielski, Ben Zion, and Anonymous Four• Dreaming: A Recovery Story• The Intervention of the Demon• Bent but Not Broken• Tortured Souls Do Not Rest• Homesick• A Professional Patient No More• My Spiritual Journey• Personal Account of Psychiatric Hospitalization• Psychiatric Hospitalization Story• As (...) Ice Is to Water• The Power Of Human-To-Human Contact• Dignity• HospitalizationCopyright © 2011 The Johns Hopkins University Press... (shrink)

Now in a fully corrected edition, one of the true spiritual classics of the twentieth century. Published for the first time with an index and Cardinal Hans Urs von Balthasar’s afterword, this new English publication of Meditations on the Tarot is the landmark edition of one of the most important works of esoteric Christianity. Written anonymously and published posthumously, as was the author’s wish, the intention of this work is for the reader to find a relationship with the author in (...) the spiritual dimensions of existence. The author wanted not to be thought of as a personality who lived from 1900 to 1973, but as a friend who is communicating with us from beyond the boundaries of ordinary life. Using the 22 major arcana of the tarot deck as a means to explore some of humanity’s most penetrating spiritual questions, Meditations on the Tarot has attracted an unprecedented range of praise from across the spiritual spectrum. (shrink)

In spite of an intensive discussion of ethical subjects, psychiatric departments rarely request clinical ethics support. However, during regular psychological supervisions subjects with an underlying ethical conflict are increasingly encountered. Based on the case study of a 39-year-old female patient suffering from personality disorder and her newborn child, the role of ethical consultation in psychiatric treatment and the decision making regarding health and welfare of child and mother will be presented. While discussing opportunities and limitations of psychological supervision as a (...) possible vehicle for clinical ethics support, it becomes obvious that during psychological supervision, ethical conflicts can also be reflected and treatment alternatives be evaluated. Psychological supervision finds its limits because of its more intuitive processes when the conflict escalates, when the patient cannot be involved and when institutional interests dominate. In these cases, the more structured and formalised process of clinical ethics consultation clearly offers advantages. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Tract 16:What I Did Not Steal, Must I Now Restore?AnonymousThe field of modern theology is replete with varied, often competing, attempts to craft a comprehensive theology of salvation. One could say many things about this phenomenon, but the difficulty of the task arises largely from the fact that Scripture nowhere gives us a tidy soteriology of that kind. Instead, we have a wide variety of ways of speaking about (...) the unique work of Christ, interpreting his life, death, and resurrection "according to the Scriptures." In keeping with this, we find among the Fathers, and even within single authors, a variety of ways of speaking about salvation and its accomplishment. The Fathers ponder, praise, and marvel at Christ and his work in a variety of literary modes. They sing the praise of the saving triune God in a variety of biblical keys.1 [End Page 313]In this essay, I will look at Christ's offering of his life for our salvation from one particular vantage-point, that of Ps 69:4:What I did not steal,Must I now restore?Ps 69 is a striking Messianic psalm.2 It shows up in explicit quotations or fairly clear allusions at least eight times in the New Testament (Matt 27:34 and parallels; John 2:17; 15:25; 19:28–29; Acts 1:20; Rom 11:9; 15:13; 2 Cor 6:2), several of which are tied to the Passion in the Gospel of John (2:17; 15:28; 19:28–29). It has close parallels with the servant songs in Isaiah. It is widely seen in the Christian tradition as a psalm that speaks of the sufferings of Jesus Christ, a key text for the apostolic authors' interpretation of Christ.3Broadly speaking, Ps 69 falls into the category of a psalm of petition in [End Page 314] the face of enemies.4 The psalmist cries out to God in the midst of severe suffering that threatens to overwhelm him like a flood. He is sunk in deep mire, unable to get a foothold. The foes who surround him outnumber the hairs of his head, and they hate him, he says at first, without cause. Later, he goes on to say that there is, in fact, a cause: his zeal for God's house, which incites his enemies to insult him, mock him, gossip about him. After pleading with God for help, the psalm concludes in a way remarkably similar to the other great psalm that the New Testament takes as a prophecy of Christ's passion, Ps 22, with a great hymn of praise (vv. 30–36). One can imagine this psalm on the lips of Christ, not only on the Cross, but in the garden, where, the author of Hebrews says: "Jesus offered up prayers and supplications, with loud cries and tears, to him who was able to save him from death, and he was heard for his godly fear" (5:7).Verse 4 of Ps 69 does not show up explicitly in the New Testament, but I will argue that it neatly encapsulates one dimension of Christ's redeeming work. On the literal level, the couplet simply states that the psalmist is innocent but is treated as guilty; he might even be quoting a proverb to that effect.5 Viewed in light of Christ's work as depicted in the New Testament as a whole, however, Ps 69:4 fits into the broad typology of Christ as the second, or last, and sinless Adam, who reverses the effect of the first human's sin. I will approach the topic by asking three questions: What was stolen? How was it restored? In what does this restoration consist?What Was Stolen?When Christ cries out in this psalm, "What I did not steal," to what is he referring? What is the stolen good that Christ must now restore? One clear candidate for this is the honor due to God, expressed fundamentally through obedience and worship,6 the honor which Adam failed to offer, choosing [End Page 315] instead to attempt to seize the glory of God for himself.7 Commenting on John 15:29–31, Augustine... (shrink)

Volume 24, Issue 7, July 2024, Page 3-5.

In lieu of an abstract, here is a brief excerpt of the content:The Difficult Road to Deciding on CircumcisionAnonymous TwoAnonymous TwoWhen I got my results back from my noninvasive prenatal testing, NIPT and found out I was going to have a little boy, one of my first thoughts was, "I don't want to circumcise him," which sounds silly because I just found out the gender of my baby and my first thought is about his genitalia. The idea of growing and (...) carrying this perfect little baby for nine months and then hurting him was unthinkable to me. I simply did not want to hurt him. The idea of it made me feel sick. Anytime the subject came up, I would protectively put my hand over my belly. And I do admit there were a lot of times I wished I was having a girl so I didn't have to deal with the circumcision debate.There was a lot of conversation between myself and my husband about it. My husband was adamant about getting it done. He referred to uncircumcised penises as "snake penises" and said our son will be made fun of for being different. He said it would be easier for him to clean and when he's old, he won't have to worry about infection. I would counter with, "well what if he falls in love with a girl from a culture that doesn't circumcise? She will think his penis is weird." The more we talked about it, the more ridiculous it felt thinking that far in advance and all these hypothetical situations he might get in over his penis. My parents wanted it done for religious reasons, but that wasn't a factor for me. My mom kept saying it's in the Bible and it needs to be done. My boss is Jewish and she joked that I could just convert to Judaism and the choice would be taken away from me so I didn't have to stress over it. Everything I read on my mommy groups and sites like Reddit called male circumcision child abuse and stated how barbaric it was. Terms like "genital mutilation" were thrown around a lot, and I didn't want to be part of a group that was seemingly looked down upon by so many.I spent my whole pregnancy saying how much I did not want to circumcise my baby. About a week after he was born and we were starting to get settled, my husband started to call around trying to get him an appointment for circumcision. It was unusual to do it this way, as typically it's done when babies are still in the hospital. But the hospital wasn't doing circumcisions because it was elective, and they weren't doing elective procedures because of COVID. At his first doctor's appointment, I talked to our pediatrician about it. She is Indian and told me she didn't circumcise her boys and said that it was very normal in many parts of the world to not do it. I would watch her pull back the skin to check it for fibers and think, "Is it really that bad to keep it? It's just skin." Our pediatrician didn't do it, as she doesn't perform procedures in the office, and she gave us some names of doctors that were supposed to be doing it. My husband called them all and none of them were doing circumcisions either. Finally, my husband found a doctor, but he was booked out for almost a month and a half. With no other option, we made the appointment. I was not thrilled about it, and made my husband do all the calls and arrange it because I did not agree with it.What made me change my mind about circumcising him was I didn't want him to be different. My husband assured me this was the best choice and he was very concerned our son would be bullied for being different. I have a good friend that is a nurse in a long term care facility currently. I called her and asked if it was really that bad for old men to care... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:"I'd Love to go Off the Grid and Never Come Back"AlishaDisclaimers. The author has chosen to disclose only her first name. All other names have been changed to protect the privacy of the individuals mentioned.I have been a nurse for 18 years. I have dealt with death. I have performed CPR, closed eyes, called families, and bagged bodies. I have taken decedents to the morgue. I knew what I (...) signed up for when I became a nurse, but nothing prepared me for the 2020–2022 pandemic years, and the havoc wreaked on my mental, emotional, spiritual, and physical health. I was then in a managerial position. Patients' accounts of tragedy and families' sorrow, confusion, denial, anger, regret, and fear came across my desk daily at the hospital, nightly to my phone, and over the weekend while at home. In March of 2020, I took responsibility for managing the hospital's morgue, an experience that proved to me that death is no respecter of man.The morgue had the capacity to hold five decedents. It was my responsibility to ensure that we had space for the decedents that were coming in droves. Though our hospital was hit disproportionally by COVID-19, we were unable to secure a refrigerated truck for the overages. Instead, we had to transfer our overflow across town to another hospital no matter the time of day or night. The funeral homes were overwhelmed and could not meet the mass demands, which caused major delays in picking up decedents from the hospital. Most funeral homes took them in body bags straight to the crematory or the cemetery for burial. Many would not open the bags to confirm identities. Instead, they trusted the information I wrote on the [End Page 77] bag in black marker and information on the ID tag attached to the zipper.As the deaths increased and more transfers were made, my social work supervisor Audi and I could barely keep track of the decedents—let alone which families we had reached. We created a process and checklist that had to be signed off before any transfers were made. My director, who supported us, encouraged me to train others to help. However, I felt an intense duty to own this process because of how easy it could be to misidentify someone. Families were losing loved ones daily. They could not be by their side as they took their last breath. The next contact the family had was picking up the decedent's ashes or burying a closed casket. I refused to be responsible for causing additional suffering by losing a loved one's remains. When I made the decision to control the process, I never dreamed I would do this job for three years, nor did I realize the trauma it would cause.One day, a lady named Pam asked us if she could see her mother in the morgue. "Of course not!" I thought. We were not opening body bags for any reason. When I spoke with Pam, she explained that her son had been shot and killed and that her mother witnessed his death. Pam's mother suffered a fatal heart attack after witnessing her grandson's murder."Ma'am, give me a moment," I said. I reviewed the decedent's chart to verify the information and considered what to do. After discussing Pam's request with Audi and my director, we decided to make an exception for this extenuating circumstance and allow Pam to see her mother. Audi and I viewed the decedent to ensure she was presentable. I closed her eyes and cleaned her. When I closed her eyes, a little fluid came out. When we brought Pam in, she noticed and wiped away her mother's "tears," lovingly looking at her. When walking Pam to the front door, she told us about her other son, who had also passed away recently. Remember, we were not supposed to touch anyone at that time "out of an abundance of caution," but with her heart-wrenching situation, we hugged Pam anyway.By the end of April 2020, Audi and I had monitored nearly 100 deaths, coordinating with funeral homes to... (shrink)

Ethicists in American medical schools feel increasingly discouraged these days. In the 1960s, 1970s, and 1980s, society's enthusiasm for teaching about medical ethics flourished as new medical technologies posed new ethical perplexities. Americans eagerly sought ethics advice and looked to medical schools to provide it. As the sites where many of the new technologies were developed and future physicians were trained, medical schools were the logical place for medical ethicists to work and teach. A few schools recognized society's need and (...) instituted explicit medical ethics teaching—allocating funds, hiring ethicists, creating departments, and trumpeting their accomplishments. But most schools responded to the need with indifference or even hostility. They distrusted outside “experts” and feared a zealous reform movement aimed at the character or practices of modern medicine. Yet even those schools were forced to create ethics programs to meet powerful accreditation requirements adopted around 1990. Complying reluctantly, these schools allocated few personnel and minimal budgets. The resulting programs struggled. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Road to RedemptionAnonymous TwoI “am Dr X.* and I am a trained and board certified neonatologist with some years of experience in a high volume NICU with complex pathologies. I have been dismissed from the care of your baby by the fetal surgeon who is not trained in what he’s attempting to do,” that was how I felt when I left the operating room (OR), after performing initial (...) resuscitation on a newborn with congenital diaphragmatic hernia (CDH) with very poor prenatal prognostic indices. CDH is a diaphragm abnormality that allows abdominal organs to move into the chest and restrict lung development. The better part of me knew not to make such a statement and chose not to do so, as this was about the family and a very sick baby, not the professional wrangling of two medical teams or the expression of frustration by a neonatologist who was morally conflicted.I work in a level four Neonatal Intensive Care Unit (NICU) and a very large one by any standard. Staff turnover had been an almost nonexistent issue in previous years because of the very conducive work environment of the NICU. Every team member (physician, nurse, respiratory therapist, pharmacist, etc.) felt like a stakeholder in providing optimal outcomes for the vulnerable neonates in the NICU.As change is the only constant thing in life, the hospital management decided to explore new frontiers and open a center for fetal medicine, with the hope of being a referral center in the region. They brought in a surgeon who came highly recommended for clinical acumen, but not for interpersonal relationship skills (unbeknownst to me). This surgeon, Dr Y., was hired to oversee the fetal center and build it into a center of excellence. Since this had to be a collaborative effort, other specialties (and subspecialties) had to be involved to make this a success. A representative from each of these specialties, including bioethics, was assigned to the fetal center team.The first inkling of a major problem occurred with the very first patient. The team met for the weekly meeting, reviewed the patient’s history and made a tentative plan, which included multidisciplinary counseling. This would require either a joint meeting with the patient or individual consults with the patient at her convenience. The following week at the weekly meeting, Dr Y. informed the group that he had met with the patient and counseled her and she had agreed to an extraordinary procedure for an oral lesion. In my opinion (and that of others), this lesion was not obstructive and could be immediately dealt with at delivery by an Otolaryngologist (ENT) surgeon, without putting the mother at risk for complications arising from the procedure being offered. There was a long discussion about why this was inappropriate [End Page E1] and why further imaging, discussion between the subspecialties and counseling should have been done prior to making this delivery plan. All felt this delivery plan could be remedied prior to delivery. However the surgeon had made plans with the obstetric team (who were at his mercy for financial/ political reasons) to continue with this plan. On the day of delivery, the NICU resuscitation team was called to another operating room instead of the labor and delivery room. I was even more appalled when I realized that the oral lesion was the size of a peanut! I felt like I failed in my obligation of veracity by avoiding the mother’s questions regarding the necessity of the procedure. Every member of my team felt the same and on several occasions I had to reassure concerned nurses that this was an aberrant occurrence that would not repeat itself... so I thought.I informed my departmental chairperson, Dr Z., who had a conversation with the fetal surgeon, Dr. Y., to inform him of my concerns and the effect of Dr. Y.’s actions on my group (physician, nurse practitioner, nurses). This led to being labeled unsupportive of Dr Y.’s goals and caused a less than cordial relationship towards me and the entire NICU group. The next week a picture of Dr Y. and the parents with the baby was on the front page... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Surprised DivideAnonymous OneAnonymous OneNot long after our daughter was born, my wife and I were expecting a son. We were busy new parents, so her pregnancy with our second child went by quickly and without a lot of the fuss that a first pregnancy brings. To our surprise, our son was born a few weeks early but aside from a little jaundice he was a happy, healthy baby.My parents (...) were caring for our daughter while we were at the hospital. After my son's birth, we were excited for them to bring our daughter up to the hospital to visit her new baby brother. The hospital photographer came by and took photos of our two kids together and photos of our son swaddled and sleeping soundly in a basket. Other family members stopped by to meet the new baby as well. It was a happy time.Little did we know that a couple of hours later we would be faced with a communication breakdown. My wife and I usually pride ourselves on how well we are able to communicate and plan our future.I grew up heavily Catholic, attending parochial schools through high school graduation. Meanwhile, my wife's family are Unitarian Universalists. You could not have two more polar opposite religions! We are used to having different points of view. We have always talked through many of life's choices and have both had to make compromises in order to have a successful relationship. It was on that happy day of my son's birth that we discovered we forgot to discuss one important topic.As our family was gathered in my wife's hospital room, joyfully celebrating the newest addition, the doctor entered the room to check on my wife and said it was time to do the circumcision if we wanted.Without hesitation, I responded in the affirmative, then the doctor and I looked over at my wife, who was staring at us with saddened, conflicted eyes. I was confused. Didn't she want the same thing for our son that I did? Surprisingly we never discussed this decision, at least not that I remember. I don't recall her ever telling me she was against it.My wife stated that she wasn't prepared to make a decision because she didn't know what our son would want and she was worried about him experiencing pain. She worked hard for 9 months to grow this baby boy, and he was so little. I understood her anguish in the thought of letting someone alter his tiny body.I am circumcised myself. My background provided me guidance and an expectation that this would be happening, so it was a nonissue for me. I never considered a scenario in which my son would not be circumcised. In truth, it felt ridiculous to even contemplate not circumcising him. My words of reassurance that it would be fine and my explanation to my wife that this was just one of the many decisions we would need to make for him and our other child did little to settle her.It was clear that no one (including me) had discussed this with my wife prior to this point, which was unfortunate. The doctor described the process and tried to reassure my wife that it was a safe and minor procedure. This still left my wife in a conflicted state. The other men in my family there visiting at the time chimed in to reassure my wife that this is what our son would want. She reluctantly agreed to the circumcision, giving in to peer pressure I suppose. I'm confident that an alliance of circumcised men telling her that our son would also want to be circumcised is what swayed her. Frankly, I'm glad they happened to be there when the doctor stopped by to help back up my position.But while our son was out of the room undergoing his procedure, my wife remained conflicted and saddened. We were both surprised at each other's response. My opinion on this was coming from the position of expectation and tradition, while she was worried about not knowing... (shrink)

I am an M.D/Ph.D. student and work as a research assistant for the director of a division of the school of medicine who is an M.D. He assigned me to research a certain topic and gave me no guidelines or guidance as to how to do it. Nevertheless, I did the research and wrote it up. My supervisor liked the report and said that he thought it was so good that “I would like to offer you the opportunity to publish (...) it and list you as the primary author.” Some bells went off when he so grandly offered to let me author the report for which I had done 100% of research and writing. I consulted some other people in the field and they said that, as long as I was the primary author, it was legitimate for him to list himself as secondary author if he did some editing later. After editing the abstract only, he e-mailed his revisions to me and in a note at the bottom he asked me what I thought of his revised author order. His name was first, mine second, and the name of his girlfriend was third. I was shocked by what seemed to be a case of unethical author attribution and confronted him asking why he changed the order when we had agreed that I was primary author. He said that he had put in several hours of work. (shrink)

This essay explores the possibilities of quietism in our time. It begins by examining briefly versions of quietism, Eastern and Western, then turns to particular works of Rilke, Kafka, and Beckett to review exigent images of quietism, variously relevant to the modern condition. Subsequently, it touches on some contradictions of quietism and politics, which Zadie Smith also considers in her essay, “Speaking in Tongues.” Finally, the essay dwells on David Malouf's novel, An Imaginary Life, as a fully achieved parable of (...) quietism, applicable to all places and ages. Throughout, the essay argues for a new, kenotic simplicity, a quietism grounded not in transcendence but in pragmatic virtues of self-dispossession. (shrink)

On the 9th of May 2020 The Lancet, the leading medical journal, published an editorial referring to the current situation of the pandemic in Brazil, which is short of being disastrous, and describing Jair Bolsonaro, the Brazilian president, as the biggest threat to Brazil – we would add to the world. In this paper, we enquire the issue of leadership, anti-intellectualism and nationalism by conducting a philosophical enquiry, whilst also questioning the role and shortcomings of the Brazilian educational system in (...) sowing the seeds, and allowing this situation to develop in the country. This philosophical enquiry does not attempt to lay blame on the Brazilian educational system; rather, it is an attempt, an urge for reflection and self-reflection, so that the errs of the past may be remediated in the future; hopefully, a near future. (shrink)

The authors, environmental scientists, warn that in the debate between "cornucopians" and informed prophets of the dangers posed by overconsumption, splitting the difference won't work -- and that the cornucopians are wrong.

When I was 19 years old, I fell crazily in love with a hometown girl. This was very surprising for both of us, as we had been acquainted since childhood but had never really noticed each other until a certain amount of maturing of mind and body took place. A second surprise, maybe inevitable in retrospect, came along a few months after we began spending virtually every possible hour in each others' arms. She called me from the university she was (...) attending a few hours away and told me she was fairly certain she was pregnant. (shrink)